Controlled Substances and Substance Abuse: Best Practices for the Healthcare Professional - 2 AOA Category 1-A Credits

At the conclusion of this activity, participants will be able to:

1. Identify clinical and prescribing factors associated with misuse, diversion, overdose risk, and evolving substance use disorder, using validated and non-stigmatizing risk frameworks.

2. Differentiate appropriate controlled-substance prescribing approaches for acute pain, subacute or chronic pain, anxiety-related conditions, and stimulant prescribing.

3. Evaluate patient-specific benefit versus harm when initiating, continuing, modifying, or tapering controlled-substance therapy, including the use of PDMP data and toxicology testing.

4. Select risk-mitigation strategies, including patient counseling, naloxone offering, monitoring, documentation, and referral, for patients receiving controlled substances.

5. Implement individualized, evidence-based, and non-stigmatizing strategies for managing acute and chronic pain in patients with sickle cell disease.

This activity is organized around the decisions prescribers actually make when using controlled substances such as opioids, stimulants, sedatives, and tranquilizers, balancing meaningful symptom relief against the risks of misuse, diversion, overdose, and substance use disorder. It addresses whether to initiate a controlled substance, how to monitor and reassess therapy, when to mitigate risk and offer naloxone, how to manage pain in special populations such as patients with sickle cell disease, and when to taper, refer, or evaluate for a substance use disorder. The content reflects current, guideline-based practice consistent with the CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022) and other contemporary standards and applies to both physicians and physician assistants who prescribe controlled substances.

Educational Need

Controlled-substance prescribing remains a high-stakes, high-frequency part of practice, and gaps between current evidence and everyday prescribing continue to contribute to preventable harm. Clinicians report uncertainty about when to initiate or continue opioids, how to apply prescription drug monitoring program data and toxicology testing without stigmatizing patients, when and how to taper, and how to recognize and treat opioid use disorder. Misapplication of general opioid-prescribing guidance to populations it was never intended for, including patients with sickle cell disease, has produced undertreated pain and eroded trust. This activity is designed to close those gaps by translating current guidelines into concrete, individualized prescribing decisions, strengthening risk assessment and monitoring, and equipping prescribers to manage special populations and complex situations safely and equitably.