Table of ContentsView AllTable of ContentsDefinitionAgreement DetailsMajor ConcernsPrecautionary Measures
Table of ContentsView All
View All
Table of Contents
Definition
Agreement Details
Major Concerns
Precautionary Measures
If you struggle with chronic pain, you may have been prescribed anopioid medication. It is also likely that you have been asked to sign a pain management agreement or opioid treatment agreement. These agreements are commonly known as “opioid contracts” or “pain contracts.” If this is the case, it is important that you understand what is being asked of you before you sign the contract.
What Is a Pain Management Agreement?
A pain medication agreement is a contract between a doctor and a patient. The goal of the agreement is to ensure that patients who are taking opioid drugs do so exactly as theirdoctor has prescribed.
In theory, these agreements are not only designed to protect the patient fromdrug abuse, but they also protect the doctor in case thepatient abuses the medicationin some way.
Pain Management Agreement Details
Although the details of every agreement vary from doctor to doctor, there are a number of elements that are consistent throughout. Here is an overview of the top five things you need to know about pain management agreements before you sign your name. If you cannot agree to these basic elements, then a pain management agreement may not be right for you.
Take Medication As Prescribed
You must agree to take the medication exactly as prescribed.What this means is that you must take the exact amount prescribed at the exact time intervals or risk being terminated from the agreement. So, even if you feel like you do not need to take your pain medication one day, you still must take it. You cannot decrease your intake or save meds on a low-pain day to take later on a high-pain day.
Likewise, if you feel that youneed more pain medicationon a given day, you have to be willing to do without the extra dose unless your doctor writes a new prescription. Do not, under any circumstances, change the dosage on your own.
Many doctors do drug testing and if they find you have too much in your system, they may assume you are abusing the drugs. Likewise, if you have too little of the drug in your system, they may think you are selling the medication or giving it to someone else.
Drug Testing Is Permitted
You must agree to random drug testing. This stipulation is usually part of the agreement because doctors want to ensure you are not abusing the drugs. They also want to be sure you are the only one using the medication. As a result, they randomly test you and then measure how much of the drug is in your system.
Remember, because prescription drug abuse is so prevalent today, doctors have to be extra careful. It’s not that they do not trust you or think that you are misusing your medication.
Doctors could lose their medical licenses and face criminal prosecution if they prescribe controlled substances to people abusing or selling them to others. As a result, these agreements are designed to protect them.
What’s more, pain management agreements typically require you to keep all your scheduled appointments and only allow for one or two cancellations before terminating you as a patient. They make this stipulation to keep patients from canceling because they fear the drug test will reveal that they are not taking their medications as prescribed.
Only One Pharmacy Is Allowed
You agree to get all your prescriptions filled at one pharmacy, and you agree to allow the doctor and pharmacist to share information about you. When people abuse drugs, they often try to get prescriptions from multiple doctors and then fill them at different pharmacies.
Because prescriptions are now entered into computers often with interconnected databases, this practice is currently much more difficult to get away with. Consequently, if you sign an agreement with your physician, be sure you only shop at one pharmacy.
No Replacement Medication
You agree that lost, stolen or destroyed medications will not be replaced. If this stipulation is part of your pain management contract, be sure you safeguard your medications at all times.
Make sure no one else has access to your medications. Ideally, opioid medications should be kept under lock and key.
There are some agreements that allow a doctor to use his own discretion if your medication is stolen and you file a police report. But remember, he usually is not required to replace the stolen medication. So you will be forced to do without pain medication until your prescription can be renewed.
Prescriptions Come From One Provider
You agree not to request nor take pain medications from other healthcare providers. Even if you visit the dentist or the emergency room, these doctors cannot prescribe pain medications for you. And, if they do, you will be violating your pain management agreement.
Only your pain management doctor can prescribe pain medications. And pain management contracts typically require you to make all other healthcare providers aware of your agreement.
Major Concerns of Pain Management Contracts
Generally, doctors who use these contracts say they are an effective way to let patients know what to expect while under their care. They also believe the contracts let patients know how to use the medications safely, including how to store them at home. But critics of the agreements worry that the contracts undermine the patient-doctor relationship.
For instance, they are concerned that the contracts put those suffering from chronic pain at the provider’s mercy. They maintain that those with chronic pain are already vulnerable and that the agreement shifts the balance of power in favor of the doctor, leaving the patient disempowered and at risk.
Another concern is that the contracts are often worded in a way that is offensive to patients, which in turn creates animosity between the doctor and the patient. Meanwhile, some patients feel as though they were treated like they have a drug addiction despite the fact that they have always used their medications responsibly.
Precautionary Measures for Pain Management Agreements
For instance, if you do not follow the agreement or do something that is forbidden, your doctor may refuse to prescribe any additional pain medications for you. You also could be dismissed as a patient.
If you are dismissed, finding another doctor to take you as a patient and treat your condition can be much harder.
Be sure you carefully read every word of the agreement before you sign it. Ask questions about anything that is unclear to you. Then, think about whether or not signing the agreement is the best option for you. And if you do agree to sign the contract, make sure you follow it word for word. You don’t want to find yourself in a situation where you can no longer get pain medications for your condition.
2 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Center for Practical Bioethics, PAINS Project.“Opioid Treatment Agreements or Contracts: Proceed with Caution.“Issue 4; Spring 2014.Rager JB, Schwartz PH.Defending opioid treatment agreements: Disclosure, not promises.Hastings Cent Rep. 2017;47(3):24-33. doi:10.1002/hast.702Additional Reading
2 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Center for Practical Bioethics, PAINS Project.“Opioid Treatment Agreements or Contracts: Proceed with Caution.“Issue 4; Spring 2014.Rager JB, Schwartz PH.Defending opioid treatment agreements: Disclosure, not promises.Hastings Cent Rep. 2017;47(3):24-33. doi:10.1002/hast.702Additional Reading
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Center for Practical Bioethics, PAINS Project.“Opioid Treatment Agreements or Contracts: Proceed with Caution.“Issue 4; Spring 2014.Rager JB, Schwartz PH.Defending opioid treatment agreements: Disclosure, not promises.Hastings Cent Rep. 2017;47(3):24-33. doi:10.1002/hast.702
Center for Practical Bioethics, PAINS Project.“Opioid Treatment Agreements or Contracts: Proceed with Caution.“Issue 4; Spring 2014.
Rager JB, Schwartz PH.Defending opioid treatment agreements: Disclosure, not promises.Hastings Cent Rep. 2017;47(3):24-33. doi:10.1002/hast.702
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