• Read the objectives and other introductory information.
• Review the slides and read the notes that accompany them.
• Take the post-test. The post-test can be accessed by clicking on the post-test icon that follows the presentation.
• Login and complete the evaluation form.
• Participants who complete the post-test, evaluation and registration will be issued a CME/CPE/CE certificate which may be printed at their location. A database of certificates awarded online is maintained at the accrediting agency. No additional certificate will be mailed. Expiration date for credit is June 30, 2009. The participant will have unlimited access to their personal transcript, documenting their participation and achievement.

In the event you are unable to print the certificate, please submit the post-test and then email editor@dannemiller.com and a certificate will be mailed to you within two weeks.

Statement of Need
State law and policy in the U.S. is undergoing major revision to recognize the legitimacy of opioid therapy for non-cancer pain, specifically in the treatment of chronic pain states. Still many clinicians are reluctant to use opioids. The consensus statement from the American Academy of Pain Medicine (AAPM) and the American Pain Society (APS) published in 1997 produced nationally accepted guidelines. To date, preconceptions on addiction and adverse side effects impede opioid use. All members of the healthcare team play key roles in providing effective pain management. It is critical for the healthcare team to be familiar with the facts on opioid analgesics and use these facts to facilitate good pain management practices in care settings.

Learning Objectives
Upon completion of this activity, the participant should be able to:

• Explain the mechanism of action of opioids.
• Discuss the pharmacology of different opioids to include dosages and adverse effects.
• Describe the role of opioids in pain therapy.
• List the advantages and disadvantages of combination agents vs. single agent therapy.
• Discuss ways to manage adverse effects associated with opioid therapy.

Intended Audience
This program is intended for physicians, nurses, clinical pharmacists, and other associated healthcare professionals who care for patients experiencing acute or chronic pain.

Accreditation/Designation of Credit

Physician
The Dannemiller Memorial Educational Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1AMA PRA Category 1 credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nursing
The Dannemiller Memorial Educational Foundation is an approved provider by the California Board of Registered Nursing. Provider approved by the California Board of Registered Nursing, Provider Number 4229 for 1.2 contact hours.

RNs outside California must verify with their licensing agency for approval of this course.


Pharmacy
Purdue University is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmaceutical education. This is a continuing education activity of Purdue, an equal access/equal opportunity university. To receive the 1 contact hour of continuing education credit, pharmacists should complete the activity requirements and evaluation at the conclusion of the slide show. Approval is valid from the initial release date of May 1, 2007. The expiration date is June 30, 2009. Program # 018-999-07-014-H04.

Faculty disclosure
In accordance with the Accreditation Council for Continuing Medical Education (ACCME), the Dannemiller Memorial Educational Foundation requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest. Accordingly: Arthur G. Lipman, PharmD, author, is a consultant for Purdue Pharma L.P., Pfizer, Inc., Merck Human Health, McNeil Pharmaceuticals, Endo Pharmaceuticals, Abbott Pain Care, UCB Pharma, Altea Therapeutics Corporation, Arius Pharmaceuticals. Inc., Progenics Pharmaceuticals, Inc., and GlaxoSmithKline. He is a member of the speaker's bureau for Endo Pharmaceuticals, Pfizer, Inc., Merck and Company and Ortho McNeil Pharmaceuticals. He has received research funding from Progenics Pharmaceuticals, Inc., UCB Pharma and GlaxoSmithKline.

The Dannemiller Memorial Educational Foundation staff that was involved in the development of this activity has no financial relationships with any commercial interests that are relevant to this activity.

To resolve identified conflicts of interest, the educational content was fully peer reviewed by a physician member of the Dannemiller Clinical Content Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence-based and commercially balanced.

Off-label statement
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Disclaimer
The contents and views presented in this educational activity are those of the authors and do not necessarily reflect those of the Dannemiller Memorial Educational Foundation or Purdue Pharma, LP. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

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