Pain specialists face the delicate balance between adequately treating pain and the fear of overmedication. The rising number of patients using opioids and the ongoing opioid crisis have led to a notable increase of psychiatric consultations for concerns that patients are “medication seeking.” Recently released guidelines by the CDC advocate for a decrease in prescribing of opioids for pain management. In response to reports of serious harm, including uncontrolled pain, withdrawal symptoms and suicide among patients who had their opioid pain medications abruptly discontinued, the FDA has issued a drug safety guidance on safe opioid tapering. Pain is a multifactorial phenomenon resulting from complex interactions between nociceptive (neurobiological) mechanisms and psychological and psychosocial factors. The treatment of pain requires the multidisciplinary contribution of each provider involved in the care of these patients. However, many physicians are still not comfortable treating patients with chronic pain. Pain and psychopathology are deeply intertwined. Pain is a major influence in the pathophysiology of several psychiatric disorders, conversely, psychiatric disorders can critically influence the experience of pain. Denial, anger and frustration are common with chronic illnesses. Physicians should take a holistic approach and not just focus on individual symptoms. Chronic pain is a complex and debilitating disease, and as a result, we need the multidisciplinary approach to address the whole person. Medical doctors, counselors and physical therapists all add valuable pieces to solving the chronic pain puzzle. 

**This content was captured for the 2020 APA OnDemand product and may reference information from various sources and terminology from previous editions of the DSM.

Learning Objectives

• Utilize a comprehensive framework for formulating an individualized treatment plan for patients with disabling and refractory chronic pain.
• Implement a structured plan of non-pharmacological psychotherapy to support improved functioning and quality of life.
• Prescribe a variety of non-opioid medication classes for the treatment of neuropathic pain.

Target Audience

Psychiatrists, Residents/Fellows

Estimated Time to Complete

Estimated Duration: 75 minutes
Begin Date: August 1, 2021
End Date: August 1, 2024

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The APA designates this enduring CME activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Program Presenters

• Michael Clark, M.D., Chair of Psychiatry in the Inova Health System, Virginia, The Johns Hopkins University School of Medicine. Reports no financial relationships with commercial interests
• Rachel Noble, M.S; LPC, Director of Women's Behavioral Health, the INOVA Health System, Reports no financial relationships with commercial interests.

Program Planners

• Tristan Gorrindo, M.D., Former Director of Education, American Psychiatric Association. Reports no financial relationships with commercial interests.
• Katie Putnam, Membership Development Specialist, American Psychiatric Association. Reports no financial relationships with commercial interests.
• Ally Brown, Associate Director, Online Learning, American Psychiatric Association. Reports no financial relationships with commercial interests.

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance