A Potpourri of Natural Opioids: Access, Safety, & Regulatory Responsibilities

The jury is out on if and/or where nonpoppy- derived opiate-like drugs fit into a self-treated pain armamentarium. Consumers might argue that their opiate options are limited and that they should have a right to use naturally occurring substances, particularly in the current environment of rapid opioid tapers or abrupt cessation due to fear of prescription regulatory oversight, government, and/or third-party payer policies. Some argue that these products should be accessible, while others believe that use should be regulated by the FDA and overseen by a boniafied fide healthcare provider. These products combine with opiate receptors that have predictable pharmacodynamic activities. Unbeknownst to providers, and absent from traditional urine drug screen analyses, use of these products by consumers are increasing for purposes of treating pain, mitigating withdrawal from previously prescribed opioids, and for euphoric effects. They are not derived from the poppy plant but instead from other plants or dairy products. Join us in this exciting debate to hear both sides of the story for use, misuse, abuse, consumer advocacy, and risks to patients and providers. There will be plenty of time for live interaction.

Learning Objectives

  • Describe the source and mechanisms of action for beta-casomorphine, collybolide, mitragyna speciosa alkaloids, and salvinorin A.
  • Review risks, benefits, and potential drug interactions of the non-poppy derived naturally occurring opiate-like remedies.
  • Discuss risk stratification and monitoring challenges associated with naturally occurring non-poppy derived opiate-like drugs.
  • Determine potential place in therapy for each of the non-poppy derived opiatelike drug.

Additional Information

Tarsus Medical Education
State Relevance: 
Course summary
Available credit: 
  • 1.00 AANP Contact Hours
  • 1.00 ACPE Pharmacy
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 ANCC
  • 1.00 APA
Course opens: 
Course expires: 

Timothy J Atkinson, PharmD, BCPS, CPE

Clinical Pharmacy Practitioner, Pain Management

Director, PGY2 Pain Management & Palliative Care Residency Program

Pain Representative, National VA Pharmacy Residency Advisory Board

VA Tennessee Valley Healthcare System

Nashville, TN

Jeffrey Bettinger, PharmD

Clinical Pharmacy Specialist, Pain Management

Saratoga Hospital Medical Group

Saratoga Springs, NY

Jessica Geiger, PharmD, MS, BCPS, CPE

Pharmacy Coordinator, Palliative Care

Program Director, PGY2 Pain Management & Palliative Care Residency

OhioHealth Riverside Methodist Hospital


  • Dr. Timothy Atkinson
    • Advisory Board, Epidemiology: Purdue Pharma LP
    • Consultant, axial Healthcare Inc
  • Dr. Jeffrey Bettinger
    • Hisamitsu America, Inc: National Advisory Board
    • PainScript: Scientific Advisory Board
  • Dr. Jessica Geiger
    • Nothing to disclose


  • 1.00 AANP
  • 1.00 ACCME (All Other)
  • 1.00 ACCME (MD/DO Only)
  • 1.00 ACPE Pharmacy
  • 1.00 ANCC
  • 1.00 APA

Available Credit

  • 1.00 AANP Contact Hours
  • 1.00 ACPE Pharmacy
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 ANCC
  • 1.00 APA
Please login or register to take this course.

Mocingbird members get an additional 10% discount on all Tarsus Medical Education - Pain Week courses. Use the discount code "MOC10" to claim the additional 10% discount before you check out from your cart.

To take this course you will be redirected to Tarsus Medical Education's website. Simply create a free account with Tarsus Medical Education in order to complete this activity. You can even use your same Mocingbird username and password to create the account.

Mocingbird is pleased to provide our members with discounted access to highly respected and awarded educational partners.


Pain ManagementOpioid Alternatives