Clinical Criteria of Chabal et al for Prescription Opiate Abuse in a Patient with Chronic Pain

Does the patient have an overwhelming focus on opiate issues during office visits?

Has this persisted beyond the third office visit?

Has the patient asked for early refills 3 or more times without any acute change in the underlying medical condition?

Has the patient been taking higher or more frequent doses without any acute change in the underlying medical condition?

Has the patient disturbed the office staff because of prescription issues?

Has the patient made multiple calls or visits to the office because of prescription problems?

Has the patient had multiple problems requiring another prescription (lost, stolen, spilled, etc)?

Has the patient sought out additional sources of opiates (multiple providers, Emergency Department, illicit)?