Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R)

J Pain. 2008 Apr;9(4):360-72. doi: 10.1016/j.jpain.2007.11.014. Epub 2008 Jan 22.


The original Screener and Opioid Assessment for Patients with Pain (SOAPP) is a conceptually derived self-report questionnaire designed to predict aberrant medication-related behaviors among chronic pain patients considered for long-term opioid therapy. The purpose of this study was to develop and validate an empirically derived version of the SOAPP (SOAPP-R) that addresses some limitations of the original SOAPP. In successive steps, items were reduced from an initial pool of 142 to a 97-item beta version. The beta version was administered to 283 chronic pain patients receiving long-term opioid therapy. Items were evaluated based on data collected at follow-up, including correlation with the Aberrant Drug Behavior Index (ADBI), derived from interview data, physician ratings, and urine toxicology screens. Twenty-four items were retained and comprise the final SOAPP-R. Coefficient alpha was .88, and receiver operating characteristics curve analysis yielded an area under the curve of .81 (P < .001). A cutoff score of 18 showed adequate sensitivity (.81) and specificity (.68). The obtained psychometrics, along with the use of a predictive criterion that goes beyond self-report, suggest that the SOAPP-R is an improvement over the original version in screening risk potential for aberrant medication-related behavior among persons with chronic pain.

Perspective: There is a need for a screener for abuse risk in patients prescribed opioids for pain. This study presents a revised version of the SOAPP-R that is empirically derived with good reliability and validity but is less susceptible to overt deception than the original SOAPP version 1.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / adverse effects*
  • Attitude to Health
  • Chronic Disease / psychology
  • Chronic Disease / therapy
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Opioid-Related Disorders / diagnosis*
  • Opioid-Related Disorders / prevention & control*
  • Opioid-Related Disorders / psychology
  • Pain, Intractable / drug therapy*
  • Pain, Intractable / psychology
  • Predictive Value of Tests
  • Psychometrics / methods
  • Psychometrics / standards
  • ROC Curve
  • Reproducibility of Results
  • Risk Assessment / methods
  • Risk Factors
  • Surveys and Questionnaires / standards*


  • Analgesics, Opioid