Description

Domino et al identified risk factors associated with relapse by a health care provider with a history of substance abuse disorder. These can help identify providers who may benefit from closer monitoring and more aggressive management. The authors are from the University of Washington in Seattle and the Washington Physician's Health Program.


Parameters:

(1) family history of substance abuse disorder

(2) concurrent psychiatric disorder

(3) substance abused

(4) history of previous relapse

 

Parameter

Finding

Points

family history of substance abuse

absent

0

 

present

1

concurrent psychiatric disorder

absent

0

 

present

1

substance abused

major opioid and concurrent psychiatric disorder

1

 

major opioid without concurrent psychiatric disorder

0

 

other substance

0

previous relapse

none

0

 

present

1

 

where:

• Major opioids include fentanyl, morphine, meperidine, methadone, oxycodone or heroin.

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• The higher the score the greater the risk of relapse.

• If all of the first 3 risk factors were present, then the hazard ratio was 13.


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