Abstract
The use of opioid contracts, which often require patients to submit to random drug screens, have become widespread amongst physicians using opioids to treat chronic pain. The main purpose of the contract is to improve care through better adherence to opioid therapy but there is little evidence as to its efficacy. The author suggests the use of opioid contracts and random drug testing destroys patients' trust which impacts health outcomes, and that physicians' motivation for their use are concerns about prosecution, medication abuse and misuse, and addiction. Statistics are provided to counter fears, and evidence is offered suggesting opioid contracts are unenforceable and lack efficacy; random drug testing is often inconclusive, and a patient's trust improves adherence to treatment.
References
Mar 1, 1989·Medical Care·S H KaplanJ E Ware
Aug 10, 1999·Journal of Pain and Symptom Management·S M FishmanD Borsook
May 8, 2000·BMJ : British Medical Journal·C A BarryN Barber
Oct 12, 2000·Journal of Pain and Symptom Management·S M FishmanD Borsook
Jun 20, 2001·Annals of Internal Medicine·E J CassellS G Kaufman
Oct 3, 2002·Family Practice·David H ThomRahman Azari
Nov 27, 2002·Evaluation & the Health Professions·Fabrizio Benedetti
Dec 14, 2002·The Clinical Journal of Pain·Michael Weaver, Sidney Schnoll
Dec 14, 2002·The Clinical Journal of Pain·Scott M Fishman, Paul G Kreis
Sep 23, 2003·Anesthesia and Analgesia·Nathaniel P KatzGilbert J Fanciullo
Aug 21, 2004·Health Affairs·David H ThomL Gregory Pawlson
Mar 28, 2006·The American Journal of Medicine·Robert M ArnoldDeborah Seltzer
Dec 16, 2006·The Journal of Pain : Official Journal of the American Pain Society·Brenda BreuerRussell K Portenoy
Mar 27, 2007·The Journal of Pain : Official Journal of the American Pain Society·Steven E RoskosLorraine S Wallace
Jul 29, 2008·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Donald M GoldenbaumArthur Thexton
Sep 26, 2008·Health Care Management Review·Hui-Ching Weng
Oct 8, 2008·Experimental and Clinical Psychopharmacology·Steven D Passik, Kenneth L Kirsh
Nov 20, 2008·Annals of Internal Medicine·Larry R Churchill, David Schenck
Dec 2, 2008·Journal of Pain & Palliative Care Pharmacotherapy·Mark Collen
Jan 23, 2009·Patient Education and Counseling·Peter Salmon, Bridget Young
Jan 24, 2009·Social Science & Medicine·Yin-Yang Lee, Julia L Lin
Feb 4, 2009·The Journal of Pain : Official Journal of the American Pain Society·Roger ChouRussell K Portenoy
Feb 4, 2009·The Journal of Pain : Official Journal of the American Pain Society·Roger ChouChristine Miaskowski
Citations
Oct 12, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R Douglas BrucePeter Selwyn
Jan 5, 2020·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Tuesday M McAuliffe Staehler, Laura C Palombi
Apr 23, 2014·The Clinical Journal of Pain·Mark Collen
Sep 6, 2019·Advances in Therapy·Celia Oreja-GuevaraDavid Yeandle
Dec 8, 2010·Journal of Pain & Palliative Care Pharmacotherapy·David B BrushwoodWinston Wong
Mar 24, 2011·Journal of Pain & Palliative Care Pharmacotherapy·Mark Collen
Mar 5, 2011·Pain Practice : the Official Journal of World Institute of Pain·Mark R Collen
Sep 10, 2013·Journal of Medical Ethics·Daniel Z Buchman, Anita Ho
May 26, 2017·The Hastings Center Report·Joshua B Rager, Peter H Schwartz
Jun 14, 2016·Journal of Pharmaceutical Health Services Research : an Official Journal of the Royal Pharmaceutical Society of Great Britain·Jennifer S AlbrechtFrancis Palumbo
Sep 1, 2017·JBJS Reviews·Joseph T Labrum, Asif M Ilyas
Jun 29, 2012·The Nurse Practitioner·Kathy Bettinardi-AngresStephanie Bologeorges
Feb 22, 2011·The American Journal of Bioethics : AJOB·Mark Collen
Jan 25, 2011·Expert Opinion on Pharmacotherapy·Bob Kwok Bun ChanChi Wai Cheung
Oct 27, 2014·The Patient·Mary P GhodsDale C Slavin
May 8, 2014·Journal of Pain & Palliative Care Pharmacotherapy·Mark Collen
May 3, 2014·Journal of Pain & Palliative Care Pharmacotherapy·Mark Collen
Nov 19, 2011·International Journal of Clinical Practice·S R LieberM L Volk
Aug 15, 2015·The Nurse Practitioner·Krista M Przybelinski, Lisa S Ball
May 25, 2021·Substance Use & Misuse·Michelle S KellerMarySue V Heilemann
Jul 14, 2021·The Hastings Center Report·Larisa Svirsky
Aug 1, 2021·Journal of Medical Ethics·Adrienne Sabine BeckDana Howard