Development of a Brief Patient-Administered Screening Tool for Prescription Opioid Dependence for Primary Care Settings

Suzanne Nielsen, Louisa Picco, Gabrielle Campbell, Nicholas Lintzeris, Briony Larance, Michael Farrell, Louisa Degenhardt, Raimondo Bruno

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


OBJECTIVE: To develop a short, patient-administered screening tool that will allow for earlier assessment of prescription opioid dependence (often referred to as addiction) in primary care settings. DESIGN AND SETTING: Cross-sectional analysis (N = 1,134) from the two-year time point of the Pain and Opioids IN Treatment (POINT) cohort was used in the scale development. SUBJECTS: Participants who completed two-year interviews in the POINT study, a prospective cohort study that followed people with chronic noncancer pain over a five-year period, and who were prescribed strong opioids for a minimum of six weeks at baseline. METHODS: An advisory committee provided advice on wording and content for screening in primary care settings. Univariate logistic regression identified individual items that were significantly associated with meeting ICD-11 criteria for prescription opioid dependence. Exploratory and confirmatory factor analysis (EFA and CFA) were conducted, and items were reduced to identify a small item set that were discriminative and shared a simple underlying structure. RESULTS: Sixty-four variables associated with ICD-11 criteria for prescription opioid dependence were initially identified. Four rounds of EFA were performed, resulting in five items remaining. CFA identified two possible four-item combinations, with the final combination chosen based on greater item endorsement and the results of goodness-of-fit indices. CONCLUSIONS: Addressing prescription opioid dependence is an important part of the global public health challenge surrounding rising opioid-related harm. This study addresses an important initial requisite step to develop a brief screening tool. Further studies are required to validate the tool in clinical settings.

Original languageEnglish
Pages (from-to)e79-e88
Number of pages10
JournalPain Medicine
Issue number2
Publication statusPublished - Feb 2020


  • Chronic Pain
  • Opioid Dependence
  • Opioid Use Disorder
  • Screening

Cite this