Those who have been on either side of a courtroom battle on chronic opioid therapy have seen experts and lawyers arguing about the extent and nature of risk mitigation and patient education necessary to demonstrate that the prescriber issued a valid controlled substance prescription. The focus of expert testimony is on whether the prescriber engaged in meaningful risk evaluation and monitoring practices, and whether the prescriber individualized medical care for the patient based on specific history and behaviors as treatment continued. This course will use published medical expert testimony and reports of illegal and insufficient risk mitigation and patient education. The main goal is to facilitate a prescriber’s self-audit of risk mitigation practices and to help attendees improve documentation of risk mitigation protocols and patient education efforts. In the era of COVID-19, a renewed effort to engage in meaningful risk mitigation is necessary for protecting patient access to quality pain care, creating a framework within which other practitioners may confidently assume care for patients when necessary, and demonstrating appropriate prescribing of chronic opioid therapy.
Examine DEA’s current position on controlled substance prescribing and telemedicine during the COVID-19 Public Health Emergency and integrate these expectations into the Prescribing Standard of Care and Risk Mitigation framework
Review examples of current medical licensing board position statements and rules on risk mitigation for chronic pain management
In a brief case discussion format, review various government and defense medical expert statements made in actions against prescribers (administrative and criminal) regarding the prescriber’s duty to take reasonable steps to prevent abuse and diversion; develop a working list of what constitutes the type of risk mitigation that demonstrates the prescriber “acted in the usual course of professional practice
Identify educational concepts and resources for patients and practice staff to facilitate “reasonable steps” to prevent abuse and diversion of, and adverse outcomes associated with, opioids