COPICs Three Hour Opioids Review-Copic's Three Hour Opioid Course

Video Transcription

Video Summary

This transcript is a three-hour CME lecture on opioid prescribing, tapering, and opioid use disorder management. The speaker explains that the course is meant to be paused and completed over time, with learners encouraged to review outside resources such as CDC, HHS, SAMHSA, AHRQ, and AMA materials.<br /><br />Key topics include the history of the U.S. opioid crisis, how aggressive pain marketing and “pain as the fifth vital sign” contributed to widespread prescribing, and how fentanyl has dramatically increased overdose deaths. The talk emphasizes that opioids are not benign and should be used only when clearly appropriate, usually at the lowest effective dose, for the shortest duration, and with immediate-release formulations for acute pain.<br /><br />The lecture reviews current prescribing best practices: reassess patients regularly, check PDMPs, consider urine drug testing, use treatment agreements, educate patients and families, and strongly consider naloxone for anyone receiving opioids. It also stresses the importance of evaluating risk factors such as benzodiazepine use, sleep apnea, mental health disorders, and overdose history.<br /><br />A major section covers tapering long-term opioids. Tapers should be slow, individualized, and collaborative; abrupt discontinuation is discouraged because it can cause withdrawal, worsening pain, destabilization, and increased overdose risk. The speaker highlights that success may simply mean reducing dose or improving function, not necessarily complete discontinuation.<br /><br />The final sections focus on opioid use disorder and medically assisted treatment (MAT), especially buprenorphine, methadone, and naltrexone. MAT is presented as evidence-based, life-saving, and increasingly accessible now that the buprenorphine waiver requirement has been removed.

Keywords

opioid prescribing

opioid tapering

opioid use disorder

medication assisted treatment

buprenorphine

methadone

naltrexone

naloxone

PDMP

urine drug testing

pain management

fentanyl overdose

CDC guidelines

withdrawal symptoms

acute pain