Opioid Risk Tool (ORT) — Sex-Specific Scoring
Aberrant Risk Screening
Select all applicable historical factors to determine the recommended level of monitoring.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
Overview
The Opioid Risk Tool (ORT) is a brief, validated, self-administered screening tool designed to predict the likelihood of aberrant drug-related behavior (ADRB) in patients being considered for long-term opioid therapy. It is widely used in chronic non-cancer pain management, palliative care, and addiction medicine to guide the intensity of monitoring and risk mitigation strategies.
When to Use
Prior to initiating long-term opioid therapy for chronic non-cancer pain
At the time of palliative care consultation for patients anticipated to need ongoing opioid analgesia
Annual opioid therapy review in patients on stable doses
When aberrant behavior is suspected or reported (e.g., lost prescriptions, dose escalation without medical guidance)
When transitioning from acute to chronic opioid management post-surgery or injury
Important Context
ORT is a risk stratification tool — not a reason to deny opioids. Patients with cancer-related pain or end-stage illness retain the right to effective analgesia regardless of ORT score. In these populations, ORT primarily informs monitoring intensity and psychosocial support needs, not prescribing eligibility.
Related Scores in Practice
In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Medd Morphine Equivalent Daily Dose, CPOT or the PAINAD to formulate a comprehensive care plan.
Last Comprehensive Review: 2026