Klimas et al identified factors associated with addiction to opioids prescribed for pain. These can help to identify a patient who may have a greater risk. The authors are from Ireland, Italy, Canada and the United States.

Patient selection: opioid prescription for pain


Outcome: addiction


Factors associated with a higher risk for addiction:

(1) history of opioid use disorder (likelihood ratio 17-22)

(2) history of other substance use disorder (likelihood ratio 4.3-17)

(3) mental health diagnoses (see below)

(4) concomitant prescriptions (see below)

(5) duration of opioid therapy >= 30 days

(6) higher daily opioid dose (> 120 mg per day)


Mental health diagnoses:

(1) personality disorder (likelihood ratio 27)

(2) mood disorder

(3) somatoform disorder

(4) psychotic disorder

(5) anxiety disorder


Concomitant prescriptions:

(1) atypical antipsychotic medication (likelihood ratio 17)

(2) anxiolytic

(3) tricyclic or other antidepressant

(4) anticonvulsant

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