Breaking the pain contract: A better controlled-substance agreement for patients on chronic opioid therapy.
"Pain contracts" for patients receiving long-term opioid therapy, though well-intentioned, often stigmatize the patient and erode trust between patient and physician. This article discusses how to improve these agreements to promote adherence, safety, trust, and shared decision-making.
Assistant Professor, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. E-mail: daniel.tobin@yale.edu.|Yale-New Haven Hospital, Saint Raphael Campus, New Haven, CT, USA.
Daniel G
DG
Tobin
Clinical Bioethicist, PeaceHealth, St. John Medical Center and Clinics, Longview, WA, USA.
Kristine
K
Keough Forte
Associate Professor, Department of Management, University of New Haven, West Haven, CT, USA.
Summer
S
Johnson McGee
D000701:Analgesics, Opioid / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy / Q000523:psychology; D003657:Decision Making; D006801:Humans; D054539:Medication Therapy Management / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics; D035502:Trust
D000701:Analgesics, Opioid