What is langcare-opioid-risk?

A clinical safety review for opioid prescriptions that calculates total opioid dose, checks other medicines and risk factors, and compares the results with CDC guidance.

Use it to calculate morphine milligram equivalents, apply the Opioid Risk Tool, check urine tests and pain assessments, and review naloxone and guideline thresholds.

It helps identify higher-risk prescribing patterns, such as high daily opioid doses, opioid and benzodiazepine combinations, or missing naloxone.

langcare-opioid-risk — Skill for Claude Code and Codex by langcare

Install

Getting it into your agent

One page per mod, every tool's command on it. A separate URL per tool would split the same page into five that compete with each other.

Any agent

npx skills add langcare/langcare-mcp-fhir --skill opioid-risk

Clone the repo

git clone --depth 1 https://github.com/langcare/langcare-mcp-fhir

Made for: Claude Code, Codex.

Wrote this? Show the measurements

A badge with what this costs and how it scanned, read live from this page, so it follows the numbers instead of freezing them. Markdown for a README, HTML for a documentation site or a project page.

README.md

[![agentmods](https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/opioid-risk/github.svg)](https://agentmods.dev/skills/langcare/langcare-mcp-fhir/opioid-risk)

Your own site

<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/opioid-risk"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/opioid-risk/github.svg" alt="Measured on agentmods" height="20"></a>

Or the 80×15 button, for a site that already has a row of RSS and ATOM ones. Only the verdict fits; the numbers stay here.

Your own site · 80×15

<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/opioid-risk"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/opioid-risk.svg" alt="Reviewed on agentmods" width="80" height="20"></a>

Per session 79 Skills are progressive disclosure: only the name and description are preloaded; the body loads when the skill is used.

When invoked 800 The whole file, excluding the scripts and references it only reads on demand.

Security scan A 0 findings. A grade says what 26 rules found in the file — not that it is safe.

Origin original No closer match found in the catalogue.

Token cost

What it costs to keep this loaded

Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.

Model	Per session	Once invoked
Fable 5.1	$0.00079	$0.00800
Opus 5.5	$0.00032	$0.00320
Sonnet 5.5	$0.00016	$0.00160
Haiku 4.5	$0.00008	$0.00080

Measured 2mo ago against content hash cbe9a169b641, method: parsed. Prices are Anthropic first-party input rates as of 2026-10-07, from the pricing page.

Security

Grade A, and why

langcare-opioid-risk scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 2mo ago.

A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.

Nothing flagged

None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.

cma/skills/medication-management/opioid-risk/SKILL.md · 67 lines

How it starts

The opening of the file, as written. The whole thing — 67 lines — stays where its author put it; the contents beside it link to each section on GitHub.

Opioid Risk Assessment

When to Use This Skill

Use when a clinician needs to evaluate opioid prescribing safety including total daily MME calculation, concurrent CNS depressant screening, ORT scoring, and CDC guideline compliance.

Clinical Workflow

Use fhir_read to retrieve Patient demographics (age, gender for ORT scoring)
Use fhir_search to pull all active MedicationRequest resources; classify as opioids, benzodiazepines, gabapentinoids, muscle relaxants, Z-drugs, naloxone
Calculate total daily MME for each opioid using dose x frequency x MME conversion factor (see references/mme-conversion-table.md)
Evaluate against CDC 2022 thresholds: <20 lower risk, 20-49 moderate, 50-89 caution, >=90 high risk
Use fhir_search to pull Condition resources for ORT scoring: substance use history, psychiatric diagnoses
Apply Opioid Risk Tool scoring (gender-specific criteria)
Use fhir_search to check for recent urine drug screen (LOINC 19295-5) and pain assessments (LOINC 72514-3)
Assess naloxone co-prescription status; recommend if MME >= 50 or concurrent CNS depressants

FHIR Resources

MedicationRequest -- Active opioid and concurrent prescriptions with dosing details
MedicationDispense -- Fill history for pattern analysis
Patient -- Age and gender for ORT scoring
Condition -- Psychiatric diagnoses, substance use history for ORT
Observation -- Urine drug screen results, pain scores

FHIR Query Examples

Pull Active Medications

fhir_search(resourceType="MedicationRequest", queryParams="patient=[patient-id]&status=active&_count=100")

Pull Substance Use History

fhir_search(resourceType="Condition", queryParams="patient=[patient-id]&_count=100")

Pull Urine Drug Screen

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&code=19295-5,3426-4&_sort=-date&_count=5")

Clinical Guidelines

CDC 2022 Clinical Practice Guideline for Prescribing Opioids for Pain
FDA REMS for extended-release/long-acting opioids
PDMP (Prescription Drug Monitoring Program) check recommended before each opioid prescription

Read the full file on GitHub · 67 lines

Files

What ships with it

1 file beside SKILL.md in the same directory: the scripts, references and assets a skill reads on demand. Not counted in the per-session cost; read them before you install if any of them is executable.

references/mme-conversion-table.md 4.0 KB

Changes

What this file has done since we first saw it

Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.

2mo ago First seen · 67 lines · 79 tokens per session scan A cbe9a169b641

Subscribe to this mod's changes

langcare-opioid-risk is a skill published in the GitHub repository langcare/langcare-mcp-fhir (71 stars, last pushed 6mo ago), licensed MIT. It adds 79 tokens to every session and 800 once invoked, about $0.0003 per session on Opus 5.5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-30.

langcare-opioid-risk next to 6 skills from other repositories
Mod	Type	Stars	Last push	Licence	Scan	Tokens	Works with
langcare-opioid-risklangcare/langcare-mcp-fhir	Skill	71	6mo ago	MIT	A	79	Claude Code, Codex
imagegenopenai/codex	Skill	133k	yesterday	Apache-2.0	A	113	Codex
playwright-climicrosoft/playwright	Skill	99k	yesterday	Apache-2.0	A	19	Claude Code
local-ai-agentsmicrosoft/ai-agents-for-beginners	Skill	79k	4d ago	MIT	A	200	Claude Code, Codex
systematic-debuggingobra/superpowers	Skill	313k	3d ago	MIT	A	21	Claude Code
next-cache-components-adoptionvercel/next.js	Skill	143k	yesterday	MIT	A	95	Claude Code
next-partial-prefetching-adoptionvercel/next.js	Skill	143k	yesterday	MIT	A	103	Claude Code