Are patient agreements helpful when initiating long-term opioid therapy?
A patient opioid-medication contract, sometimes called a controlled-substances agreement, is not required by federal regulations; yet, many pain management practitioners employ them for some or all patients receiving long-term opioid therapy. In a nationwide survey of more than 2,500 board-certified pain specialists, 85% reported using an opioid agreement (Breuer et al. 2006). Although the evidence favoring the efficacy of these agreements in curbing drug abuse is limited, proponents of patient agreements believe they can serve as a communication tool between physician and patient by clarifying the patient’s (and healthcare provider’s) responsibilities. Agreements seem to be most helpful in patients with a history of substance abuse, or if the healthcare provider determines that a patient is at high risk for medication abuse. Carefully worded patient agreements may help with the following: • explaining the goals of therapy; • educating patients and caregivers about benefits, side effec
