Safe and Effective Prescription of Controlled Substances-References

References

Pdf Summary

This document is a course/module reference list focused on chronic pain, opioid prescribing, opioid use disorder (OUD), and the role of Certified Registered Nurse Anesthetists (CRNAs) in reducing opioid-related harm. It is organized into six modules that align with the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain.<br /><br />The early modules provide context on the scale and impact of chronic pain and the opioid epidemic, including economic costs, overdose mortality, rural disparities, and racial/ethnic inequities in pain treatment. They also emphasize CRNAs’ role in safe anesthesia and pain management.<br /><br />Subsequent modules review the CDC guideline recommendations and supporting evidence. These include first-line use of multimodal, non-pharmacologic, and non-opioid therapies; careful selection and dosing of initial opioid prescriptions; and appropriate duration, tapering, and follow-up. The materials highlight the risks of persistent opioid use after surgery, overdose, misuse, and harm from high-dose or long-duration prescribing.<br /><br />Another module focuses on discharge safety and risk mitigation. Topics include PDMP use, naloxone co-prescribing, monitoring for high-risk patients, urine drug testing, and avoiding dangerous drug combinations such as opioids with benzodiazepines. It also addresses special populations such as pregnant patients, postpartum patients, newborns exposed to opioids, and patients with obstructive sleep apnea.<br /><br />The final module addresses OUD diagnosis and treatment in the perioperative period, emphasizing evidence-based medications such as buprenorphine, methadone, and naltrexone, along with counseling and continuity of care. Overall, the document supports a patient-centered, evidence-based, multimodal approach to pain management and opioid stewardship, with CRNAs positioned as key contributors to safer perioperative and discharge prescribing practices.

Keywords

chronic pain

opioid prescribing

opioid use disorder

CDC opioid guideline

CRNA

multimodal pain management

naloxone co-prescribing

prescription drug monitoring program

buprenorphine

perioperative opioid stewardship