*3.1.3 Patient factors*

There will always be a proportion of patients who misuse prescription opioids and other controlled drugs for non-medical purposes or will divert them to others for intended profit or for non-medical use. However, it is incumbent upon the modern practitioner to use validated screening tools to try to mitigate and avoid contributing to these potential behaviors when considering initiating the prescription of a controlled substance, and at regular intervals such as every 1–2 years for those using them in a stable and responsible fashion. Specific validated tools and questionnaires are easy to implement in clinical practice and can be filled out by the patient as they wait in the exam room for the practitioner to start the visit. It should be noted that these questionnaires rely on honest self-reporting by the patient, an inherent limitation on reliability. Commonly used validated tools include the following:


As the COVID-19 pandemic ushered in a sudden and widespread adoption of telemedicine by necessity, the care of patients being prescribed controlled substances was immediately transformed. The use of these screening tools may assist providers with determination of which patients are appropriate for continued support with telemedicine, and which require assessment in clinic with appropriate thorough risk assessment including physical exam, urine toxicology screening, pill count, or other measures not accessible via telehealth [36].
