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Opioid Contracts and Random Drug Testing for People with Chronic Pain — Think Twice

Published online by Cambridge University Press:  01 January 2021

Extract

It is common for physicians who prescribe opioids for chronic pain to have their patients sign an opioid contract (OC) in order to receive opioid therapy. A vast majority of these contracts contain a stipulation requiring patients to submit to random drug testing (RDT) which screens for both licit and illicit drugs. Physicians who prescribe opioids may be concerned about prosecution and disciplinary actions; medication abuse and misuse; and addiction. Steven Passik et al. write, “…physicians still fear the risk of abuse or addiction as well as the potential legal consequences of their prescribing.”

Issues surrounding OC/RDT need a closer look with a focus on enforceability and efficacy of the opioid contract; accuracy and complications of drug screens and their interpretation; and the importance of trust between patient and physician. In addition, it is vital to dispel fears with facts regarding prosecutions, nonmedical use of prescription opioids, and addiction.

Type
Independent
Copyright
Copyright © American Society of Law, Medicine and Ethics 2009

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