Anaesthesia / Critical Care Emergency Medicine General Medicine Strong — CDC-endorsed; standard tool for opioid risk assessment

Morphine Milligram Equivalents (MME) Calculator

Converts opioid doses to morphine milligram equivalents (MME) to assess total opioid burden, guide dose adjustments, and identify high-risk prescribing. Daily MME ≥ 90 mg/day associated with overdose risk.

Score interpretation

Low MME — < 50 MME/day 0–49

Daily MME < 50: Low opioid burden.

→ Standard prescribing. Review pain control adequacy. Ensure bowel regimen co-prescribed. Reassess at each review.

Moderate MME — 50–89 MME/day 50–89

Daily MME 50–89: Moderate opioid burden.

→ Review indication and efficacy. Consider specialist pain review. Ensure naloxone co-prescribed if high-risk patient. Assess for dependence and side effects.

High MME — ≥ 90 MME/day — Overdose Risk ≥ 90

Daily MME ≥ 90: High opioid burden. 3-fold increased overdose risk vs < 20 MME/day (CDC).

→ Urgent specialist pain / palliative care review. Co-prescribe naloxone 400µg SC/IM (patient-held). Consider opioid rotation. Avoid concurrent benzodiazepines. Taper if appropriate. Document risk discussion.

Interpretation bands for the MME Calculator. Apply clinical judgement and local guidance.

References

Dowell D, et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep. 2022;71(3):1–95.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

Related