Opioid Stewardship in Practice: Safer Prescribing, Non-Opioid Strategies and Harm Reduction Across Care Settings-FREE NO CME-Module-3

Video Transcription

Video Summary

This microlearning focuses on chronic low back pain management for a rural primary care patient, Jennifer, who uses intermittent tramadol but still has pain, fatigue, and poor sleep. The main goal is to improve function and quality of life rather than eliminate pain. Key recommendations include setting realistic expectations, using pain neuroscience education, and prioritizing non-opioid treatments such as NSAIDs, duloxetine, and possibly topical agents. Gabapentinoids are discouraged because evidence is weak and they may worsen fatigue. Strong emphasis is placed on non-pharmacologic care: daily movement, structured walking or exercise, CBT for insomnia, and self-management strategies. Clinicians should use motivational interviewing, validate patient concerns, track function with tools like PEG-3, and consider tapering opioids if they are not helping. Rural care can be effective through practical, low-cost, evidence-based approaches delivered in a patient-centered way.

Keywords

chronic low back pain

non-opioid pain management

pain neuroscience education

motivational interviewing

rural primary care