Differences Among Clinical Tools for Predicting the Risk of Opioid-Related Aberrant Behaviors

Ted Jones, PhD

Behavioral Medicine Institute
Knoxville, TN

Recent guidelines call for assessing the risk for aberrant medication-related behavior in chronic pain sufferers who are candidates for long-term opioid therapy. Although reliable screening for this risk is considered critical to achieving optimal patient outcomes, the predictive accuracy of the various measures has been confounded by a lack of empirical data comparing the sensitivity and selectivity of the tools and methods currently in use—eg, the Opioid Risk Tool (ORT), the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R), the Pain Medication Questionnaire (PMQ), and the clinical interview. In two recent studies that address this issue, Jones and colleagues found that the SOAPP-R and clinical interview were more successful in predicting future medication misuse and nonadherance to a pain contract than were the PMQ and ORT. Here, Dr. Jones discusses the implications of the first comparative data to emerge and suggests clinical applications that may help pain specialists individualize treatments.

References

1. Jones T, Moore T, Daffron S, et al. A comparison of various risk screening methods for patients receiving opioids for chronic pain management. Presented at: PAINWeek’10; September 8-11, 2010; Las Vegas, NV.
2. Moore TM, Jones T, Browder JH, Daffron S, Passik SD. A comparison of common screening methods for predicting aberrant drug-related behavior among patients receiving opioids for chronic pain management. Pain Med. 2009;10:1426-1433.
3. Passik SD, Squire P. Current risk assessment and management paradigms: snapshots in the life of the pain specialist. Pain Med. 2009;10(Suppl 2):S101-S114.

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