CME: The Toxicology Laboratory’s Role in Pain Management

Number of Credits






This course provides CME credit and is only for individuals that are eligible for CME credit (physicians, nurse practitioners, nurses). All others should register for the course under the Laboratory Training category where the course is offered for
P.A.C.E. credit.

Course Details:

This course will provide an overview of general drugs of abuse testing with an emphasis on urine testing for opiates and other narcotics used in the practice of pain management.

Toxicology is the study of adverse effects of chemicals on living organisms. General toxicology is typically associated with environmental toxins and poisons such as ethylene glycol, heavy metals, pesticides, and carbon monoxide. However, drugs of abuse (DOA) are usually considered part of the clinical toxicology laboratory’s test menu as they are chemicals that have adverse effects on humans. This course will focus on DOA testing in the clinical laboratory and specifically in the context of pain management.

DOA testing in non-medical settings, including employment testing and legal testing is not within the scope of this course.

Intended Audience: The target audience for this course is laboratory professionals eligible for CME credit (Physician Laboratory Directors, Pathologists, nurses, who are involved in pain management.

Learning Objectives

  • List the common drugs of abuse that are tested on a routine urine drug screen.
  • Describe the advantages of urine testing versus serum testing in the context of drugs of abuse testing.
  • Describe testing methods used in the clinical toxicology laboratory.
  • Define pain management in a clinical context and explain the lab’s role in this practice.
  • Identify parent and metabolite compounds of common opiate medications.
  • Interpret urine drug screen and confirmation results and decide if the result is consistent with the patient’s history and current prescriptions.

This CME activity has been designed to change learner competence and focuses on the American Board of Medical Specialties areas of patient care, practice-based learning and systems-based practice.

This Enduring Material activity, Laboratory Director Continuing Education Program, has been reviewed and is acceptable for credit by the American Academy of Family Physicians. Term of approval begins 08/01/2019. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Approved for 2.0 AAFP Prescribed credits.


AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 Credit™ toward the AMA Physician’s Recognition Award.  When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

This course will take 2 hours to complete and there are no prerequisites. A credit certificate will be issued upon completion of the course evaluation and post-test with a score of 80% or better.

Release Date: 8/1/2017
Expiration Date: 8/1/2018

  • Laboratory Testing Methods For Drugs of Abuse
  • The Use of Opiates For Pain Management and the Problem of Drug Abuse
  • Interpretation of Drugs of Abuse Testing in Pain Management
  • References
  • Graded Exam

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It is the policy of the AAFP and COLA Resources, Inc. that the faculty, authors, planners, and other persons who may influence content of this CME activity disclose all relevant financial relationships with commercial interests* in order to allow CME staff to identify and resolve any potential conflicts of interest. Faculty must also disclose any planned discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). For this educational activity all conflicts of interests have been resolved and detailed disclosures are listed below:

Activity Planner and Course Reviewer: Verlin K. Janzen, MD, FAAFP

No relevant financial relationships to disclose, No discussion of unlabeled/unapproved uses of drugs/devices during presentation.

* 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 The ACCME does not consider providers of clinical service directly to patients to be commercial interests.

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