Development of a self-report screening instrument for assessing potential opioid medication misuse in chronic pain patients

J Pain Symptom Manage. 2004 May;27(5):440-59. doi: 10.1016/j.jpainsymman.2003.10.009.


This study constituted the first step in the psychometric development of a self-report screening instrument for risk of opioid medication misuse among chronic pain patients. A 26-item instrument, the Pain Medication Questionnaire (PMQ), was constructed based on suspected behavioral correlates of opioid medication misuse, which heretofore have received limited empirical investigation. The PMQ was administered to 184 patients at an interdisciplinary pain treatment center. Reliability coefficients for the PMQ were found to be of moderate but acceptable strength. Construct and concurrent validity were examined through correlation of PMQ scores to measures of substance abuse, physical and psychological functioning, and physicians' risk assessments. To explore high and low cutoff points for misuse risk, subgroups were formed according to the upper and lower thirds of PMQ scores and compared on validity measures. Higher PMQ scores were associated with history of substance abuse, higher levels of psychosocial distress, and poorer functioning. Future psychometric analyses will consider predictive validity and examine shortened versions of the instrument.

Publication types

  • Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Attitude to Health
  • Chronic Disease
  • Comorbidity
  • Female
  • Health Care Surveys / methods
  • Humans
  • Male
  • Middle Aged
  • Narcotics / therapeutic use*
  • Pain / diagnosis*
  • Pain / drug therapy*
  • Pain / epidemiology
  • Pain / psychology
  • Psychometrics / methods*
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Risk Assessment / methods*
  • Risk Factors
  • Sensitivity and Specificity
  • Substance Abuse Detection / methods*
  • Substance Abuse Detection / statistics & numerical data
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / prevention & control
  • Substance-Related Disorders / psychology*
  • United States / epidemiology


  • Analgesics, Opioid
  • Narcotics