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Drug Alcohol Depend. 2016 Feb 1;159:152-7. doi: 10.1016/j.drugalcdep.2015.12.007. Epub 2015 Dec 21.

A comparison of an opioid abuse screening tool and prescription drug monitoring data in the emergency department.

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Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States. Electronic address:
Tufts University School of Medicine, Boston, MA, United States. Electronic address:
Boston Medical Center and Boston University Department of Emergency Medicine Providence, RI Inflexxion, Inc., Newton, MA, United States. Electronic address:
Inflexxion, Inc., Newton, MA, United States. Electronic address:



This study aimed to: (a) determine the percentage of ED patients receiving prescriptions for opioid pain medications that meet the criteria for "high-risk for abuse potential" on the Screener and Opioid Assessment for Patients with Pain (SOAPP(®)-R), (b) determine the percentage of patients with high-risk behavior on the state prescription drug monitoring program (PDMP) database, (c) compare the SOAPP-R with data from the PDMP, and (d) determine psychometric properties of SOAPP-R for ED patients


Convenience sample of ED patients who were being considered for discharge with a prescription for an opioid pain medication. Subjects completed SOAPP-R on an electronic tablet and PDMP data was obtained. Scores on SOAPP-R ≥ 18 were defined as "at-risk", and PDMP data showing both ≥ 4 opioid prescriptions and ≥ 4 providers in 12 months was considered the criterion standard for high-risk behavior.


82 patients (88.2%) provided consent. 32.9% (n=27) were determined to be "at-risk" (score ≥ 18) by SOAPP-R. 15.9% (n=13) subjects met PDMP criteria and 53.9% (n=7) of those had SOAPP-R scores ≥ 18 (sensitivity 54%, specificity 71%, positive predictive value 26%, negative predictive value 89%). The association of an at-risk SOAPP-R score and PDMP high-risk criteria was an adjusted odds ratio of 1.39 (95% confidence interval 0.73-3.68).


In our population, about one-third of patients being considered for discharge with an opioid prescription scored "at-risk" on SOAPP-R and 15.9% met the PDMP high-risk criteria. The high negative predictive value of SOAPP-R indicates it may be a useful screening tool for the ED patient population.


Emergency department; Opioids; Prescription drug monitoring program; Screening

[Indexed for MEDLINE]

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