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 Self Assessment Credit
  • 0.75 Certificate of Completion
Course opens: 
Course expires: 

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


Disclosure Policy

In accordance with the ACCME’s Accreditation Criteria, the American College of Surgeons must ensure that anyone in a position to control the content of the educational activity has disclosed all relevant financial relationships with any commercial interest. Therefore, it is mandatory that both the program planning committee and speakers complete disclosure forms. Members of the program committee were required to disclose all financial relationships and speakers were required to disclose any financial relationship as it pertains to the content of the presentations. The ACCME defines a ‘commercial interest’ as “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.” It does not consider providers of clinical service directly to patients to be commercial interests. The ACCME considers “relevant” financial relationships as financial transactions (in any amount) that may create a conflict of interest and occur within the 12 months preceding the time that the individual is being asked to assume a role controlling content of the educational activity.

The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the presentation. The planning committee members and speakers were contacted and the conflicts listed below have been managed to our satisfaction. However, if you perceive a bias, please advise us of the circumstances on the evaluation form.

Please note we have advised the speakers that it is their responsibility to disclose at the start of their presentation if they will be describing the use of a device, product, or drug that is not FDA approved or the off-label use of an approved device, product, or drug or unapproved usage.

The requirement for disclosure is not intended to imply any impropriety of such relationships, but simply to identify such relationships through full disclosure, and to allow the audience to form its own judgments regarding the presentation.

Available Credit

  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 Self Assessment Credit
  • 0.75 Certificate of Completion

Accreditation Period

Course opens: 
Course expires: 
Please login or register to take this course.

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.