Resources & Information

Jun 8 2016

Revised CME rule would require training in pain management

Comments:   4 comments  Print Friendly Version  |   Share this item
After a vigorous debate, the Board voted during its March meeting to seek approval for rule changes that would require physicians and physician assistants to complete continuing medical education (CME) in chronic pain management and related topics. Three members of the Board were not present for the vote.

As proposed, the rule changes would require physicians to earn three hours of eligible CME during each three-year CME cycle. PAs would be required to complete two hours of eligible CME during each two-year cycle. To count towards the new requirement, courses would have to cover "controlled substances prescribing practices, recognizing signs of the abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management.”

The proposed changes were supported by the Board over an alternate version that would have afforded prescribers the flexibility to tailor controlled substances CME courses to their clinical interests. For example, the alternate rule language would have allowed physicians whose primary use of controlled substances is prescribing benzodiazepines to satisfy the CME requirement by completing courses in prescribing benzodiazepines.

The alternate change considered was inspired by feedback received from licensees who gave comments on the new proposed CME requirement. Several licensees who gave comments indicated that, while they do prescribe some controlled substances and would be subject to the requirement, they do not prescribe opioids and would not benefit from CME in chronic pain management.

After lengthy discussion and debate, the Board affirmed the requirement that courses cover addressing abuse or misuse and chronic pain management. Board Members who spoke in favor of this requirement expressed conviction that all licensees who prescribe controlled substances will benefit from a better understanding of the clinical challenges in chronic pain management, abuse and misuse of opioids and the associated risk of patient harm or death. It was noted that licensees who do not prescribe opioids likely treat patients who take opioids prescribed by others and, consequently, need to be informed about possible risks and side effects.

NCMB has submitted the proposed CME rule changes to the NC Rules Review Commission, which must approve them before they take effect. The Board anticipates a decision by the end of August.

Review proposed changes to the physician and PA CME rules


What: Public hearing on proposed changes to physician and PA CME rules to require CME in chronic pain management and related topics.

When: July 14 at 10 a.m.

Where: NCMB’s offices, 1203 Front Street, Raleigh, NC

Can’t attend? Submit comments on the proposed rule to:

Read FAQs about the pending CME requirement

 Comments on this article:

I am a child psychiatrist. I believe in my 10 years of treating children, I have seen 4 individuals who have been prescribed opioids. None who have received them chronically. I would be better served getting CME on how to spot diversion, misuse and abuse of all medications that can be abused. Limiting it to one concept for ALL three credits makes no sense. This is NOT useful CME to add on as I am already having to do much extra work to keep my board certification.

By Anne-Marie Turnier on Jun 09, 2016 at 5:42pm

What about out of state licensees who have not prescribed anything in NC for years? Would we need to take the controlled substances CME.? But I have prescribed non-opioid only controlled substances in another state.  NC was my first license, so I keep iit active for reciprocity through the FLEX.

By Terry brown on Jun 09, 2016 at 7:07pm

Those who don’t prescribe should be exempt

By jesse powell on Jun 14, 2016 at 10:52pm

Dr. Brown - As drafted, the requirement would apply to any licensee who prescribed controlled substances, regardless of whether those medications were prescribed in NC or in another state. So you would be subject to the new requirement.

Dr. Powell - The requirement would apply only to physicians and PAs who prescribe controlled substances. If you have not prescribed controlled substances at any time during your most recent CME cycle, you would be exempt.

Thanks for the questions!

By Jean Fisher Brinkley on Jun 16, 2016 at 11:36am
 Post a comment on this article
Please do not include links to external websites in your comment. Please limit comments to no more than 300 words. The NCMB reserves the right to edit comments to meet the length limit. Abusive or profane remarks and personal attacks will not be published. The editor will make every effort to review and post comments in a timely fashion.