Table 2.

Overdose Risk Assessment and Willingness to Prescribe Naloxone by Residents for a Series of Clinical Vignettes

Summarized clinical vignettes	Assumed risk category*	Percentage endorsing risk of opioid-related overdose		Percentage willing to prescribe naloxone to patient
		Not likely to low	Medium to high
Correctly identified those at most risk for opioid-related overdose
Young man endorsing prescription opioid misuse (currently taking 50 mg morphine equivalents/day). No history of overdose or injection drug use	Medium-high	5	95	68
Middle age man with injection opioid use w/ overdose 1 month prior	Medium-high	5	95	90
Underestimated risks in patients prescribed opioids
Young man w/ sickle cell disease presenting with acute on chronic pain on baseline of 90 mg MME/day with 15 MME 1–2×/day	Medium-high	50	50	44
Elderly female prescribed 100 mg morphine equivalents (MME)/day chronically	Medium-high	60	40	25
Varied risk assessment in patients receiving low-dose opioids chronically or acutely
Middle age man w/ femur fracture c/b alcohol withdrawal. Discharged on 7.5 MME every 4 h	Medium-high	21	79	52
Elderly woman prescribed 5 MME every 8 h as needed for knee pain	Low	63	37	25
Young woman with a history of pancreatitis on 15 MME every 4 h	Medium-high	36	64	34

MME morphine milligram equivalents. *Risk factors for risk based on opioid risk (low risk is < 50 MME/day, medium risk is ≥ 50–100 MME/day, > 100 MME/day is high risk); presence of substance use disorder (elevated (medium-high) risk if positive), history of opioid overdose (elevated (high) risk if positive)