The Current Opioid Misuse Measure (COMM) is meant to help a clinician monitor aberrant drug-related behaviors in chronic pain patients who are taking opioids. The authors are from Inflexxion, Inc, Brigham and Women's Hospital, Tufts University and Analgesic Research in Massachusetts.

Number of items: 17


Timeframe: recent (past 30 days)


Items - How often?

(1) do you have trouble thinking clearly or memory problems?

(2) do people complain that you are not completing necessary tasks?

(3) to you need to go to someone other than prescribing physician to get sufficient pain relief?

(4) do you take medications differently from how they are prescribed?

(5) have you seriously thought about hurting yourself?

(6) do you spend time thinking about opioid medications?

(7) have you been in an argument?

(8) have you had trouble controlling your anger?

(9) have you needed to take pain medications belonging to someone else?

(10) have you been worried about how you're handling your medications?

(11) have others been worried about how you are handling your medications?

(12) have you made an emergency phone call or shown up at the clinic without an appointment?

(13) have you gotten angry with people?

(14) have you had to take more of your medication than prescribed?

(15) have you borrowed pain medication from someone else?

(16) have you used your pain medicine for symptoms other than for pain?

(17) have you had to visit the emergency room?


Concept clusters:

(1) signs and symptoms of drug abuse: 1

(2) emotional problems or psychiatric issues: 2, 5, 7, 8, 13

(3) inconsistent appointment patterns: 3, 12, 17

(4) evidence of lying and illicit drug use: 4, 6, 9, 10, 11,

(5) medication misuse and noncompliance: 14, 15, 16

(6) poor response to medications












very often



total scores =

= SUM(points for all 17 items)



minimum score: 0

maximum score: 68

A cutoff score of >9 was used to identify a patient who may be showing aberrant behavior.



A cutoff of 9 had a sensitivity of 0.77 and specificity of 0.66.

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