P.A.C.T.: Practical Approaches to Comprehensive Treatment of Pain

The nation is facing competing public health issues: the need to treat a large number of Americans with acute and chronic pain vs the crisis of prescription opioid abuse. Pri-Med’s P.A.C.T.: Practical Approaches to Comprehensive Treatment of Pain curriculum focuses on improving practitioners’ ability to recognize, diagnose, and classify pain; educating clinicians on the full spectrum of pain management options, including non-opioid pharmacologic interventions; and providing risk reduction strategies through integration of opioids into individualized pain management plans. Clinicians will learn to recognize signs and symptoms of opioid dependence and abuse in order to optimally manage patients’ pain and medication use.

This activity is supported by an independent educational grant from the Opioid Analgesic REMS Program Companies.

Please see https://www.opioidanalgesicrems.com/Resources/Docs/List_of_RPC_Companies.pdf for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the U.S. Food and Drug Administration (FDA).

Learning Objectives

  • Discuss the definitions and mechanisms of pain
  • Identify risk factors and stratification for opioid-related aberrant behavior and opioid use disorder as part of the initial assessment
  • Apply individualized recommendations for nonpharmacologic and non-opioid treatment options for patients in pain  
  • Review general characteristics of opioid analgesics including their intended use and risks
  • Differentiate among tolerance, physical dependence, and manifestations of opioid use disorder
  • Recognize best practices to reduce the risks associated with prescription of opioid analgesics, including safe storage and disposal 
  • Anticipate and manage adverse effects of opioid use including signs of opioid overdose and the use of naloxone
  • Select approaches to safely initiate opioids for the treatment of acute pain and chronic pain 
  • Identify strategies for ongoing safe and effective use of opioids in patients with chronic pain, including titration, referral, and discontinuation, when appropriate 
  • Summarize counseling strategies for caregivers and patients on opioid therapy
  • Act appropriately to evaluate, treat, or refer patients with opioid use disorder 

Additional Information

Course summary
Available credit: 
  • 3.50 AANP Contact Hours
  • 1.59 AANP Pharmacology Contact Hours
  • 3.50 AMA PRA Category 1 Credit
Course opens: 
Course expires: 

Charles E. Argoff, MD, FABPM

Vice Chair
Professor of Neurology
Albany Medical College
Director, Comprehensive Pain Center
Director, Pain Management Fellowship
Albany Medical Center
Albany, New York

Oscar A. de Leon-Casasola, MD

Professor of Anesthesiology and Medicine 
Senior Vice-Chair
The Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo 
Chief, Pain Medicine and Professor of Oncology 
Roswell Park Cancer Institute
Buffalo, NY

Katherine E. Galluzzi, DO, CMD, FACOFP

Professor and Chair
Department of Geriatrics
Philadelphia College of Osteopathic Medicine
Philadelphia, PA


The following relevant financial relationships have been disclosed by faculty, and all have been mitigated by Pri-Med Institute.

Charles E. Argoff, MD, FABPM: Speaker’s bureau: AbbVie, Amgen, Averitas Pharma, Biohaven, Grunenthal, Impel Pharmaceuticals, Kowa Pharmaceuticals America, Lilly, Lundbeck, Nevro, and Teva. Advisory Board: AbbVie, Amgen, Averitas Pharma, Clexio Biosciences, EnZen Therapeutics, Kowa, Lundbeck, Nevro, Tremeau Pharmaceuticals, Tris Pharma, Vertex and Xgene Pharma.  Consultant: Neumentum, PainScript, and Tris Pharma. Researcher: AbbVie, Amgen, Lilly, Lundbeck, and Teva. Stock Holder: Pfizer and Trevena.

Oscar A. de Leon-Casasola, MD: Advisory Board and Consultant: Kowa Pharmaceuticals.

Katherine Galluzzi, DO, CMD, FACOPF: No relevant financial relationships disclosed.  

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose. 

AMA PRA Category 1 Credits

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Pri-Med Institute and Miller Medical Communications. Pri-Med Institute is accredited by the ACCME to provide continuing medical education for physicians. 

Designation Statement

Pri-Med Institute designates this enduring material for a maximum of 3.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Accreditation Statement

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners® (AANP) through the joint providership of Pri-Med Institute and Miller Medical Communications. Pri-Med Institute is accredited by the AANP as an approved provider of nurse practitioner continuing education. Provider Number 040308. 

Designation Statement

This activity is approved for 3.50 contact hour of continuing education, which includes 1.59 hour of pharmacology.

MOC Credit Information

Successful completion of this CME activity (“P.A.C.T.: Practice Approaches to Comprehensive Treatment of Pain”), which includes participation in the evaluation component, enables the participant to earn up to 3.5 Medical Knowledge & Patient Safety MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. 

Other Boards:
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory (https://www.continuingcertification.org), Strategies for Effective Pain Management in Clinical Practice has met the requirements as a Lifelong Learning CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

ABMS Lifelong Learning CME Activity: 
Allergy and Immunology 
Colon and Rectal Surgery 
Family Medicine 
Physical Medicine and Rehabilitation 
Plastic Surgery 
Preventive Medicine 
Psychiatry and Neurology 
Thoracic Surgery

This MOC/CME is self-reported to the Other Boards listed above. 


Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS).

For guidance on how clinicians can attest to participation in a MIPS Improvement Activity, visit https://qpp.cms.gov/mips/improvement-activities

Instructions for Obtaining Credit

Once you have completed the activity, please click the "next" button to advance to the post-activity assessment. To complete this activity and claim credit, you must answer 8 out of the 11 questions correctly. If you are not successful after your first attempt, you will be given an opportunity to reflect upon the answer rationales and have the opportunity to review the educational content before proceeding. Once you have selected your answers, click the "submit" button to complete the evaluation questions and proceed to the claim credit screen. For PAs, the NCCPA accepts for Category 1 CME credit activities designated for AMA PRA Category 1 Credit.

State Licensure Requirements

This activity satisfies topic-specific CME/CE requirements (pain management, controlled substances, etc.) of many state licensing boards. Please check with your state’s licensing boards for specific requirements, and print this page as appropriate for documentation.

Iowa: This activity is designed to satisfy requirements of ARNPs, for CE regarding the US Centers for Disease Control and Prevention Guideline for prescribing opioids for chronic pain. Please print this page as documentation, for submission with your CE certificate.

Texas: This activity is approved for Pain Management and Prescription of Opioids requirements from the Texas Medical Board/Board of Nursing, as well as Medical Ethics and/or Professional Responsibility.

Massachusetts: This activity is designed to satisfy all prescriber training requirements according to Massachusetts General Law, Chapter 94C, Section 18. Please print this page as documentation, for submission with your CE certificate.

This activity satisfies training requirements for the MATE Act, which requires all DEA-registered practitioners to complete 8 hours of CME/CE credit on opioid or other substance use disorders. Please visit https://www.pri-med.com/state/mate-act-cme for more information about the MATE Act. 

Available Credit

  • 3.50 AANP Contact Hours
  • 1.59 AANP Pharmacology Contact Hours
  • 3.50 AMA PRA Category 1 Credit
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This course is offered through Pri-Med. 


To take this course you will be redirected to Pri-Med's website. You must login or create an account with Pri-Med in order to complete this activity. 


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