ToolsCalculators
Current Opioid Misuse Measure (COMM)
Seventeen-item self-report screen for aberrant medication-related behaviour in patients on chronic opioid therapy.
Current Opioid Misuse Measure (COMM)
Trouble with thinking clearly or memory problems
Difficulty completing usual tasks (work or home)
People have expressed concern about how you are using your pain medication
Feeling groggy or 'high' from pain medication
Emotional problems interfering with handling of pain treatment
Taking someone else's medication
Feeling bothered by others about your medication use
Worrying about how you are handling your medications
Others worried about how you are handling your medications
Trouble thinking of anything besides your medications
Time spent thinking about your next medication dose
Arguments with family or friends about medication use
Avoiding interactions with people because of your medication use
Using more medication than prescribed
Relying on medication to manage emotions, not just pain
Emergency room or clinic visit related to medications
Needing early refills or running out of medication early
Result0 points
Score below the usual positive-screen threshold of 9.
When to use
- Periodic monitoring of patients on long-term opioid therapy for signs of misuse, as part of a broader risk-management strategy.
Formula
Sum of 17 items, each scored 0 (never) to 4 (very often) over the past 30 days. Range 0-68; a score of 9 or more is a positive screen.
Pearls and pitfalls
- Intended for ongoing monitoring during opioid therapy, not for pretreatment risk assessment (use a tool such as ORT or SOAPP-R for that).
- A positive screen should prompt further clinical assessment, not automatic discontinuation of therapy.