Cross Validation of the Current Opioid Misuse Measure to Monitor Chronic Pain Patients on Opioid Therapy

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 alpha) 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.