Opioid Dosing Guideline and DOH Pain Management Rules Online CME Activity

Welcome to this online CME activity offered by the Medical Quality Assurance Commission (MQAC), in consultation with the Washington State Department of Health (DOH) and the Washington State Agency Medical Directors' Group (AMDG), in collaboration with the Washington State Department of Labor and Industries (L&I).

   How do I start?

This free CME activity is a package consisting of 3 parts:

  1. A 20-minute video on the DOH Pain Management Rules. These rules were developed pursuant to ESHB 2876, passed by the Washington legislature in 2010. The video was produced by the Medical Quality Assurance Commission in consultation with the Washington State Department of Health, the Nursing Care Quality Assurance Commission, the Podiatric Medical Board, the Dental Quality Assurance Commission, and the Board of Osteopathic Medicine and Surgery. (The full text of the rules is available at: www.doh.wa.gov/hsqa/Professions/PainManagement)

  2. The AMDG Opioid Dosing Guideline.

  3. A 40-item test, which you may complete online.
To prepare for the CME activity:

  • Study the "Interagency Guideline on Opioid Dosing for Chronic Non-cancer Pain". The guideline is 13 pages, with additional appendices offering valuable tools you may use in your clinical practice.

    PDF Opioid Dosing Guideline for Chronic Non-cancer Pain (209 KB PDF)

    This activity is "open book". You may find it helpful to print the guideline for reference, as you will be referring to it throughout.

  • Also, watch the 20-minute video on the DOH Pain Management Rules. Clicking on the video icon below will take you to an external site in a new browser window. This video is housed on the GoToWebinar server and is viewable on demand, 24 hours a day, at no charge.

    DOH Pain Rule Video
The free Adobe Reader ® is required in order to view or print files in PDF format. You can download the Reader at no cost from Adobe's web site.

How much time will it take?

  • After studying the materials provided, it should take approximately one (1) hour to complete the activity (40 questions) and brief survey.

  • You must finish the activity in its entirety before clicking "Submit".

  • After clicking "Submit", your score will immediately be determined.  If you have a passing score (70%
    or greater), you will be able to print your certificate for up to four (4) hours of Category 1 Continuing Medical Education (CME) credit, or four (4) hours of Continuing Education credit through the Washington Board of Pharmacy, immediately following the completion of the activity.

   What will I learn?

The target audience includes physicians, pharmacists and others in the health care community who prescribe opioids or are involved in management of chronic non-cancer pain.

At the conclusion of this CME activity, the participant should be able to:

  • Describe state and national trends in opioid-related drug overdose deaths
  • Use tools and prevention strategies to address opioid misuse and abuse using
    evidence-based medicine
  • Describe key aspects of the new dosing guideline
  • Understand how to use the new dosing guideline in a clinical setting
  • Describe how to assess a patient’s pain relief and functional level to determine
    if the patient is improving with opioid treatment, using widely available,
    standardized functional assessment tools
  • State two reasons why ESHB 2876 was passed
  • List the elements REQUIRED in the management of chronic non-cancer pain
  • List three circumstances under which the rule does NOT apply
  • List the CME requirements that should be completed prior to prescribing long-acting opioids
  • Define the requirements of an exempt provider, i.e. NO consultation needed when
    the 120 mg MED dose is exceeded
  • Define the circumstances when mandatory consultation is required


If at any point you close out of the activity by closing your browser window, be aware that your answers will not be saved and you will need to restart the activity over again.

Thank you for your participation.

Click continue when you are ready to begin.

© Washington State Agency Medical Directors' Group. Use of this site is subject to the laws of the state of Washington.

Activity Version 2, July 2011