Perioperative Pain Management in Opioid-Tolerant Patients

The Perioperative Pain Management in Opioid-Tolerant Patients course was presented at ACS Clinical Congress 2017 and was part of a larger panel session focused on surgical perioperative strategies to reduce opioid consumption while maintaining safe and effective pain control.

James B. Ray, PharmD, CPE, shares best practices for managing surgical pain in opioid-tolerant patients, specifically those who may be taking buprenorphine, methadone, or naltrexone. Additionally, he includes opioid-related adverse drug events that must be watched for while patients are hospitalized, centering specifically on avoiding respiratory depression and sleep-disordered breathing conditions, which can quickly become fatal.

Additional courses in this series will focus on an introduction to the national opioid epidemic as well as pharmacologic considerations when selecting and utilizing multimodal pain control therapies for opioid-naive patients.

The online course, Perioperative Pain Management in Opioid-Tolerant Patients offered by the American College of Surgeons Division of Education is intended for use only by the course participant. Thank you in advance for your participation.

Target Audience

  • Surgeons
  • Residents
  • Health care professionals with patients who are opioid-dependent

Learning Objectives

  • Identify perioperative strategies for managing acute postsurgical pain in opioid-tolerant patients
  • Recognize the most common opioid-related, adverse drug events (ORADEs) in perioperative management.

Course Outline

  • Pretest
  • Course
  • Posttest
  • Additional resources
  • Course evaluation
  • Certificate


If you have any questions about this course, please contact

If you have any technical questions, contact

Course summary
Available credit: 
  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 Certificate of Completion
  • 0.75 Self Assessment Credit
Course opens: 
Course expires: 

Disclosure Information

In accordance with the ACCME Accreditation Criteria, the American College of Surgeons must ensure that anyone in a position to control the content of the educational activity (planners and speakers/authors/discussants/moderators) has disclosed all relevant financial relationships with any commercial interest (see below for definitions).

Commercial Interest

The ACCME defines a “commercial interest” as any entity producing, marketing, re-selling, or distributing health care goods or services used on or consumed by patients. Providers of clinical services directly to patients are NOT included in this definition.

Financial Relationships

Relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

Conflict of Interest

Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.

The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the educational activity. Any conflicts noted below have been managed to our satisfaction. The disclosure information is intended to identify any commercial relationships and allow learners to form their own judgments. However, if you perceive a bias during the educational activity, please report it on the evaluation.


Faculty and Disclosure

James B. Ray, PharmD, CPE
University of Iowa, College of Pharmacy
Clinical Associate Professor, Department of Pharmacy Practice and Science
Otterbeck Professor in Hospice and Palliative Care

Disclosures: Receives consulting fees from Alchemy Consulting

Continuing Medical Education Credit Information


The American College of Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA PRA Category 1 Credits™

The American College of Surgeons designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Of the AMA PRA Category 1 Credits™ listed above, a maximum of 0.75 credit meets the requirements for Self-Assessment.

Of the AMA PRA Category 1 Credits™ listed above, a maximum of 0.75 credits meets the requirements for Opioid/pain Management. *

*The content of this activity may meet certain mandates of regulatory bodies. Please note that ACS has not and does not verify the content for such mandates with any regulatory body. Individual physicians are responsible for verifying the content satisfies such requirements.

American College of Surgeons and ACGME Logos


Royal College of Physicians and Surgeons of Canada Accreditation

Through an agreement between the American College of Surgeons and the Royal College of Physicians and Surgeons of Canada, MOC Program participants may record completed self-assessment programs or simulation activities developed and accredited by the American College of Surgeons in Section 3 of the Royal College's MOC Program.

Available Credit

  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 Certificate of Completion
  • 0.75 Self Assessment Credit
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You may enroll in the online course at no charge. You will be asked to register for the course and provide information to complete the registration process. You will not be charged a participation fee.