Opioid Risk Tool (ORT) for Narcotic Abuse
Risk of narcotic abuse/misuse.
id
1757
full_title
Opioid Risk Tool (ORT) for Narcotic Abuse
short_title
Opioid Risk Tool (ORT)
med_description
Estimates risk of opioid-related aberrant behaviors.
description
The Opioid Risk Tool for Narcotic abuse estimates risk of opioid-related aberrant behaviors based on patient history.
keywords
ORT, ORT calc, Opioid risk tool, opiate calc, opiate addiction score, opiate addiction risk, history based opioid risk, narcotic abuse risk tool, narcotic opiate tool, rule out opiate addiction, narcotic addiction calc, pain management risk tool, pain management calc
complaint
[ "Pain" ]
formula
Addition of the selected points. Complete scoring information can be found in thederivation study.
evidence
measurements
[]
information
Score interpretation:
- Low risk: 0–3.
- Moderate risk: 4–7.
- High risk: ≥ 8.
Other Notes:
- 185 patients were followed in chronic pain clinic.
- Tracked to determine who developed "aberrant behaviors".
- Developed a score based on this to calculate this risk.
- Of note, still 5% of "low-risk" patients still had aberrant behaviors..
Aberrant behaviors included a long list of behaviors indicating possible abuse, including but not limited to:
- Used additional opioids than those prescribed.
- Requested refills instead of clinic visit.
- Canceled clinic visit.
- Solicited opioids from other providers.
- Unauthorized ER visits.
refrences
{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/16336480", "text": "Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005 Nov-Dec;6(6):432-42. PubMed PMID: 16336480." } ], "Other References": [ { "href": "", "text": "" } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "", "text": "" } ], "Validations": [] }
pearls
usecase
The ORT may help identify patients at high risk for misuse, and who who might benefit more from other modalities of pain control besides narcotics (primarily applicable to patients with chronic pain).
reasons
Substance use, particularly of prescribed drugs, has been an increasing problem in the United States. It is reasonable to consider risk of future abuse/diversion/misuse, especially if considering prescribing narcotics to high risk patients.
next_advice
- Pain medications should not be withheld for painful conditions simply because a patient is deemed “high risk” by the ORT, but these patients should be considered for other modalities of pain control if appropriate.
- These high risk patients may be appropriate candidates for referral to pain management.
- Providers should exercise caution when starting any patient on chronic opiates.
next_actions
next_management
diseases
[ "Chronic Pain" ]
instructions
This tool studied patients at a chronic pain clinic.
published
2022-04-21T20:29:00.831Z
purpose
[ "Prognosis" ]
search_terms
[ "narcotic", "opiate", "opioid", "drug-seeking", "seeking", "abuse", "addiction" ]
seo
{ "keywords_en": "ORT, ORT calc, Opioid risk tool, opiate calc, opiate addiction score, opiate addiction risk, history based opioid risk, narcotic abuse risk tool, narcotic opiate tool, rule out opiate addiction, narcotic addiction calc, pain management risk tool, pain management calc", "meta_description_en": "The Opioid Risk Tool for Narcotic abuse estimates risk of opioid-related aberrant behaviors based on patient history." }
specialty
[ "Emergency Medicine", "Family Practice", "Internal Medicine", "Pain Management", "Primary Care", "Psychiatry", "Toxicology" ]
departments
[ "Psychiatric" ]
tags
[]
version_number
1
versions
[]
related
[ { "calcId": 10483, "short_title_en": "ORT-OUD", "slug": "revised-opioid-risk-tool-ort-oud" }, { "calcId": 1985, "short_title_en": "COWS Score", "slug": "cows-score-opiate-withdrawal" }, { "calcId": 10525, "short_title_en": "BAM", "slug": "brief-addiction-monitor-bam" } ]
ismed
false
section
[ "whenToUseViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]
cleaned_departments
[ "psychiatry" ]
cleaned_use
[ "The ORT may help identify patients at high risk for misuse, and who who might benefit more from other modalities of pain control besides narcotics (primarily applicable to patients with chronic pain)." ]
pub
true