Cross Validation of the Current Opioid Misuse Measure to Monitor Chronic Pain Patients on Opioid Therapy
Open accessAbstract
OBJECTIVES: The Current Opioid Misuse Measure (COMM) is a self-report measure of risk for aberrant medication-related behavior among persons with chronic pain who are prescribed opioids for pain. It was developed to complement predictive screeners of opioid misuse potential and improve a clinician's ability to periodically assess a patient's risk for opioid misuse. The aim of this study was to cross-validate the COMM with a sample of chronic noncancer pain patients. METHODS: Two hundred and twenty-six participants prescribed opioids for pain were recruited from 5 pain management centers in the United States. Participants completed the 17-item COMM and a series of self-report measures. Patients were rated by their treating physician, had a urine toxicology screen, and were classified on the Aberrant Drug Behavior index. RESULTS: The reliability and predictive validity in this cross validation as measured by the area under the curve (AUC) were found to be highly significant (AUC=0.79) and not significantly different from the AUC obtained in the original validation study (AUC=0.81). Reliability (coefficient α) was 0.83, which is comparable to the 0.86 obtained in the original sample. DISCUSSION: Results of the cross validation suggest that the psychometric parameters of the COMM are not based solely on unique characteristics of the initial validation sample. The COMM seems to be a reliable and valid screening tool to help detect current aberrant drug-related behavior among chronic pain patients.
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The COMM total score of nine or more indicates positive opioid misuse.
“A total score of nine or more indicates positive opioid misuse.”
From Pain acceptance creates an emotional context that protects against the misuse of prescription opioids: A study in a sample of patients with chronic noncancer pain (2021) · cites this paper as [56]
The Results state that a COMM score of 9 or more is a positive COMM score and is suggestive of aberrant medication-related behavior. The Discussion cautions that the screen can produce false positives, so the score does not by itself establish opioid misuse. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPsychiatric comorbidity is common among persons with chronic pain, with a high incidence of self-reported anxiety, depression, and history of abuse, or early childhood trauma.
“Psychiatric comorbidity is common among persons with chronic pain, with a high incidence of self-reported anxiety, depression, and history of abuse, or early childhood trauma.20,21”
From Risk Factors for Self-Harm Ideation among Persons Treated with Opioids for Chronic Low Back Pain (2023) · cites this paper as [21]
The Discussion mentions mood disorders as one possible cause of behaviors associated with opioid misuse, and the Materials and Methods section says the questionnaire asks about psychiatric and family history. Neither passage reports how common psychiatric comorbidity, anxiety, depression, abuse history, or childhood trauma is among people with chronic pain. Searches for anxiety and childhood trauma found no passage establishing the claimed high incidence; page numbers were unavailable. (LLM, conf=0.76)
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References 26 · Cited by 198
Research works printed but not linked: 3
- [22]Butler SF Budman SH Fernandez K Jamison RN Validation of a screener and opioid assessment measure for patients with chronic pain. Pain 2004 112 65 75 15494186
- [24]Savage SR Assessment for addiction in pain-treatment settings. Clin J Pain 2002 18 S28 38 12479252
- [26]Butler SF Budman SH Fernandez KC Development and validation of the Current Opioid Misuse Measure. Pain 2007 130 144 156 17493754 PMC1950245
- Authors
- Butler, S. F., Budman, S. H., Fanciullo, G. J., & Jamison, R. N.
- Affiliations
- Inflexxion (United States) (US)
- Dartmouth–Hitchcock Medical Center (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Butler, Stephen F.
- Budman, Simon H.
- Venue
- The Clinical Journal of Pain
- Published
- 2010-11
- Volume
- 26
- Issue
- 9
- Pages
- 770-776
- ISSN
- 0749-8047 (ISSN-L)
- PMC
- PMC2955853
- OpenAlex
- W2072543293
- Cited by
- 198
- References
- 26
- Citations by year
- 2026: 11 · 2025: 11 · 2024: 12 · 2023: 13 · 2022: 17 · 2021: 14 · 2020: 12 · 2019: 19 · 2018: 17 · 2017: 21 · 2016: 10 · 2015: 15 · 2014: 6 · 2013: 14 · 2012: 2
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (DA024298, DA015617, R43DA015617, R44DA015617, R21DA024298)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid misuse, chronic non-cancer pain, opioid therapy, screening tool, cross-validation, psychometric properties, predictive validity, urine toxicology
- MeSH terms
- Adult, Aged, Aged, 80 and over, Analgesics, Opioid, Chronic Disease, Female, Humans, Male, Middle Aged, Opioid-Related Disorders, Pain, Pain Measurement, Psychometrics, Surveys and Questionnaires, ROC Curve, United States, Urinalysis, Risk Assessment, Area Under Curve
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