| Frequent unscheduled clinic visits or phone calls for refills |
| Self-escalation of opioid dose |
| Frequent emergency department visits for opioids |
| Edmonton Symptom Assessment Scale pain intensity 10 out of 10, with all other symptoms 0 out of 10 |
| Seeking opioids from multiple physicians ("doctor shopping") |
| Request for specific opioids |
| Reports of stolen/lost opioids |
| Family member expressing concern over the patient's opioid use |
| Obtaining opioids from nonmedical sources, stealing, selling |
| Requesting opioids for insomnia or anxiety |
| Abnormal urinary drug screen |
| Discrepancy in pill counts |
