Revised Opioid Risk Tool (ORT-OUD)
Revised version of the Opioid Risk Tool specifically predicting opioid use disorder (OUD) risk in patients prescribed opioids for chronic pain. 5 items, score 0–26. Score ≥8 = high risk.
Score interpretation
ORT-OUD 0–3 — low risk of opioid use disorder
→ Standard opioid prescribing protocols; routine monitoring; urine drug screens periodically; reassess if dose escalation needed
ORT-OUD 4–7 — moderate risk of opioid use disorder
→ Enhanced monitoring; more frequent urine drug screens; consider addiction medicine co-management; prescribe minimum effective dose; pill counts; consider abuse-deterrent formulations
ORT-OUD ≥8 — high risk of opioid use disorder
→ Addiction medicine or pain medicine co-management required before initiating opioids; if already prescribed, taper and transition to non-opioid analgesia; naloxone co-prescription; close monitoring; consider buprenorphine if OUD develops
Interpretation bands for the ORT-OUD. Apply clinical judgement and local guidance.
References
- Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005;6(6):432–442.
Related
Curated clinical cross-links plus same-class fallbacks.
- Fentanyl Transdermal Patch (Elderly Chronic Pain) · Opioid Analgesic — Transdermal Patch
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Morphine (Orthopaedic Acute Pain) · Opioid Analgesic — Strong
- Oxycodone (Orthopaedic Post-operative Pain) · Opioid Analgesic — Strong
- Ketamine (Sub-anaesthetic — Orthopaedic Pain) · NMDA Receptor Antagonist — Opioid-Sparing Analgesic
- Codeine Phosphate (Orthopaedic — Mild-Moderate Pain) · Opioid Analgesic — Weak (Prodrug)
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.