Table 1

Opioid Risk Tool: Check the box if the item applies; a score of 0–3 indicates low risk, a score of 4–7 indicates moderate risk, and a score of 8 or higher indicates high risk.

ITEM	WOMEN	MEN
1. Family history of substance abuse:
• alcohol	[ ] 1 point	[ ] 3 points
• illegal drugs	[ ] 2 points	[ ] 3 points
• prescription drugs	[ ] 4 points	[ ] 4 points
2. Personal history of substance abuse:
• alcohol	[ ] 3 points	[ ] 3 points
• illegal drugs	[ ] 4 points	[ ] 4 points
• prescription drugs	[ ] 5 points	[ ] 5 points
3. Age between 16 and 45 y	[ ] 1 point	[ ] 1 point
4. History of preadolescent sexual abuse	[ ] 3 points	[ ] 0 points
5. Psychological disease
• attention deficit disorder, obsessive-compulsive disorder, bipolar disorder, or schizophrenia	[ ] 2 points	[ ] 2 points
• depression	[ ] 1 point	[ ] 1 point
Total

Adapted from Webster and Webster.¹¹