Opioid misuse and opioid use disorder rates have led to record opioid-related deaths nationally. Virginia public health officials declared a public health emergency due to the opioid crisis. Provider prescribing practices are part of this complex local and national public health problem. Evidence indicates that prescribers should assess for risks related to substance misuse and abuse in high-risk populations, such as patients on long-term opioid therapy. By evaluating risk level, the provider has additional information to guide treatment decisions and a baseline for assessing future changes in risk status. This project used quality improvement methods to study the implementation of an opioid risk screening tool in a rural pain management clinic. Addiction screening was implemented in two iterative Plan-Do-Study-Act (PDSA) cycles, aiming to screen 80% of eligible patients by Cycle 2. Participants completed an anonymous paper version of the Opioid Risk Tool-Opioid Use Disorder (ORT-OUD) as part of their intake assessment paperwork. The number of patients seen, the number and percent of eligible patients, screened patients, and the risk level for each screened patient was calculated. The project implemented the ORT-OUD screening with 78 patients, three of which completed the screening with nurse assistance. Thus, 100% of eligible patients were screened, meeting the screening goal. The screening identified 16 patients (21%) as high-risk. Opioid risk screening can provide valuable information when assessing and treating patients receiving long-term opioid therapy for chronic non-malignant pain. This project successfully implemented an opioid risk screening protocol using an interdisciplinary team approach.



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