RIOSORD Opioid Overdose Risk Index (Veterans and Commercial Versions)
RIOSORD score and risk class for opioid overdose or serious respiratory depression.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Version
- Veterans (VHA), 2015
- Opioid dependence (veterans) or substance use disorder (commercial) visit
- No
- Chronic hepatitis or cirrhosis
- No
- Bipolar disorder or schizophrenia
- No
- Chronic pulmonary disease
- Yes
- Kidney disease with clinically significant renal impairment
- No
- An active traumatic injury, excluding burns
- No
- Sleep apnea
- Yes
- An extended-release or long-acting opioid product
- Yes
- Methadone
- No
The other 6 values
- Oxycodone
- Yes
- A prescription antidepressant
- Yes
- A prescription benzodiazepine
- Yes
- One or more emergency department visits in the past 6 months
- Yes
- Hospitalized for one or more days in the past 6 months
- No
- Maximum prescribed opioid dose
- 60 MME/day
Result: RIOSORD 51 of 115: risk class 7 of 10 (50 to 54 points), average predicted probability 64% over 6 months in the study sample.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Version
- Opioid dependence (veterans) or substance use disorder (commercial) visit
- Chronic hepatitis or cirrhosis (veterans version)
- Bipolar disorder or schizophrenia
- Chronic pulmonary disease
- Kidney disease with clinically significant renal impairment
- An active traumatic injury, excluding burns (veterans version)
- Sleep apnea (veterans version)
- Stroke or other cerebrovascular disease (commercial version)
- Heart failure (commercial version)
The other 13 fields
- Nonmalignant pancreatic disease (commercial version)
- Recurrent headache (commercial version)
- An extended-release or long-acting opioid product (counted once)
- Methadone
- Oxycodone (veterans version)
- Fentanyl (commercial version)
- Morphine (commercial version)
- Hydromorphone (commercial version)
- A prescription antidepressant
- A prescription benzodiazepine
- One or more emergency department visits in the past 6 months (veterans version)
- Hospitalized for one or more days in the past 6 months (veterans version)
- Maximum prescribed opioid dose
How this is calculated
Citation
Zedler B, Xie L, Wang L, et al. Pain Med 2015;16(8):1566-1579, Tables 3 and 4 (veterans). Zedler BK, Saunders WB, Joyce AR, Vick CC, Murrelle EL. Pain Med 2018;19(1):68-78, Tables 3 and 4 (commercially insured). Read the sources: Zedler 2015 (veterans) ↗, Zedler 2018 (commercial) ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.