Purpose & Evidence:

  • Purpose: The Opioid Risk Tool (ORT) assesses the risk of aberrant behaviors when patients are prescribed opioid medication for chronic pain
  • Target population: Adults
  • Evidence:
    • Provides excellent discrimination between high risk and low risk patients (Passik et al. 2008)
    • Exhibited a high degree of sensitivity and specificity for determining which individuals are at risk for opioid abuse (Webster & Webster 2005).
    • Patients categorized as high-risk on the ORT have an increased likelihood of future abusive drug-related behavior (Chou et al. 2009).
  • Advantages/Limitations


    • Developed specifically for pain patients (Butler 2008)
    • Brief, simple scoring tool that is validated in pain populations (Passik et al. 2008).
    • Validated for both male and female patients (Webster & Webster 2005).


    • One question on the ORT is limited by the patient's knowledge of family history of substance abuse (Passik et al. 2008).
    • Not validated in non-pain populations.

Test features:

  • Estimated time: Less than 1 minute to administer and score
  • Length: 5 items
  • Administered by: Self-Report
  • Intended settings: Primary care
  • Scoring and Interpretation: The risk assessment can be scored by hand, either by the patient or the health professional. Each item that the patient answers positively on the ORT is awarded a certain point value. The points of the entire assessment add up to a patient opioid risk score. Total Score Risk Category:

    Low Risk 0-3
    Moderate Risk 4-7
    High Risk 8+

Available Formats & Links:

View ReferencesHide References
Butler SF. Evidence of Co-occuring Alcohol and Prescription Opioid Abuse in Clinical Populations: Implications for Screening. Tufts Health Care Institute, Program on Opioid Risk Management: Conference on Co-Ingestion of Alcohol with Prescription Opioids. 2008.
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.
Passik SD, Kirsh KL, Casper D. Addiction-related assessment tools and pain management: instruments for screening, treatment planning and monitoring compliance. Pain Med. 2008; 9: S145-S166.
Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the Opioid Risk Tool. Pain Medicine. 2005; 6(6): 432-442. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16336480 Accessed on: 2013-09-12.