Table 2

Summaries of recommended items used to identify patients with life-threatening illnesses who are at high risk of aberrant opioid medication-taking behaviours and opioid overdose

Summary topicStrongly recommend assessing forConsider assessing forAgreement level n (%)Total no. of experts
Items to identify patients with life- threatening illnesses who are at high risk of aberrant opioid medication-taking behavioursAlcoholism using validated tools (ie, CAGE, Alcohol Use Disorders Identification Testalcohol screening tool)Young age (18–24 years old)18 (82)22
History of non-medical drug use (ie, cocaine)Older age (65 years or older)
Current non-medical drug useAlcohol family history
History of injection drug useHistory of tobacco use
Current injection drug useCurrent tobacco use
Post-traumatic stressDepression
Sexual abuse historyAnxiety
Criminal record(s) related to substance use disordersPersonality disorders
Somatisation
Premorbid chronic pain
Unstable housing
Financial instability
Items to identify patients with life- threatening illnesses who are at high risk of opioid overdoseBenzodiazepine use (ie, lorazepam)Older age (65 years old and greater)17 (81%)21
Alcohol useRenal impairment
History of previous opioid overdoseLiver impairment
Receiving opioid prescriptions from two or more physiciansMuscle relaxant use (ie, cyclobenzaprine)
History of substance use disorderSleep medication/hypnotic use (ie, zopiclone)
Active substance use disorderMethadone use for pain management
Methadone use for opioid use disorder management
Opioid-naïve patients
Untreated psychiatric conditions (ie, schizophrenia)
History of obstructive sleep apnoea
Filling opioid prescriptions at two or more pharmacies