Von Korff M, Saunders K, et al. De facto long-term opioid therapy for noncancer pain. Clin J Pain. 2008;24(6):521-7.

Dunn KM, Saunders KW, Rutter CM, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152(2):85-92.

Centers for Disease Control and Prevention. CDC grand rounds: prescription drug overdoses - a U.S. epidemic. 2012;61(01):10-13.

Fudin J, Raouf M, Wegrzyn EL, Schatman ME. Safety concerns with the Centers for Disease Control opioid calculator. J Pain Res. 2018;11:1-4.

OTHER

//define vars
var calc_output = [];
var drug = parseFloat(drug);
var amount = parseFloat(amount) || 1;
var amount2 = parseFloat(amount2) || 1;
var amount3 = parseFloat(amount3) || 1;
var dosage_1 = parseFloat(dosage_1) || 0;
var dosage_2 = parseFloat(dosage_2) || 0;
var dosage_3 = parseFloat(dosage_3) || 0;
var dosage2_1 = parseFloat(dosage2_1) || 0;
var dosage2_2 = parseFloat(dosage2_2) || 0;
var dosage2_3 = parseFloat(dosage2_3) || 0;
var dosage3_1 = parseFloat(dosage3_1) || 0;
var dosage3_2 = parseFloat(dosage3_2) || 0;
var dosage3_3 = parseFloat(dosage3_3) || 0;
var add1 = parseFloat(add1) || 0;
var add2 = parseFloat(add2) || 0;
var drug2 = parseFloat(drug2) || 0;
var drug3 = parseFloat(drug3) || 0;
var dosage;

if (drug == 1) {
 dosage = dosage_3;
} else if (drug == 10) {
 dosage = dosage_2;
} else {
 dosage = dosage_1;
}

var dosage2;

if (drug2 == 1) {
 dosage2 = dosage2_3;
} else if (drug2 == 10) {
 dosage2 = dosage2_2;
} else {
 dosage2 = dosage2_1;
}

var dosage3;

if (drug3 == 1) {
 dosage3 = dosage3_3;
} else if (drug3 == 10) {
 dosage3 = dosage3_2;
} else {
 dosage3 = dosage3_1;
}

var names = ['codeine',
'fentanyl patch',
'hydrocodone',
'hydromorphone',
'methadone',
'morphine',
'oxycodone',
'oxymorphone',
'tramadol',
'tapentadol',
'fentanyl buccal or sublingual tablets'];


var conversion = [0.15,
2.4,
1,
5,
4.7,
1,
1.5,
3,
0.2,
0.4,
0.13];

var convert = conversion[drug];
var convert2 = conversion[drug2];
var convert3 = conversion[drug3];
 
//calculation
var mme = dosage*amount*convert + dosage2*amount2*convert2 + dosage3*amount3*convert3;

var rec;

if (mme > 0 && mme < 20) {
 rec = ' Acceptable therapeutic range for acute pain and opioid-naïve patients';
} else if (mme >= 20 && mme < 50) {
 rec = ' 2x higher risk of overdose than <20 MME/day; there is no completely safe opioid dose; use caution when prescribing opioids at any dose and always prescribe the lowest effective dose';
} else if (mme >= 50 && mme < 100) {
 rec = ' 3.7x higher risk of overdose; strongly consider non-opioid analgesics and decreasing daily opioid dose';
} else if (mme >= 100) {
 rec = ' 8.9x higher risk of overdose; consult pain specialist to reassess pain regimen and decrease dosage and/or wean off opioids';
}

if (drug == 10) {
 unit1 = 'mcg';
} else if (drug == 1) {
 unit1 = 'mcg/hr';
} else {
 unit1 = 'mg';
}
if (drug2 == 10) {
 unit2 = 'mcg';
} else if (drug2 == 1) {
 unit2 = 'mcg/hr';
} else {
 unit2 = 'mg';
}
if (drug3 == 10) {
 unit3 = 'mcg';
} else if (drug3 == 1) {
 unit3 = 'mcg/hr';
} else {
 unit3 = 'mg';
}
var i, f, g;

if(add1 == 0) {
 i = dosage*amount;
 i = i.toFixed(1);
 var breakdown = i + ' ' + unit1 + ' ' + names[drug];
} else if (add1 == 1 && add2 == 0) {
 i = dosage*amount;
 i = i.toFixed(1);
 f = dosage2*amount2;
 f = f.toFixed(1);
 var breakdown = i + ' ' + unit1 + ' ' + names[drug] + ' ' + f + ' ' + unit2 + ' ' + names[drug2];
} else if (add1 == 1 && add2 == 1) {
 i = dosage*amount;
 i = i.toFixed(1);
 f = dosage2*amount2;
 f = f.toFixed(1); 
 g = dosage3*amount3;
 g = g.toFixed(1); 
 var breakdown = i + ' ' + unit1 + ' ' + names[drug] + ' ' + f + ' ' + unit2 + ' ' + names[drug2] + ' ' + g + ' ' + unit3 + ' ' + names[drug3];
}

//results
calc_output.push({
 name: 'mini',
 value: mme.toFixed(1),
 value_text: '',
 message: 'MME/day'
});
calc_output.push({
 name: '10170_MME_result (per day)',
 value: mme.toFixed(1),
 value_text: '',
 message: 'MME/day' + rec
});
calc_output.push({
 name: '10170_MME_result (list)',
 value: '',
 value_text: '',
 message: 'Drug(s): ' + breakdown
});

Morphine Milligram Equivalents (MME) Calculator

drug

dosage_1

dosage_2

dosage_3

amount

add1

drug2

dosage2_1

dosage2_2

dosage2_3

amount2

add2

drug3

dosage3_1

dosage3_2

dosage3_3

amount3

Calculates total daily morphine milligram equivalents.

Morphine Milligram Equivalents

Sergey Motov, MD

The Morphine Milligram Equivalents (MME) Calculator calculates total daily morphine milligram equivalents.

Dosage

mcg_mme

doses per day

DIRE Score

Benzodiazepine Conversion Calculator

Opioid Risk Tool (ORT)

EB Medicine is the premier provider of evidence-based clinical content and CME resources for emergency medicine practitioners.

Listen to the VACO co-creators break down how to use VACO\, what it does\, and what it doesn’t.

Calc Function