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Post-Overdose Care in the

Emergency Department 

Screening for Opioid Use Disorder (OUD)

Interacting with patients who you suspect may have an opioid use disorder (OUD) can be stressful to both the clinician and the patient. Using an evidence based, standardized approach can help optimize care, avoid emotional confrontations, and reduce stigma.

Use our Clinical Decision Support Flowchart to guide your assessment. Also consider using the Sample Pain Agreement that you can modify to fit your practice.

Screening Tools for Evaluation of Acute and Chronic Pain

Guide to Chronic Pain Assessment Tools

  • A comprehensive history, physical, and psychological examination performed during a chronic pain patient’s initial assessment is vitally important and will guide the proper diagnosis and treatment plan. Find information on commonly used pain, disability, emotional, and global scales.

List of Clinically Tested and Validated Pain Scales

  • Access a list of the current clinically tested and validated scales used to assess pain in patients.

PEG Scale Assessing Pain Intensity and Interference (Pain, Enjoyment, General Activity)

  • A brief assessment scale that includes measurement of pain-related functioning. The score is best used to track an individual’s changes over time. The initiation of therapy should result in the individual’s score decreasing over time.
  • Please note: The CDC states that a 30% improvement from baseline represents clinically meaningful change in PEG score. A 30% improvement may not be meaningful for all patients, providers should determine improvement thresholds depending on the individual.

University of Michigan Pain Disability Index

  • A simple and rapid instrument for measuring the impact that pain has on the ability of a person to participate in essential life activities. This can be used to evaluate patients initially to monitor them over time and to judge the effectiveness of interventions.

Understanding pain

  • Find information on acute vs. chronic pain, the causes of pain, the pain pathway, and the impact of pain.

Types of Chronic Pain

  • Learn about the two broad categories of chronic pain –neuropathic and nociceptive pain.

Screening Tools for Substance Use and Opioid Use Disorders

 

General Drug and Alcohol Risk Screening Tools

 

ASAM Screening tools

  • Access screening and assessment tools for alcohol and drug use among patients.

 Adolescent Screening for Drugs and Alcohol- The CRAFFT

  • A behavioral health screening tool designed for children under the age of 21 to access for drug and alcohol use.

The AUDIT (Alcohol Use Disorder Identification Test) 

  • Access the AUDIT, a simple, 10 question method of screening for excessive drinking and alcohol use disorders.
  • Or use the AUDIT-C, a modified 3-item or the 10 question AUDIT instrument.

DAST-10 (Drug Abuse Screen Test) 

  • Access the DAST-10, a survey administered by the clinician or self-administered by the patient used to screen for drug abuse.

NIDA: Tobacco, Alcohol, Prescription medications, and other Substance (TAPS) Tool

  • This instrument is used to assess primary care patients for tobacco, alcohol, prescription drug, and illicit substance use and problems related to their use, and is available for self-administration and interviewer-administration to detect substance use, sub-threshold substance use disorder (i.e., at-risk, harmful, or hazardous use), and substance use disorders. 

Opioid-Specific Risk Assessments

 

Risk Assessment: Safe Opioid Prescribing Tools

  • This site provides information on three types of risk assessments designed to detect different opioid-related dangers.

Opioid Risk Tool

  • A brief, self-report screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse before and after patients are initiated on opioids for treatment of chronic pain.

DIRE Score: Patient Selection for Chronic Opioid Analgesia

  • Use this brief tool to determine if a patient is a suitable candidate for long-term opioid analgesia.

COWS

  • Assess this clinical opiate withdrawal scale to access – a Flowsheet for measuring symptoms over a period of time during buprenorphine induction.
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Current Opioid Misuse Measure (COMM)

  • A brief, 17-item patient self-assessment to monitor chronic pain patients on opioid therapy and to determine if patients already on long-term opioid treatment are exhibiting aberrant medication-related behaviors.

Assessment Tools for Co-morbid Mood Disorders

 

Generalized anxiety scale (GAD) –GAD 7

  • Screening tool that identifies if a complete assessment for anxiety is recommended.

Patient Health Question (PHQ-9) 

  • 9 item depression assessment to determine severity of depressive symptoms and indicate if a depressive disorder should be considered.

APA: PTSD Assessment Instruments

  • Follow this link to find interview and self-report assessments for PTSD.