Risk Management Tools & Resources

 

Put It in Writing: An Overview of Pain Management Contracts

Put It in Writing: An Overview of Pain Management Contracts

Healthcare providers who have patients that require pain medications as part of their treatment regimens might want to consider pain management contracts as a technique to improve patient adherence and address problematic patient behaviors. Part of practitioners' role in patient care includes setting standards and expectations for effective relationships. Pain management contracts are a tool that helps facilitate this process.

Pain contracts should be specific and directly related to the patient's pain management plan/program. Providers also might want to incorporate specific statements about behaviors to avoid. Below are examples of behavioral expectations that might be included in a pain contract:

  • I agree to abide by the terms of this contract. I understand that upon violation of the contract, my provider will stop prescribing me controlled-substance medications.
  • I agree to seek psychiatric treatment, psychotherapy, and/or psychological treatment if my provider deems it necessary.
  • I will not use any illegal controlled substances (e.g., marijuana, cocaine, etc.), and I will not misuse or self-prescribe/medicate with legal controlled substances.
  • I agree to take a drug test upon request.
  • I will bring all my unused medication to office visits.
  • I will not share my medication with anyone.
  • I will store my medication in a secure location to prevent it from being lost, stolen, or unintentionally used by others.
  • Replacement of stolen medications will be considered upon completion of a police report. OR — Lost or stolen medications will not be replaced.
  • I will not attempt to obtain any controlled medications — including opioid pain medications, controlled stimulants, or anti-anxiety medications — from any other provider.
  • I understand that my provider may contact community resources (e.g., pharmacies, law enforcement agencies, etc.) to ensure that I am complying with my medication treatment plan.

Other Pain Management Considerations

As part of pain management processes, healthcare providers also might want to:

  • Consider when they or their staff members are able to address refills (e.g., only at the time of a visit or during regular office hours).
  • Define appropriate use of alcohol as part of the patient contract, such as "Have no more than x number of beers/liquor per timeframe, and do not drive or operate machinery." For some patients, providers might need to prohibit the use of alcohol.
  • Designate the specific pharmacy where the patient must fill or refill all prescriptions.
  • Consider creating a patient rights and responsibilities policy specific to pain management. By doing so, providers can reference that resource within the pain management contract and decrease the length of individual contracts.
  • Review state-specific reporting requirements.

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