The correct answer is:

 history of depression

Educational Objective:

Identify the factors which are associated with an increased risk of opioid misuse disorder .

Key Point:

The strongest predictive factors for the risk of developing opioid misuse disorder are a personal or family history of substance misuse, a history of sexual abuse in females, and psychiatric comorbidity.

Explanation:

The strongest predictive factor for the risk of developing opioid misuse disorder are a personal or family history of substance misuse. Other predictive factors include a history of preadolescent sexual abuse in females, and psychiatric comorbidity.

The opioid risk tool includes depression, ADD, schizophrenia, bipolar disorder, and obsessive compulsive disorder as psychiatric conditions that raise the risk for substance misuse.

Citalopram itself does not affect opioid.

This patient’s chronic kidney disease does not increase the risk of an opioid misuse disorder, it does increase the risk of accidental overdose due to a decreased ability to metabolize and excrete the drug.

Being a former smoker does not affect current risk for an opioid misuse disorder.

References :

Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the opioid risk tool. Pain Medicine 2005; 6(6):432-442

Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recomm Rep. 2016;65(1):1-49.