A Brief Screening Tool for Opioid Use Disorder: EMPOWER Study Expert Consensus Protocol

Abstract

Growing concerns about the safety of long-term opioid therapy and its uncertain efficacy for non-cancer pain have led to relatively rapid opioid deprescribing in chronic pain patients who have been taking opioid for years. To date, empirically supported processes for safe and effective opioid tapering are lacking. Opioid tapering programs have shown high rates of dropouts and increases in patient distress and suicidal ideation. Therefore, safe strategies for opioid deprescribing that are more likely to succeed are urgently needed. In response to this demand, the EMPOWER study has been launched to examine the effectiveness of behavioral medicine strategies within the context of patient-centered opioid tapering in outpatient settings (https://empower.stanford.edu/). The EMPOWER protocol requires an efficient process for ensuring that collaborative opioid tapering would be offered to the most appropriate patients while identifying patients who should be offered alternate treatment pathways. As a first step, clinicians need a screening tool to identify patients with Opioid Use Disorder (OUD) and to assess for OUD severity. Because such a tool is not available, the study team composed of eight chronic pain and/or addiction experts has extended a validated screening instrument to develop a brief and novel consensus screening tool to identify OUD and assess for OUD severity for treatment stratification. Our screening tool has the potential to assist busy outpatient clinicians to assess OUD among patients receiving long-term opioid therapy for chronic pain.

Clinical correlates of drug‐related dreams in opioid use disorder

“…The standard Diagnostic and Statistical Manual for Mental Disorders (DSM‐5) self‐report checklist for OUD was used to assess OUD severity in the time period leading up to their most recent treatment. Individuals were assessed using a self‐reported checklist rather than clinician assessment due to the method of data collection (anonymous survey), similar to other work 21,22 . Participants endorsed symptoms (range: 0–11) and were non‐diagnostically assigned to an OUD severity class: none (0–1), mild (2–3), moderate (4–5), severe (<6).…”

Identifying and Treating Incarcerated Women Experiencing Substance Use Disorders: A Review

“…115 Another example is the use of the DSM SUD Checklist to assist with medication tapering among patients in outpatient settings. 116 In a recent study with incarcerated women, 107 rates of opioid use disorder were high when screened with the DSM-5 OUD Checklist with an average of 10.4 symptoms endorsed before incarceration, with most scoring in the severe range, which was considerably higher than non-incarcerated samples. 117 While more commonly used as a clinical component of SUD assessment, the DSM SUD Checklist also has utility for screening among incarcerated women.…”

Racial inequities in opioid use disorder management: can the anesthesiologist improve outcomes?

“…The most common perceived barrier to screening by surgical providers in this study was insufficient clinic time. However, the opioid risk tool (ORT) and EMPOWER OUD screening protocol are quick and practical questionnaires that can be administered in less than a minute 58,59. These tools are essential to identifying patients with OUD or at risk for opioid abuse and should be employed equitably.…”