Table 3.

Risk Stratification

Low Risk	No past/current history of a substance use disorder	May be safely managed in primary care settings
	No family history of a substance use disorder	Adherence monitoring at least annually
	No major untreated psychiatric disorder
	Presence of social support System
Moderate Risk	History of treated substance use disorder	May be managed in primary care in consultation with appropriate specialist support
	Significant family history of substance use disorders
	Past or concurrent psychiatric disorder	Adherence monitoring every 6 months or less
	Current pharmacotherapy for addiction (methadone, buprenorphine)
	Younger than 25 years of age
High Risk	Active substance use disorder or aberrant behaviors	Recommended management by pain management and addiction specialists as needed, as these patients pose significant risk to themselves and others
	Active addiction	Frequent adherence monitoring weekly or monthly
	Majoruntreated psychiatric disorder

Adapted from Gourlay, et al., 2005