Opioid Agreements
Opioid Agreements (no longer “contracts”) are documents negotiated between patients and their healthcare providers, and are usually associated with the prescription of opioids. While usually between healthcare provider and patient, agreements may be used to clarify the roles and responsibilities of all parties in the management of pain. Opioid agreements spell out the requirements for the patient when prescribed controlled substances, and often state that patients must provide urine specimens on demand, submit to pill counts, participate in all aspects of care, keep scheduled appointments, refrain from obtaining medicine from anyone else, and use only “on pharmacy.” The agreement may also involve any other relevant aspect of care described as part of general “Universal Precautions” for pain management. These agreements may be written to be educational and provide a common framework or they may be written in stronger language intended to establish warnings and guardrails. In the past, opioid agreements were called opioid contracts, but after a legal decision against a pain practitioner who gave a rule-breaking patient one more chance (the patient died from an overdose and the physician successfully sued for breech of contract), most have now abandoned pain and/or opioid contracts for “agreements.” There is no legal standing for agreements, so they cannot be used against practitioners in legal actions. Many examples of opioid agreements are available on the internet.