Opioid misuse in Canada and critical appraisal of aberrant behavior screening tools

Table 3 Risk factors associated with opioid misuse[8,23,24,26,27,37]

Non-modifiable risk factors	Age: Younger age (inverse risk relationship)
	Gender:
	Males (caucasian)
	Women misuse due to emotional issues versus men who misuse due to legal/behavioral issues
	Genetics:
	Family history of substance use disorder(s)
	Variations in OPRM1
	PENK gene polymorphisms
Reported pain severity/type of pain	Multiple pain complaints
	Chronic back pain
	Report greater degree of pain-related limitations
Comorbid psychological factors	History of substance use (cannabis, alcohol and other illicit drugs especially)
	Concomitant mood disorder, depression and/or anxiety
	Multiple psychosocial stressors
	Interpersonal problems with coworkers/family/friends
	History of risk-taking or thrill-seeking behavior
	Frequent contact with high-risk individuals or environments
Drug-related factors	Self-reported craving
	High daily doses (≥ 120 mg morphine equivalents per day)
	Use of short-acting opioids

OPRM1: μ-opioid receptor gene 1; PENK: Pre-proenkephalin.