Preliminary validation of the Diversion Risk Scale (DRS): Using environmental and individual factors to predict opioid-related diversion events

Ted Jones, PhD; Todd M. Moore, PhD; Diana S. Meske, PhD; Steven D. Passik, PhD

doi:10.5055/jom.2023.0757

Authors

Ted Jones, PhD https://orcid.org/0000-0002-9232-1260
Todd M. Moore, PhD https://orcid.org/0000-0001-7722-4334
Diana S. Meske, PhD https://orcid.org/0000-0002-4039-3609
Steven D. Passik, PhD

DOI:

https://doi.org/10.5055/jom.2023.0757

Keywords:

diversion, opioid prescribing, opioid risk assessment

Abstract

The standard of care calls for the assessment of patients with chronic pain prior to the initiation of opioids, with one part of this assessment including assessment of the risk of misuse of medications. However, traditional opioid risk assessment tools focus almost entirely on individual factors and on the risk of misuse and addiction to opioids. Diversion of opioid medications has been found to be not uncommon, but to date, there have been no assessment tools specifically designed to assess the risk of diversion. In this study, we developed a measure designed specifically to assess the risk of an opioid medication ending up in the hands of someone other than the chronic pain patient to whom they were prescribed. A 15-item measure, the Diversion Risk Scale, was created and administered to 85 patients at a chronic pain practice. Results found that the measure had acceptable predictive validity. It was moderately correlated with traditional opioid risk assessment tools and showed improved ability to predict specific indicators of diversion. Diversion has been an understudied phenomenon, and the clinical value of an assessment tool that can help predict diversion in the chronic pain population is discussed.

Author Biographies

Ted Jones, PhD

Pain Consultants of East Tennessee, Knoxville, Tennessee

Todd M. Moore, PhD

University of Tennessee, Knoxville, Tennessee

Diana S. Meske, PhD

Senior Director, Clinical Development at Concentric Analgesics, Chicago, Illinois;* Collegium Pharmaceuticals Inc, Stoughton, Massachusetts. *At the time of this work, she was with Collegium.

Steven D. Passik, PhD

Vice President, Scientific Affairs and Head of Clinical Data Programs, Millennium Health, San Diego, California;* Collegium Pharmaceuticals Inc, Stoughton, Massachusetts. *At the time of this work, he was with Collegium

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