This tool should be administered to patients upon an initial visit prior to beginning or continuing opioid therapy for pain management. A score of 2 or lower indicates low risk for future opioid use disorder; a score of >/= 3 indicates high risk for opioid use disorder.
| Mark each box that applies | Yes | No |
|---|---|---|
| Family history of substance abuse | ||
| Alcohol | 1 | 0 |
| Illegal drugs | 1 | 0 |
| Rx drugs | 1 | 0 |
| Personal history of substance abuse | ||
| Alcohol | 1 | 0 |
| Illegal drugs | 1 | 0 |
| Rx drugs | 1 | 0 |
| Age between 16-45 years | 1 | 0 |
| Psychological disease | ||
| ADD, OCD, bipolar, schizophrenia | 1 | 0 |
| Depression | 1 | 0 |
| Scoring totals | ||
Cheatle M, Compton P, Dhingra L, Wasser T, O’Brien. Development of the Revised Opioid Risk Tool to Predict Opioid Use Disorder in Patients with Chronic Non-Malignant Pain. Journal of Pain. 20 (7): 842-851, 2019.
Funded by NIH/NIDA grant R01 DA032776