Risk Factors Opioid Toxicity in Patient Being Treated for Pain

Has the dose of the opioid been rapidly increased to relatively high doses?

Is the kidney the main route of excretion for the opioid or its significant metabolites?

Does the patient have a moderate to severe impairment in renal function?

Has the pain been poorly responsive to the opioid?

Has the patient just undergone a pain relieving intervention (nerve block, radiation therapy, etc)?

Has too large of an opioid dose been given because of a dose miscalculation?

Is the patient receiving the opioid through a drug infusion pump that is malfunctioning?