Which patient is at high risk for opiate addiction if given a prescription for Percocet according to the Opioid Risk Tool?
A. A 35 yo F with a history of preadolescent sexual abuse B. A 44 yo M with a personal history of depression and a family history of alcohol abuse C. A 24 yo M with bipolar disorder and a family history of prescription drug abuse. D. An 18 yo M with a personal history of alcohol abuse and a family history of prescription drug abuse. E. An 82 yo F with depression and a personal history of alcohol abuse.
An 18 yo M with a personal history of alcohol abuse and a family history of prescription drug abuse.
The Opioid Risk Tool (ORT) is a brief test patients can take before their initial visit to the pain clinic. It stratifies risk based on family history of substance abuse, personal history of substance abuse, age, history of sexual abuse, and psychological comorbidities. Of the patients described in the question, choice D is an 18 year old (1 point for age) male with history of alcohol abuse (3 points) and a family history of prescription drug abuse (4 points). This adds up to 8 points, which is considered high risk.
Webster LR, Butera PG, Moran LV, et al. Oxytrex minimizes physical dependence while providing effective analgesia: a randomized controlled trial in low back pain. J Pain 2006;7:937–946.