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People who live with chronic severe pain sometimes are prescribed narcotic medications. Their doctors, usually specialists in pain management who realize that narcotics can be addictive, require these patients to sign a pain management agreement, sometimes called a pain treatment agreement or a contract. The agreement is printed on a piece of paper that spells out exactly what is expected of the patient while he is under his doctor’s care and taking these prescriptions. The patient who agrees to sign the form is expected to adhere to a list of rules related to narcotic use. This list can include an agreement to undergo urine testing at the doctor’s request.
Usually a pain management agreement says the patient cannot receive prescriptions for narcotic medications from any other physician. The patient is expected to store these dangerous medications in a safe location, and to fill prescriptions at a single pharmacy. The agreement also states the doctor will not write a replacement prescription for one that is stolen unless a valid police report outlining the theft is provided by the patient, and the doctor will not write a new prescription for one that is reported lost.
A pain management agreement could also require a patient to refrain from imbibing alcohol or taking illegal drugs without the physician’s consent. The agreement holds the patient responsible for keeping track of his medications and their refill dates so that he does not run out and enter into a state of withdrawal. The patient also agrees in writing to not share his medication with other people. The agreement typically also specifies the various terms under which a doctor can terminate the agreement, usually for noncompliance with the contract’s terms.
Some doctors and patients appreciate the formality of a pain management agreement, but others do not. Such a document is a record of expectations and a means of communication. Both sides — doctor and patient — are aware of what is expected from the patient, leaving no room for misunderstandings because the rules are spelled out in writing. The patient keeps a copy for his records, and the doctor retains a copy signed by the patient on file. Some doctors, however, do not use a pain management agreement in their practices because they feel it places an unnecessary wall between them and their pain patients, hindering open communication. Some patients and doctors also dislike the pain management agreement because they feel it fosters an atmosphere of suspicion between two parties who should be working together for the patient’s benefit. Some people dislike these types of agreements because they see them solely as a way for physicians to limit responsibility and keep from running afoul of government regulations.