Current Opioid Misuse Measure (COMM) Assessment

Identifies and helps with monitoring opioid-related behaviors in chronic pain patients treated with opioids.

Instruction: Please answer the questions below using the following scale:

0 = Never | 1 = Seldom | 2 = Sometimes | 3 = Often | 4 = Very Often

1In the past 30 days, how often have you had trouble with thinking clearly or had memory problems?
NeverVery Often
2In the past 30 days, how often do people complain that you are not completing necessary tasks? (i.e., doing things that need to be done, such as going to class, work or appointments)
NeverVery Often
3In the past 30 days, how often have you had to go to someone other than your prescribing physician to get sufficient pain relief from medications? (i.e., another doctor, the Emergency Room, friends, street sources)
NeverVery Often
4In the past 30 days, how often have you taken your medications differently from how they are prescribed?
NeverVery Often
5In the past 30 days, how often have you seriously thought about hurting yourself?
NeverVery Often
6In the past 30 days, how much of your time was spent thinking about opioid medications (having enough, taking them, dosing schedule, etc.)?
NeverVery Often
7In the past 30 days, how often have you been in an argument?
NeverVery Often
8In the past 30 days, how often have you had trouble controlling your anger (e.g., road rage, screaming, etc.)?
NeverVery Often
9In the past 30 days, how often have you needed to take pain medications belonging to someone else?
NeverVery Often
10In the past 30 days, how often have you been worried about how you’re handling your medications?
NeverVery Often
11In the past 30 days, how often have others been worried about how you’re handling your medications?
NeverVery Often
12In the past 30 days, how often have you had to make an emergency phone call or show up at the clinic without an appointment?
NeverVery Often
13In the past 30 days, how often have you gotten angry with people?
NeverVery Often
14In the past 30 days, how often have you had to take more of your medication than prescribed?
NeverVery Often
15In the past 30 days, how often have you borrowed pain medication from someone else?
NeverVery Often
16In the past 30 days, how often have you used your pain medicine for symptoms other than for pain (e.g., to help you sleep, improve your mood, or relieve stress)?
NeverVery Often
17In the past 30 days, how often have you had to visit the Emergency Room?
NeverVery Often
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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.

The Current Opioid Misuse Measure (COMM) is a self-report measure of risk for aberrant opioid-related behavior. It is addressed to chronic pain patients under long term opioid therapies and helps healthcare professionals identify and monitor concurrent misuse.

COMM consists of 17 items that regard key issues associated with aberrant medication related behaviors, as follows:

  • Signs & Symptoms of Intoxication;
  • Emotional Volatility;
  • Evidence of Poor Response to Medications;
  • Addiction-Healthcare Use Patterns;
  • Problematic Medication Behavior.

Benefits of the COMM include its ease of delivery being self-administered, quickness as it can be completed in less than 10 minutes and the fact that it is easy to score. Healthcare professionals may then establish whether a particular patient’s treatment plan needs adjustments. However, please note that the questionnaire relies on patients not misrepresenting their symptoms and behaviors.

Each of the 17 questions may be answered by the following:

  • Never (0 points)
  • Seldom (1 point)
  • Sometimes (2 points)
  • Often (3 points)
  • Very Often (4 points)

To score the COMM the points awarded to each of the 17 answers are summed. A cut-off value of 9 is proposed with scores of 9 or higher being considered positive for opioid misuse. Such a low score has been proposed as cut-off to ensure over-identification of misuse rather than missing out on cases that may be borderline.

Specialty: Toxicology

Abbreviation: COMM