# DIRE > Clinical tool for opioid prescribing risk assessment in chronic pain. (iPhone/iPad app by Riemenrade Studios LLC.) - Source: https://appshunter.io/ios/app/dire/id1188944849 (this page in markdown: same URL + `.md`) - Developer: [Riemenrade Studios LLC](https://appshunter.io/developer/801028125) - Category: Medical, Utilities - Price: Free - Rating: 5.00/5 from 1 App Store ratings · 3 written reviews indexed - Age rating: 17+ - Requires: iOS 12.0 · 8 MB - Languages: English - Released: 2017-01-17 - Data updated: 2026-06-03 - Monetization: free - User reviews in markdown: https://appshunter.io/ios/app/dire/id1188944849/reviews.md ## What is DIRE? The DIRE Score is a tool that can be used to aid clinicians in their decision-making process when considering prescribing opioids for chronic non-malignant pain. Using the DIRE Score, the clinician rates seven factors each on a scale of 1, 2 or 3 with 1 being the least favorable or highest risk for prescribing opioids and 3 being the most compelling or lowest risk for prescribing. The seven DIRE factors are: Diagnosis, Intractability, Risk (there are four risk factors—psychological and chemical health, patient reliability and social support/life roles) and Efficacy. Adding the scores for these seven factors gives a total of 7 – 21. A score of 7-13 was predictive of a low probability of success when prescribing opioids; whereas a score of 14-21 was more likely to be associated with a successful prescribing process and outcome. The DIRE Score does not take into account medical risk factors for opioid prescribing such as comorbid medical conditions (chronic obstructive lung disease, sleep apnea, concomitant use of benzodiazepines, etc.). The clinician should understand that active use of illicit drugs, drug diversion and other aberrant behaviors is incompatible with ongoing opioid prescribing no matter what the DIRE Score may be. The DIRE Score is not meant to be a substitute for sound clinical judgment in the context of any individual patient. This App is meant for informational use only, and is not intended to aid in the diagnosis, treatment or prevention of disease. Decisions about prescribing are solely the responsibility of the licensed prescriber. ## Key features - Opioid prescribing risk assessment - Seven-factor scoring system - Chronic non-malignant pain focus - Decision-making aid for clinicians - Risk vs. success prediction ## Recent user reviews (3 of 3) All indexed reviews: https://appshunter.io/ios/app/dire/id1188944849/reviews.md ### 5/5 — Simple and to the point *2017-01-28* Great app. Very useful . ### 5/5 — Great tool *2017-01-28* This is a great app. It's easy to use and intuitive. Really helps as a guideline when considering opioids. And it's the only tool that isn't a a self report questionnaire filled out by patients, so the kind of bias in that sort of tool just isn't there. ### 5/5 — Easy to use opioid screening tool! *2017-01-18* I have used the DIRE Score and taught about it for years. This app makes it simple, intuitive and lightening fast to calculate a score for patients you know. It is as handy as your phone. I love the red yellow and green buttons that, like traffic signals, guide the clinicians' go no-go decision about long-term prescribing. ## Frequently asked questions about DIRE ### What is the DIRE Score used for? The DIRE Score is a tool designed to help clinicians make informed decisions when considering prescribing opioids for patients with chronic non-malignant pain. It assesses seven factors to predict the likelihood of success with opioid therapy. ### How does the DIRE Score work? The app guides clinicians to rate seven factors (Diagnosis, Intractability, Risk, and Efficacy) on a scale of 1 to 3. The total score ranges from 7 to 21, with lower scores indicating a higher risk and higher scores suggesting a greater likelihood of successful prescribing. ### Does DIRE consider all medical risk factors for opioid prescribing? No, the DIRE Score does not account for all medical risk factors such as comorbid conditions like COPD or sleep apnea, nor does it directly address active illicit drug use or aberrant behaviors. Clinicians must use their professional judgment. ### Is DIRE a substitute for clinical judgment? No, the app explicitly states it is not a substitute for sound clinical judgment. It is intended for informational use only and decisions about prescribing remain solely the responsibility of the licensed prescriber. ### What devices is DIRE available on? DIRE is supported on iPhone, iPad, and iPod devices. It was released on January 17, 2017, and its latest version is 1.2, last updated on March 31, 2022. ### What is the age rating for DIRE? DIRE has an age rating of 12+, indicating it is suitable for users aged 12 and older. This rating is based on its content and intended use within a medical context. ### Does DIRE have ads? DIRE does not contain advertisements. As a free application, it focuses on providing its clinical tool without interruption from promotional content. ### What is the user rating for DIRE? DIRE has a perfect rating of 5.0 stars, based on one user review. This indicates a highly positive reception from its initial users. ## Version history (last 4 releases) ### 1.3 — 2026-05-28 No change to functionality - new version to maintain App Store relevance ### 1.2 — 2022-03-31 Updates for iOS 15 Thank you for supporting DIRE! ### 1.1 — 2017-02-24 This app has been updated by Apple to display the Apple Watch app icon. Added a confirmation screen to initial Terms and Conditions ### 1.0 — 2017-01-17 No release notes. ## Apps similar to DIRE | App | Rating | Price | Category | | --- | --- | --- | --- | | [Case Files: Geriatrics](https://appshunter.io/ios/app/case-files-geriatrics/id866926025) | — | Free | Medical | | [Adult Gerontology Guidelines](https://appshunter.io/ios/app/adult-gerontology-guidelines/id1555638493) | 5.0 (3) | Free | Medical | | [AGS GEMS](https://appshunter.io/ios/app/ags-gems/id1093131635) | 4.7 (13) | Free | Medical | | [EWSfai](https://appshunter.io/ios/app/ewsfai/id6504622929) | — | Free | Medical | | [AMI Facial Anatomy for iPads](https://appshunter.io/ios/app/ami-facial-anatomy-for-ipads/id1592258505) | — | Free | Medical | | [Pain Scored](https://appshunter.io/ios/app/pain-scored/id1397046102) | 4.1 (10) | Free | Medical | ## Related topics [riemenrade studios llc](https://appshunter.io/ios/topics/riemenrade-studios-llc) --- *Data collected daily from the US App Store and indexed by [AppsHunter](https://appshunter.io/). User reviews are verbatim App Store reviews. Ratings, prices and chart positions refresh continuously; this snapshot is from 2026-06-03.*