Breaking the pain contract: A better controlled-substance agreement for patients on chronic opioid therapy

Daniel G Tobin; Kristine Keough Forte; Summer Johnson McGee

doi:10.3949/ccjm.83a.15172

Breaking the pain contract: A better controlled-substance agreement for patients on chronic opioid therapy

Cleve Clin J Med. 2016 Nov;83(11):827-835. doi: 10.3949/ccjm.83a.15172.

Authors

Daniel G Tobin^{1

2}, Kristine Keough Forte³, Summer Johnson McGee⁴

Affiliations

¹ Assistant Professor, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. E-mail: daniel.tobin@yale.edu.
² Yale-New Haven Hospital, Saint Raphael Campus, New Haven, CT, USA.
³ Clinical Bioethicist, PeaceHealth, St. John Medical Center and Clinics, Longview, WA, USA.
⁴ Associate Professor, Department of Management, University of New Haven, West Haven, CT, USA.

PMID: 27824537
DOI: 10.3949/ccjm.83a.15172

Abstract

"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.

Publication types

Review

MeSH terms

Analgesics, Opioid / therapeutic use
Chronic Pain* / drug therapy
Chronic Pain* / psychology
Decision Making
Humans
Medication Therapy Management / ethics*
Physician-Patient Relations / ethics
Trust*

Substances

Analgesics, Opioid