Introduction

Current clinical guidelines make a strong recommendation based on weak evidence to assess for risk and current substance abuse, misuse or addiction during initial contemplation of opioid therapy for chronic pain (Chou et al. 2009). Results of these assessments help in developing an opioid treatment plan that minimizes risk of long-term dependence and other substance use problems. Risk stratification helps determine the amount of treatment structure needed in order to control and monitor progress of opioid therapy, such as opioid agreements of frequent urine drug testing (Chou et al. 2009). Patients should be monitored throughout long term opioid treatment.

The five categories of screening and assessment tools in this guide are presented according to their primary purpose in a clinical setting. Some tools are specifically designed for chronic pain patients, while others were not evaluated in this patient population. Tools may also vary according to the substance being assessed, delivery (interview vs. questionnaire), or the patient age.

Important Message:

With the many assessment tools that are available, it can be difficult to distinguish what makes each tool unique, and which ones to use. A main focus should be on when to use the instruments in clinical practice.

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Chou R, Fanciullo GJ, Fine PG, et al. Opioids for chronic noncancer pain: prediction and identification of aberrant drug-related behaviors: a review of evidence for an American Pain Society and American Academy of Pain Medicine Clinical Practice Guideline. J Pain. 2009a; 10(2): 131-146. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19187890 Accessed on: 2013-09-12.