Strategies to Identify Patient Risks of Prescription Opioid Addiction When Initiating Opioids for Pain

Key Points Question How can physicians identify patients with pain for whom prescription opioids can be safely prescribed? Findings This systematic review found that a history of opioid use disorder or other substance use disorder, a mental health diagnosis, and concomitant prescription of certain psychiatric medications may be associated with an increased risk of prescription opioid addiction. However, only the absence of a mood disorder appeared useful for identifying lower risk, and assessment tools incorporating combinations of patient characteristics and risk factors were not useful. Meaning This study suggests that there are few valid ways to identify patients who can be safely prescribed opioid analgesics.