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The Opioid Risk Tool (ORT) is a useful way to monitor opioid risk assessment.

The Opioid Risk Tool (ORT) is a useful way to monitor opioid risk assessment.

Fortunately, new tools like the Opioid Risk Tool have helped to monitor the risk for opioid addiction. There’s no denying that the opioid problem in our country has gotten out of hand. The Opioid Risk Tool Before we discuss the tool, what it is, and how it works, let’s talk about the opioid epidemic. Some say that it’s gotten out of control, and experts believe that to be true. However, with the right intervention, it may be possible to change directions. In fact, this could potentially save the lives of so many people in our country.

Opioid Abuse in the U.S.

Opiates are among the most prescribed medications in the country. Medications like morphine, Oxycodone, and Vicodin are usually given to help with serious pain. However, these addictions frequently lead to heroin addictions or the abuse of other illicit drugs. According to the National Institute on Drug Abuse, as many as 36 million people are abusing opioids worldwide. It is estimated that more than 2 million of these individuals are from the United States. In 2012, about 2.1 million people in the U.S. suffered from a substance abuse disorder related to prescribed opiate drugs. Additionally, about 467,000 people report being addicted to heroin. This is devastating news, and the problem is that it’s not getting better. Experts expect the problem to only get worse with every passing year. This is evidenced by the fact that the number of overdoses from these prescribed drugs has quadrupled since 1999. Opioid Abuse in the U.S.

Factors Contributing to the Country’s Opioid Problem

There are many reasons why opioid use in the United States has gotten out of control. Among these are:

  • The fact that more prescriptions have been written for these drugs than ever before in recent years.
  • The pain relievers are considered to be socially acceptable.
  • Pharmaceutical companies aggressively market pain medications to the public.
  • These prescribed drugs are being used for more than just treating pain.
  • They are very easy to obtain on the street or online illegally.

Opioid Epidemic and Statistics

The American Society of Addiction Medicine has weighed in on the opioid epidemic. It’s incredible to think of how it has impacted so many people in our country. They state that:

  • In 2015, 2 million people had a substance abuse disorder that involved prescribed opiate drugs.
  • An additional 591,000 people had a substance abuse disorder that involved the use of heroin.
  • About 23% of those who use heroin will develop an opioid addiction.
  • Many people with heroin addictions first start by using prescription opiates.
  • In 2015, there were 276,000 teens that were using pain relievers non-medically.
  • Of that number, 122,000 of them were addicted to these drugs.
  • During that same year, 21,000 adolescents had reported using heroin within the last 12 months.
  • 5,000 of them reported being current heroin users.
  • In 2014, 6,000 teens had a heroin use disorder or addiction.
  • Between 1994 and 2007, the prescribing rates for opioid drugs for young people almost doubled.

As you can imagine, overdoses on opioid drugs are quite common in the United States. The CDC tells us that:

  • Between 1999 and 2015, more than 183,000 people have died because of ODing on prescribed painkillers.
  • This works out to being about half of all prescribed opioid overdose deaths.
  • In 2015 alone, more than 15,000 people died because they overdosed on these medications.
  • The opioid drugs responsible for the most overdoses are Methadone, Oxycodone and Hydrocodone.
  • Overdose rates tend to be the highest among people aged 25 to 54.
  • Men tend to be more likely to die from an overdose than women.

Every day, there are more than 1,000 people treated in emergency rooms for misusing their opioid medications. Also, for someone being treated for non-cancer pain with opiates, they have a 25% chance of becoming addicted. These statistics are alarming to say the least. It’s time there was a way to assess people for their risk of opioid abuse and potentially, addiction.

Help Reduce Opioid Abuse

How the Opioid Risk Tool (ORT) and SOAPP-R Help Reduce Opioid Abuse

Opioid risk assessment has become a very necessary part of dealing with the epidemic of opioid abuse in the United States. Various opioid risk tools were created to help the medical industry fight against the opioid addiction problem. The opioid painkillers that are being assessed are for those with non-cancer related pain. Recently there have been reports that reveal the growing increase in deaths due to prescription opioids. The rate of opioid related sales and deaths related to opioid use increased the same amount. The age group that saw the highest death rates due to prescription opioids were 35-54. An alarming opioid risk factor statistic is that more women are dying from prescription opioids than heroin or cocaine. The Center for Disease Control and Prevention (CDC) describes the opioid use in the US an epidemic and is recommending strategies to prevent further related opioid deaths from occurring. From 2000 to 2015, over 500,000 people that have overdosed on opioids like prescription pain killers or heroin. Nearly 100 Americans die every day from opioid overdose. Plans are being set out to help those who are already using opioids, but more importantly, practices are being used to prevent “at risk” patients from taking opioid prescriptions. To start with the DEA reclassified hydrocodone-containing products from Schedule III to Schedule II. This limits the number of pills you can be prescribed at any one time. It also requires you to visit your doctor’s office for further refills. The US Surgeon General is asking for doctors help in fighting the epidemic against prescription opioids. Furthermore, the CDC is encouraging further education on prescription opioids, pain management, and addiction for those in the medical profession. The article published by the CDC outlined how important it is for physicians to understand opioid risk factors. They listed several tools health professionals could utilize to screen patients before prescribing opioid therapy. This includes the Opioid Risk Tool and the Screener and Opioid Assessment for Patients in Pain-Revised.

The Opioid Risk Tool

The Opioid Risk Tool (ORT)

The ORT tool is a quick report used as an opioid risk assessment, determining the risk of opioid abuse in patients that have chronic pain. The report can be administered and scored in less than a minute. Patients that are categorized as high-risk through the test will be considered likely to show abusive drug-related behavior. ORT has been validated to be used on both male and female patients. A preliminary study on patients who were prescribed opioids for chronic pain showed that the ORT tool was a highly accurate way to determine risk in patients for their opioid-related abuse potential. Some studies say opioid abuse potential hasn’t been distinguished between those with chronic pain and the general population. Other studies disagree saying that the abuse potential for patients with pain are higher. This stems from addictive disorders being attributed to those who sustain major trauma by 60%. The Opioid Risk Tool Statistics

  • It has been said that the ORT tool provides excellent discrimination between patients that are high and low risk.
  • The ort scale is very specific in determining which patients will be at high risk for opioid abuse.
  • Patients that are determined to be high-risk on ORT are more likely to show drug-related abuse behavior in the future.
  • There are five items on the report
  • You do the report on your own as opposed to being asked questions
  • The intended setting is primary care
  • The risk assessment is scored by hand either by yourself or a medical professional.
  • With every positive answer you give, the ort scale awards a specific point value
  • The points of the assessment will then add up your opioid risk score.
  • If you get 0-3, you’re considered low risk. A moderate risk will be 4-7 and a high risk is 8 or more.

Screener and Opioid Assessment

Opioid Addiction

For many people, an opioid addiction occurs accidentally. They’re prescribed painkillers because they needed them. They take them as prescribed, and many people take them for far too long. These drugs are only meant to be a short-term solution. Eventually, the body and brain grow accustomed to having these medications. At that point, they might stop being as effective as they once were. To compensate for this, people will often increase how much they take. They may also take dosages too closely to each other. When this occurs, it’s called forming a tolerance. This is often one of the first signs that an addiction is present. An opioid addiction may begin with a choice to use these drugs. However, that’s not where it ends. Once the addiction has set in, it becomes a disease of the brain. This makes it almost impossible to stop using on your own. The brain actually goes through changes that make recovery very difficult. However, with the right support, it is possible.

Signs You’re Addicted to Opiates

There are many other signs that someone might be addicted to their opiate pain medications. These include:

  • Feeling a euphoric high when taking them
  • Becoming very depressed or anxious
  • Feeling drowsy or fatigued
  • Having frequent mood swings
  • Becoming irritable or physically agitated

Once you’re addicted to opioid drugs, it’s hard to think about anything else. You have to take your medication on a certain schedule. It becomes an obsession. If you miss a dose, you may panic. If you miss too many doses, you may begin to go through opioid withdrawal.

Opioid Addiction Treatment

Getting treated for an opioid addiction – whether illegal or prescribed – is the best way to recover. It’s the safest, and it gives you the highest chance of being successful. Whether you realize it or not, you need professional support in order to recover from this addiction. Research has shown that there are several excellent ways for you to recover. Opioid Replacement Medications: Certain medications have been approved for the purpose of treating opioid addiction. Medications like Suboxone, Subutex and Vivitrol have been approved for this reason. In some cases, Methadone can be used as well. These drugs are opioid drugs, but they can help for those who are dependent on painkillers. Therapy: Whether you take any of the above medications or not, therapy is highly recommended. This ensures that you understand the reasons behind your addiction. It may be more than just physical pain that you’re facing. You could have depression, anxiety or another issue that needs to be addressed. Therapy is very important for anyone with this type of addiction. Opiate Rehab Programs: Quite often, people who are addicted to prescribed pain relievers need rehab to recover. There are different options for opioid treatment available. You will be assessed for whether you need inpatient or outpatient treatment. Once that is determined, you’ll be given the next steps. Detoxification: Depending on how long you’ve been using opioid drugs, you may need to go through a period of opioid detox treatment. This allows your body to get used to not having the medications. It rids itself of toxins during this period. You may be given other medications to help you with any withdrawal symptoms. You may also be weaned off your medication slowly. This tends to help lessen the severity of withdrawal.

Opioid Risk Factors

Opioid Risk Factors

There are various opioid risk factors researchers have found to increase dependence patients have for prescription painkillers. The combined opioid risk factors include:

  • Family history of addiction
  • Environmental influences and/or previous substance use
  • Underlying emotional issues like depression
  • How your body processes drugs
  • To what degree your pain impairment is. This can cause higher, more consistent doses to be taken.
  • Age

For example, a younger patient who is depressed with abuse history who is currently on psychiatric medication, this is a high-risk patient. Great caution should be taken when prescribing opioids for pain not relating to cancer. If a high-risk patient like this is prescribed opioid pain killers out of necessity, they should be closely monitored. The specific abuse and risk factors aren’t completely known yet so there are investigations into the prevalence of these risk factors. Researchers are looking at patient data from electronic health records to determine the validity of risks in patients.

Screener and Opioid Assessment for Patients in Pain-Revised (SOAPP-R)

Screener and Opioid Assessment for Patients in Pain-Revised (SOAPP-R)

SOAPP-R is a questionnaire for patients with chronic pain who are being considered for long-term opioid therapy. SOAPP-R differs from the ORT tool because it”s not designed to rule out any patients based on their risk of opioid abuse. Instead, this assessment was developed with concepts that make it easier to predict which patients will require monitoring during opioid therapy. It assesses the prediction of potential opioid abuse for those with chronic pain. The higher the score, the higher the risk. The assessment shouldn’t be used in order to deny patients from getting pain relief, even those with a history of substance abuse. The advantages include:

  • It can be easily understood
  • Takes very little time
  • Gives medical professionals valuable information on what kind of care and monitoring will be required for you.

These opioid risk tools will help doctors keep patients from the potential of becoming addicted to pain killers. Opioid risk assessment tools like ORT and SOAPP-R give medical professionals assistance in determining how to help patients best with pain while preventing a larger issue of addiction to opioids. Make no mistake, opioid addiction is an epidemic where attending detox for prescription medication has become quite common. The advantages of soapp-r While opioid prescriptions won’t be withheld for those with chronic pain, tools like SOAPP-R will guide medical professionals of how much monitoring is needed for every patient. Essentially, opioids pain killers have their use to patients but need to be prescribed more responsibly. The likes of the ORT tool and other risk assessments tools is a simple way to ensure that happens.

Full Infographic:

The Opioid Risk Tool