What is the ORT?

The Opioid Risk Tool (ORT) is a brief, self-report questionnaire designed to help clinicians assess a patient’s risk of opioid misuse before initiating long-term opioid therapy. Developed by Webster & Webster in 2005, the ORT consists of 10 scored items and is validated for use in individuals aged 16 and older. It identifies patients as low, moderate, or high risk for exhibiting aberrant drug-related behaviors during opioid treatment.

Use in Clinical Settings

The ORT is commonly used in primary care, pain management, and behavioral health settings to support informed prescribing decisions and promote safe opioid use. Importantly, the ORT is not intended to deny access to medication but to guide appropriate monitoring and follow-up for those at elevated risk.

How It Works

Patients complete the questionnaire by answering questions related to personal and family history of substance use, psychiatric conditions, and other risk factors. Responses are scored based on their association with higher risk of misuse:

• Low Risk: Score 0–3

• Moderate Risk: Score 4–7

• High Risk: Score 8 or higher

When administered through Creyos, responses are automatically scored and summarized in a report for clinical interpretation.

Cognition and Opioid Risk

Cognition and substance use are deeply interconnected. The effects of pain relief, medication, and withdrawal can each impact cognitive function differently. Likewise, deficits in attention, impulse control, or decision-making may increase the likelihood of misuse or relapse. When paired with Creyos cognitive tasks, the ORT provides a fuller picture—combining subjective risk screening with objective cognitive measures to guide comprehensive care.

Related Tools

The ORT complements other Creyos behavioral health questionnaires such as the AUDIT (Alcohol Use Disorders Identification Test) and DAST-10 (Drug Abuse Screening Test), helping clinicians assess multiple dimensions of substance use, risk, and recovery.

Clinical Considerations

The ORT is a validated screening tool intended to support—not replace—clinical judgment. Its results should be interpreted alongside cognitive testing, patient history, and functional assessments to inform personalized treatment planning and risk mitigation strategies.

To explore all behavioral and cognitive health tools available in the Creyos platform, refer to the Creyos Standardized Questionnaires Guide.