Journal-based CME Course: Revisiting the WHO Analgesic Ladder for Surgical Management of Pain

Activity ID

10846

Expires

July 25, 2026

Format Type

Journal-based

CME Credit

Fee

$30

CME Provider: AMA Journal of Ethics

Description of CME Course

The opioid epidemic challenges current attitudes toward pain management and necessitates the reexamination of the World Health Organization (WHO) 3-step analgesic ladder, introduced in 1986 for cancer pain management. Surgical treatment of pain is a logical extension of the original guideline, which is often absent in conversations with patients about treatment options for their pain and consequentially underutilized. However, with concerns growing regarding opioid use, a shift in the stepwise approach of the WHO analgesic ladder in an age of developing technology and surgical offerings could have profound implications for patients and public health. Surgical interventions potentially provide a long-term, cost-effective management strategy to reduce opioid use. This review canvasses surgical options, highlights literature on failed back surgery syndrome and spinal cord stimulation, and reconsiders the current ladder approach to pain management.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

ABMS Member Board Approvals by Type

ABMS Lifelong Learning CME Activity

Allergy and Immunology

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Preventive Medicine

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More Information

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NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

General Information on CME Activity

Educational Objectives

1. Explain a new or unfamiliar viewpoint on a topic of ethical or professional conduct
2. Evaluate the usefulness of this information for health care practice, teaching, or conduct
3. Decide whether and when to apply the new information to health care practice, teaching, or conduct

Keywords

Ethics, Pain Medicine, Opioids, Substance Use and Addiction Medicine

Competencies

Medical Knowledge, Professionalism

CME Credit Type

AMA PRA Category 1 Credit

DOI

10.1001/amajethics.2020.695