Knowledge of opioid safety is an essential clinical practice competency for all prescribers of opioids. In light of the increasing death rates from opioid overdose and increasing rates of opioid abuse, improved education about safe opioid prescribing is necessary.


COPE-REMS is a continuing medical education activity offered through the University of Washington School of Medicine. This online interactive course is aimed at healthcare providers, including physicians, registered nurses, ARNPs, physician assistants, psychologists, and other care managers who are involved in treating patients with chronic pain and opioid prescribing. The approach of the COPE (Collaborative Opioid Prescribing Education) program is to promote a shared decision-making approach between providers and patients. Course content covers opioid safety requirements as described by the US Food and Drug Administration (FDA) in its 2012 approval of a Risk Evaluation and Mitigation Strategy (REMS) for long-acting and extended-release opioids. COPE-REMS uses realistic video vignettes of providers and patients to demonstrate clinical practice through a self-paced tutorial course.

This course is a new and revised version of an earlier REMS-compliant COPE-REMS course that builds off the online interactive course called COPE, one of the few online courses on opioid prescribing to have been tested and proven effective in a clinical trial. (1)

Learning Objectives

At the conclusion of the course, participants should be able to:

  • Identify elements of safe opioid prescribing and be able to assess patients for treatment 
  • Model effective communication skills to improve provider-patient interaction and build trust as well as demonstrate ways to manage requests for opioid therapy from patients for whom this type of therapy is appropriate, and those for whom it is not appropriate
  • Describe the risks of serious adverse outcomes from opioid use, according to characteristics of opioid regimens and patients, and apply this knowledge in their patient assessment and ongoing treatment plans for improved patient safety
  • Successfully document treatment and patient action plans, and know how to counsel patients on how to safely use, store and dispose of opioid medications
  • Discuss general and product-specific drug information concerning extended-release and long-acting opioids/li>

Already Registered

If you have already registered for the COPE-REMS course, please visit


The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The University of Washington School of Medicine designates this enduring material for a maximum of 4.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The course includes a pretest; 7 chapters of audiovisual content; and a post-test for those desiring CME credit. There is also a comprehensive resources section.


Development of COPE resources is led by Mark Sullivan, MD, PhD, a leading pain specialist and Professor of Psychiatry and Behavioral Sciences at the University of Washington as well as a clinician at the UW’s Center for Pain Relief.


This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies. Please see for a listing of the member companies. This activity is intended to be fully compliant with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration. Copyright © 2014 University of Washington. All Rights Reserved.

The University of Washington School of Medicine also gratefully acknowledges receipt of educational grant support for this activity from Pfizer, Inc.; Mallinckrodt, Inc., a Covidien Company; and Endo Pharmaceuticals. Copyright © 2014 University of Washington. All Rights Reserved. COPE-REMS was developed by Mark Sullivan, MD, PhD, Professor of Psychiatry & Behavioral Sciences, University of Washington; and Laura Cooley, MA, Director, COPE Online Education, Department of Psychiatry & Behavioral Sciences, University of Washington. COPE-REMS builds upon the UW CME course known as COPE. Copyright © 2006 University of Washington. All Rights Reserved.

Other Contributions

COPE-REMS (ver 1.0 and 2.0) builds upon the online CME course COPE (Collaborative Opioid Prescribing Education) developed by Mark Sullivan, MD, PhD, with assistance from Barak Gaster, MD, and supported by grants from the Greenwall Foundation, Aetna Inc, Ortho-McNeil®, and Johnson & Johnson. Copyright © 2006 University of Washington. All Rights Reserved.

Disclosure Policy and Information

The University of Washington School of Medicine endorses the Standards of the Accreditation Council for Continuing Medical Education (ACCME) and the guidelines of the Association of American Colleges that the sponsors of continuing medical education activities and the planners and speakers at these activities disclose significant relationships with commercial companies whose products or services are discussed in educational presentations. Significant relationships include receiving from a commercial company research grants, consultancies, honoraria and travel, or other benefits or having a self-managed equity interest in a company. Disclosure of a relationship is not intended to suggest or condone bias in any presentation, but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.
The UW staff listed below have indicated they do not have any relevant financial relationships to disclose.

Planning Committee and Authors

Mark Sullivan, MD, PhD
Laura Cooley, MA

Technical Requirements

Click here for a list of the technical requirements for this online course

Obtaining CME Credit

To obtain CME course credit, course participants must complete a post-test and pass with a score of 80% or better (20 out of 25). They will then receive a printable certificate.

Privacy and Confidentiality 

Click here for the University of Washington's Policy on Privacy and Confidentiality 

Terms and Conditions

Click here for the University of Washington's Terms and Conditions of Use

The COPE-REMS CME course was released in its revised form on July 15, 2014 after an initial release date of April 23, 2013. COPE-REMS is approved for designation of CME credit through April 23, 2015.


For questions about credit please contact the University of Washington CME Office at 

For technical questions please contact the Training Xchange Help Desk.

Already registered and looking for COPE-REMS? Go to


*This course is free of charge.

  1. Clinical Journal of Pain Vol. 26, No. 6, July/Aug. 2010.