This Opioid risk tool calculator checks whether the patient is at risk of opioid addiction or abuse due to the medication plan they are on. Discover more about the criteria involved in the model and its score interpretation below the form.
How does this Opioid risk tool calculator work?
This is a health tool that takes the for of a self report screening questionnaire that can be used on a wide range of adult patients to determine whether they are at risk of opioid abuse due to them being prescribed opioids as a treatment for the various conditions they are used for.
The questionnaire has been developed by Lynn R. Webster, MD and presented in the 2005 study.
This Opioid risk tool calculator not only helps in identifying the patients at risk of misuse but can also be employed to analyze patients in primary care before they are prescribed opioids to ensure this treatment is really a fit for them and decrease future abuse or diversion cases which are becoming increasingly frequent nowadays.
The following table presents the criteria in the ORT calculator and the points awarded to each of the variables, based on gender.
| Criteria | Female | Male |
| Family history of substance abuse | ||
| Alcohol | 1 | 3 |
| Illegal drugs | 2 | 3 |
| Rx drugs | 4 | 4 |
| Personal history of substance abuse | ||
| Alcohol | 3 | 3 |
| Illegal drugs | 4 | 4 |
| Rx drugs | 5 | 5 |
| Age between 16 - 45 | 1 | 1 |
| Sexual abuse and psychological disease | ||
| Preadolescent sexual abuse | 3 | 0 |
| ADD, OCD, bipolar, schizophrenia | 2 | 2 |
| Depression | 1 | 1 |
ORT interpretation
This is used as a screening tool in the context of chronic pain management and has shown is predictability in the validation studies as well. It focuses mainly on family and personal history in order to determine the type of the behavior the patient might develop in time during the medication.
The risk assessment tool has shown great discrimination between the extreme ends of the score range as well as a high degree of sensitivity (Webster & Webster, 2005).
Once the questionnaire has been filled in, the assessor will then add up the points taking in consideration the gender of the patient and this will come up as an overall score.
Scores between 0 and 3 are considered low risk, scores between 4 and 7 are moderate risk while scores above 8 are interpreted as high risk. Therefore patients scoring high in the ORT are most likely to take on a pattern of substance, drug related abuse. However, this doesn’t mean that patients who score high in ORT should not receive the appropriate medication as this is then left to clinical judgment and the medical professional will simply know that the patient requires more monitoring than other patients who might have scored lower.
The screening should take place preferably before any prescription but in some cases, further monitoring and other evaluations might be necessary.
There are other opioid abuse risk assessment tools such as the DIRE or the SISAP but also tools that assess the degree of withdrawal symptoms the patient might experience after having to cut opioid medication as the COWS calculator.
The only criticism received by the model is that it has not been validated in patients suffering from conditions that are not pain related and is only focused on chronic pain.
References
1) Webster LR, Webster RM. (2005) Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med; 6(6):432-42.
2) Jamison RN, Serraillier J, Michna E. (2011) Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain. Pain Research and Treatment Volume 2011, Article ID 941808.
3) Bohn TM, Levy LB, Celin S, Starr T, Passi S. (2011) Screening for Abuse Risk in Pain Patients Clark MR, Treisman GJ (eds): Chronic Pain and Addiction. Adv Psychosom Med. Basel, Karger, vol 30, pp 113–124
30 Sep, 2015