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PTSD, Chronic Pain, and Opioid Use Disorder: A Case Discussion

Activity Type:

  • On Demand

Release Date: 8/22/2017

Expiration Date: 8/22/2020

  • AMA PRA Category 1 Physician: 1
  • Participation: 1



Treating patients with co-occurring chronic, non-cancer pain, and opioid use disorder can be difficult. Adding PTSD to this clinical picture can be even more challenging. The prevalence of chronic pain is higher in patients with PTSD than those without with one VA study showing co-occurring chronic pain in 66% of patients suffering from PTSD (Shipherd et al 2007). It is no surprise since patients with PTSD have more risk factors for pain including higher rates of other psychiatric conditions, medical conditions, and substance use disorders. Further, patients with PTSD report greater pain severity, greater pain related impairment, are more likely to be prescribed opioid medications for chronic pain, and are more likely to have opioid use disorders than patients without PTSD. Patients with PTSD also report higher levels of maladaptive coping and beliefs about pain than those with chronic pain alone.  In the following case based webinar, we will discuss the challenges in treating this population while describing approaches which may help providers improve the care of these patients. 


  • General Member - Free
  • Resident-Fellow Member - Free
  • Medical Student Member - Free
  • Non-Member - Free

Educational Objectives

  • Recognize the clinical complexity and overlapping symptoms for patients experiencing co-occurring disorders of chronic pain, opioid use disorder, and PTSD including how to assess these conditions and set expectations for care.
  • Describe evidence-based approaches to the treatment of co-occurring PTSD, chronic pain, and opioid use disorders
  • Discuss strategies for supervision of trainees working with patients experiencing co-occurring PTSD, chronic pain, and opioid use disorders

Target Audience

Physicians and other clinicians with interests in safe and effective use of opioid medications for the treatment of chronic pain and the interface of pain and opioid use disorder.   

Estimated Time to Complete

Estimated Duration: 1 hour
Begin Date: August 22, 2017
End Date: August 22, 2020

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. A multiple-choice quiz is provided based on the content. A passing score of 70% must be achieved. Retakes are available for the test. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The APA designates this enduring CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures


  • Jonathan Buchholz, M.D., Medical Director of Inpatient Psychiatry, VA Puget Sound. Reports no financial relationships with commercial interests.

Program Planners

  • John A. Renner, Jr., M.D., Boston University School of Medicine, Director, Addiction Psychiatry Residency Training, Boston University Medical Center and VA Boston Healthcare System. Disclosure: Stock/other financial options: Johnson & Johnson and General Electric.
  • Roke Iko, Program Manager, Sub-Specialty Education, American Psychiatric Association. Reports no financial relationships with commercial interests.

Hardware/Software Requirements

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

  • Flash Player: Adobe Flash Player 10.3+ 
  • Browser: Firefox (latest version), Internet Explorer 8.0+, Safari 7.0+, Microsoft Edge (latest version) or Google Chrome (latest version)
  • Operating System: Windows XP+ or Mac OS X 10.4+ 
  • Internet Connection: 1 Mbps or higher

Minimum Requirements:

  • Windows PC: 500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Macromedia Flash Player 10.3 or higher; Sound Card at least 16-bit; audio playback with speakers for programs with video content
  • Macintosh:Mac OS X 10.4+ or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit; audio playback with speakers for programs with video content

For assistance: Contact for questions about this course | Contact for technical assistance

All materials copyright American Psychiatric Association. ©2017

American Psychiatric Association 
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