title: Physician continuing education to reduce opioid misuse, abuse, and overdose: Many opportunities, few requirements.
abstract: The opioid overdose epidemic in the United States is driven in large part by inappropriate opioid prescribing. Although most American physicians receive little or no training during medical school regarding evidence-based prescribing, substance use disorders, and pain management, some states require continuing medical education (CME) on these topics. We report the results of a systematic legal analysis of such requirements, together with recommendations for improved physician training.
  
  
  
  To determine the presence and characteristics of CME requirements in the United States, we systematically collected, reviewed, and coded all laws that require such education as a condition of obtaining or renewing a license to practice medicine. Laws or regulations that mandate one-time or ongoing training in topics designed to reduce overdose risk were further characterized using an iterative protocol
  
  
  
  Only five states require all or nearly all physicians to obtain CME on topics such as pain management and controlled substance prescribing, and fewer than half require any physicians to obtain such training.
  
  
  
  While not a replacement for improved education in medical school and post-graduate clinical training, evidence-based CME can help improve provider knowledge and practice. Requiring physicians to obtain CME that accurately presents evidence regarding opioid prescribing and related topics may help reduce opioid-related morbidity and mortality. States and the federal government should also strongly consider requiring such training in medical school and residency.
authors.affiliation: Network for Public Health Law-Southeastern Region, 101 E. Weaver St. #G-7, Carrboro, NC 27510, United States. Electronic address: cdavis@networkforphl.org.
authors.forename: Corey S
authors.initials: CS
authors.lastname: Davis
authors.affiliation: Network for Public Health Law-Southeastern Region, 101 E. Weaver St. #G-7, Carrboro, NC 27510, United States. Electronic address: carrderekh@gmail.com.
authors.forename: Derek
authors.initials: D
authors.lastname: Carr
mesh_terms: D000701:Analgesics, Opioid; D062787:Drug Overdose / Q000517:prevention & control*; D004502:Education, Medical, Continuing; D006801:Humans; D057970:Inappropriate Prescribing; D007880:Legislation, Drug; D008004:Licensure; D009293:Opioid-Related Disorders / Q000517:prevention & control*; D059408:Pain Management; D010820:Physicians; D063487:Prescription Drug Misuse / Q000517:prevention & control*; D014481:United States
chemical_list: D000701:Analgesics, Opioid
keywords: Opioid; Overdose; Prescription drugs; Provider training