title: Development of an opioid-related Overdose Risk Behavior Scale (ORBS).
abstract: Drug overdose has emerged as the leading cause of injury-related death in the United States, driven by prescription opioid (PO) misuse, polysubstance use, and use of heroin. To better understand opioid-related overdose risks that may change over time and across populations, there is a need for a more comprehensive assessment of related risk behaviors. Drawing on existing research, formative interviews, and discussions with community and scientific advisors an opioid-related Overdose Risk Behavior Scale (ORBS) was developed.
  
  
  
  Military veterans reporting any use of heroin or POs in the past month were enrolled using venue-based and chain referral recruitment. The final scale consisted of 25 items grouped into 5 subscales eliciting the number of days in the past 30 during which the participant engaged in each behavior. Internal reliability, test-retest reliability and criterion validity were assessed using Cronbach's alpha, intraclass correlations (ICC) and Pearson's correlations with indicators of having overdosed during the past 30 days, respectivelyInternal reliability, test-retest reliability and criterion validity were assessed using Cronbach's alpha, intraclass correlations (ICC) and Pearson's correlations with indicators of having overdosed during the past 30 days, respectively.
  
  
  
  Data for 220 veterans were analyzed. The 5 subscales-(A) Adherence to Opioid Dosage and Therapeutic Purposes; (B) Alternative Methods of Opioid Administration; (C) Solitary Opioid Use; (D) Use of Nonprescribed Overdose-associated Drugs; and (E) Concurrent Use of POs, Other Psychoactive Drugs and Alcohol-generally showed good internal reliability (alpha range = 0.61 to 0.88), test-retest reliability (ICC range = 0.81 to 0.90), and criterion validity (r range = 0.22 to 0.66). The subscales were internally consistent with each other (alpha = 0.84). The scale mean had an ICC value of 0.99, and correlations with validators ranged from 0.44 to 0.56.
  
  
  
  These results constitute preliminary evidence for the reliability and validity of the new scale. If further validated, it could help improve overdose prevention and response research and could help improve the precision of overdose education and prevention efforts.
authors.affiliation: a National Development and Research Institutes, Inc. , New York , New York , USA.
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Pouget
authors.affiliation: a National Development and Research Institutes, Inc. , New York , New York , USA.
authors.forename: Alex S
authors.initials: AS
authors.lastname: Bennett
authors.affiliation: a National Development and Research Institutes, Inc. , New York , New York , USA.
authors.forename: Luther
authors.initials: L
authors.lastname: Elliott
authors.affiliation: a National Development and Research Institutes, Inc. , New York , New York , USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Wolfson-Stofko
authors.affiliation: a National Development and Research Institutes, Inc. , New York , New York , USA.
authors.forename: Ramona
authors.initials: R
authors.lastname: Almeñana
authors.affiliation: b Canandaigua VA Medical Center, Center of Excellence for Suicide Prevention , Canandaigua , New York , USA.|c Department of Psychiatry , University of Rochester Medical Center , Rochester , New York , USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Britton
authors.affiliation: a National Development and Research Institutes, Inc. , New York , New York , USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenblum
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D062787:Drug Overdose / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000523:psychology*; D063487:Prescription Drug Misuse / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D015203:Reproducibility of Results; D012309:Risk-Taking; D014728:Veterans / Q000523:psychology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Drug use; opioids; overdose; risk behavior