Open Access Open Access  Restricted Access Subscription or Fee Access

A Rasch analysis of the Current Opioid Misuse Measure for patients with chronic pain

Courtney Morris, PhD, Kathy E. Green, PhD, Lilian L. Chimuma, MAT


Objective: Pilot study to assess psychometric indices of the Current Opioid Misuse Measure (COMM).

Design: Correlational.

Setting: Patients with varied chronic pain from a family healthcare center.

Patients: Inclusion criteria were over 21 years of age and prescribed opioids for any-origin noncancer pain; 46 patients were enrolled.

Outcome measure(s): The COMM, the Pain Self-Efficacy Questionnaire (PSE-Q), and the Patient Health Questionnaire-9 (PHQ-9) and a demographic questionnaire.

Results: Preliminary analysis indicated issues with dimensionality and scale use. Analysis after remedial procedures yielded unidimensionality and appropriate scale use, with the measure showing invariance across sex and low significant correlation with the PHQ-9 but not the PSE-Q.

Conclusions: The COMM had adequate reliability, measured a distinct construct, and no significant differential item function was found. However, scale use for this sample was questionable, and three items misfit the Rasch model. Replication with a larger sample is needed to ensure the measure's psychometric quality for diagnostic use.


Rasch model, COMM, opioid use

Full Text:



Gaskin DJ, Richard P: The economic costs of pain in the United States. J Pain. 2012; 13(8): 715-724.

Katz NP, Mou J, Paillard FC, et al.: Predictors of response in patients with post-therapeutic neuralgia and HIV-associated neuropathy treated with the 8% capsaicin patch (Qutenza). Clin J Pain. 2015; 31(10): 859-866.

Vaisy M, Gizzi L, Petzke F, et al.: Measurement of lumbar spine functional movement in low back pain. Clin J Pain. 2015; 31(10): 876-885.

Wawrzyniak KM, Sabo A, McDonald A, et al.: Root cause analysis of prescription opioid overdoses. J Opioid Manage. 2015; 11(2): 127-137.

Calabresi M: The price of relief: Why America can't kick its painkiller problem. Time. 2015; 185(22): 26-33.

Garland EL, Manusov EG, Froeliger B, et al.: Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: Results from an early-stage randomized controlled trial. J Consult Clin Psychol. 2014; 82: 448-459.

Paulozzi LJ, Kilbourne EM, Shah NG, et al.: A history of being prescribed controlled substances and risk of drug overdose death. Pain Med. 2012; 13(1): 87-95.

Jaret P: When pain kills. Opioid prescription pain medication addiction overdoses – AARP. (2015, September). Available at Accessed March 5, 2016.

Butler SF, Budman SH, Fernandez KC, et al.: Development and validation of the Current Opioid Misuse Measure. Pain. 2007; 130: 144-156.

Finkelman MD, Kulich RJ, Zoukhri D, et al.: Shortening the Current Opioid Misuse Measure via computer-based testing: A retrospective proof-of-concept study. BMC Med Res Methodol. 2013; 13(1): 1.

Linacre JM: A user's guide to Winsteps: Rasch-model computer programs. 2016. Chicago: MESA Press.

Bond T, Fox CM: Applying the Rasch model: Fundamental measurement in the human sciences. 2015. New York, NY: Routledge.

Linacre JM: When to stop removing items and persons in Rasch misfit analysis? Rasch Measure Transact. 2010; 23(4): 1241.

Linacre JM: Optimizing rating scale effectiveness. J Appl Measure. 2002; 3: 85-106.

Nicholas MK: Mental disorders in people with chronic pain: An international perspective. J Pain. 2007; 129: 231-232.

Kroenke K, Spitzer MD, Williams DW: The PHQ-Validity of a brief depression severity measure. J Gen Intern Med. 2001; 16: 606-613.

Compton P, Darakjian J, Miotto K: Screening for addiction in patients with chronic pain and “problematic” substance use: Evaluation of a pilot assessment tool. J Pain Symptom Manage. 1998; 16(6): 355-363.

Passik SD, Kirsh KL, Whitcomb L, et al.: A new tool to assess and document pain outcomes in chronic pain patients receiving opioid therapy. Clin Therap. 2004; 26(4): 552-561.

Adams LL, Gatchel RJ, Robinson RC, et al.: Development of a self-report screening instrument for assessing potential opioid medication misuse in chronic pain patients. J Pain Symptom Manage. 2004; 27(5): 440-459.

Chou R, Fanciullo GJ, Fine PG, et al.: Opioids for chronic noncancer pain: Prediction and identification of aberrant drug-related behaviors: A review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009; 10(2): 131-146.

Meltzer EC, Rybin D, Saitz R, et al.: Identifying prescription opioid use disorder in primary care: Diagnostic characteristics of the Current Opioid Misuse Measure (COMM). Pain. 2011; 152: 397-402.

Asghari A, Nicholas MK: Pain self-efficacy beliefs and pain behavior: A prospective study. J Pain. 2001; 94: 85-100.

Michna E, Ross EL, Hynes WL, et al.: Predicting aberrant drug behavior in patients treated for chronic pain: Importance of abuse history. J Pain Symptom Manage. 2004; 28: 250-258.

Sullivan MJL: The Pain Catastrophizing Scale User Manual. Departments of Psychology, Medicine, and Neurology School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, 2009.



  • There are currently no refbacks.