• Louisa Picco, Melissa Middleton, Raimondo Bruno, Michala Kowalski, and Suzanne Nielsen.
• Monash Addiction Research Centre, Monash University Peninsula Campus, Frankston, Victoria, Australia.
• Pain Med. 2020 Nov 1; 21 (11): 2757-2764.

ObjectiveThe OWLS is a screening tool for prescription opioid use disorder designed for use in primary care. This study aimed to confirm the optimal wording, scoring methods, and cutoff for the OWLS.Design And SettingCross-sectional analysis of an online sample.SubjectsParticipants comprised those with chronic noncancer pain who regularly used prescription opioids.MethodsEligible participants self-completed an online version of the OWLS prescription opioid use disorder screening tool and the Composite International Diagnostic Interview Substance Abuse module. Receiver operating characteristics were calculated for three scoring methods for the OWLS, and these were compared with DSM-5 classification of any use disorder and moderate to severe opioid use disorder.ResultsAmong the sample (N = 324), utilizing scoring method (i) (i.e., positive endorsement ≥ response option "a little bit") and a cutoff of 3 increased the percentage of correctly classified participants, with concurrent increases in specificity and decreases in false discovery rate, and false positive rate.ConclusionOWLS utilizing scoring method (i) with a cutoff of 3 was shown to be the optimal version and scoring method of this tool. This represents a time-efficient, simple scoring method, allowing for quick and accurate screening for opioid use disorder to occur.© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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