title: Opioid contracts and random drug testing for people with chronic pain - think twice.
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.
authors.affiliation: Journal of Pain & Palliative Care Pharmacotherapy. http://PainExhibit.com
authors.forename: Mark
authors.initials: M
authors.lastname: Collen
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease; D032982:Contracts / Q000941:ethics* / Q000331:legislation & jurisprudence; D006801:Humans; D009293:Opioid-Related Disorders / Q000517:prevention & control*; D010146:Pain / Q000188:drug therapy*; D028701:Patient Rights; D010817:Physician-Patient Relations / Q000941:ethics*; D015813:Substance Abuse Detection / Q000941:ethics* / Q000331:legislation & jurisprudence; D035502:Trust; D014481:United States
chemical_list: D000701:Analgesics, Opioid