Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Prescription Opioid Misuse Index (POMI) is a tool designed to help pinpoint potential misuse of prescription opioids. It does this through responses to six specific questions that probe behaviors related to pain medication usage.

For each of the following questions, responses of "Yes" are scored as 1 point, while "No" responses score 0 points:

- Do you ever use more of your medication (take a higher dosage) than is prescribed for you?
- Do you ever use your medication more often (shorten the time between dosages) than is prescribed for you?
- Do you ever need early refills for your pain medication?
- Do you ever feel high or get a buzz after using your pain medication?
- Do you take your pain medication because you are upset, using it to relieve or cope with problems other than pain?
- Have you ever visited multiple physicians, including emergency room doctors, seeking more of your pain medication?

Once responses are collected, the scores for each question are summed. This total score can range from 0 to 6, providing a gauge for understanding an individual's behavior concerning prescription opioid use.

Interpretation of the total score is straightforward:

- A score of 2 or higher indicates that the criteria for prescription opioid misuse are met. This suggests there may be patterns of behavior pointing to the misuse of opioid medications.
- A score of 0 or 1 means the criteria for prescription opioid misuse are not met. This indicates that the individual's patterns of behavior typically do not suggest misuse according to the index.

The Prescription Opioid Misuse Index (POMI) is a clinical calculator used in the field of addiction medicine and pain management. It is specifically designed to assess the risk of prescription opioid misuse in patients who are being treated for chronic pain. The POMI is a valuable tool for clinicians as it helps to identify patients who may be at risk of developing opioid misuse behaviors, thus allowing for early intervention and prevention strategies. It is important to note that this calculator should not be used in patients who are not prescribed opioids or in those who are being treated for acute pain. The POMI is not designed to diagnose opioid use disorder, but rather to identify risk factors for misuse in a chronic pain population.

Methadone prescribing

Guidelines

Key sources