BEHAVIORAL
e
STEVEN D. PASSiK PHD/TED W. JON S PHD, CPE
by
abstract: Risk assessment is the term given
to the evaluation of individuals prior to the
prescribing of opioids for chronic pain in
an attempt to predict future misuse, abuse,
or diversion of opioids. Our purpose here is
to review briefly some history of risk assessment, its current status, and where we think
the field should be headed in the future.
We need not belabor the statistics on the
opioid abuse problem in our country to
date. The Centers for Disease Control and
Prevention (CDC) has reported that overdose deaths from prescription medications
have tripled over the last decade, and in
2009 there were a half million visits to emergency departments related to prescription
medication overdoses. Risk assessment has
been promoted as one tactic of many to help
curtail this problem. The logic, with which
we agree, is that if there is increased scrutiny and discernment by prescribers before
the initiation of opioids, this will go a long
way towards helping reduce the misuse, addiction, diversion, and overdoses. To this
end, some states such as Washington and
our own state of Tennessee have now legislatively mandated that those treating chronic pain with opioids must use some form of
risk assessment in evaluating patients.
“Risk is not a permanent characteristic of the patient. Risk varies across time.”
6 | PWJ | www.painweek.org
Q3 | 2013