Cross validation of the current opioid misuse measure to monitor chronic pain patients on opioid therapy

Clin J Pain. Nov-Dec 2010;26(9):770-6. doi: 10.1097/AJP.0b013e3181f195ba.


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 α) 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.

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*
  • Analgesics, Opioid / therapeutic use*
  • Area Under Curve
  • Chronic Disease / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / diagnosis*
  • Opioid-Related Disorders / prevention & control
  • Pain / drug therapy*
  • Pain Measurement
  • Psychometrics
  • ROC Curve
  • Risk Assessment
  • Surveys and Questionnaires
  • United States
  • Urinalysis


  • Analgesics, Opioid