Clinical Inquiry: is there a primary care tool to detect aberrant drug-related behaviors in patients on opioids?

Yes. Of the several screening instruments developed and originally validated in patients in a pain center population (TABLE), one also has been validated in primary care. The Current Opioid Misuse Measure (COMM) predicts aberrant drug-related behaviors in primary care patients who have been prescribed opioids within the past 12 months with a sensitivity of 77% and specificity of 77% (strength of recommendation [SOR]: B, cohort studies). Although not validated in primary care populations, 3 other instruments (the Addiction Behaviors Checklist [ABC], Prescription Opioid Misuse Index [POMI], and Prescription Drug Use Questionnaire [PDUQ]) detect aberrant drug-related behaviors in pain center patients with chronic pain with sensitivities of 82% to 87.5% and specificities of 86.14% to 92.3% (SOR: B, cohort studies).