A few years ago, her primary provider asked her to sign a treatment agreement for opioids and Xanax, an anti-anxiety drug she also took regularly. Every three months, she visited the doctor so that he could assess her condition and write her a new cycle of prescriptions. Sometimes he would do a urine test. Some lawyers and political experts say that agreements, instead of ensuring security, encroach on patients` privacy and damage the trust needed for the doctor-patient relationship. To monitor drug use, some physicians ask patients to sign “pain contracts” or “opioid treatment agreements” that clarify the rules patients must follow to take these drugs safely. Contracts are designed to discourage people from taking too many drugs, mixing drugs or, among other things, sharing or selling them. Agreements may require patients to undergo blood or urine drug tests, to complete their prescriptions at a single pharmacy, or to refuse to take painkillers from another doctor. When patients do not follow the rules, agreements often stipulate that doctors can reject them from their practice. Wendy Zellner Vice President 412-586-9777 firstname.lastname@example.org Others disagree. They say treatment agreements can be used as an educational tool and a roadmap for care.
“It provides a framework for talking about the problems that appear in a treatment plan,” says S. Hughes Melton, a family physician in rural Lebanon, Va., where addiction, including the search for painkillers, is a serious problem. After working in the mining industry for 22 years, Jeffery Boyd has consistently developed back and leg pain. In collaboration with Melton, he manages his pain with an opioid and another medication. For Boyd, signing a treatment contract and closely monitoring Melton are secondary: most of the time, he`s just happy to control his pain. Courtney Caprara Manager 412-647-6190 email@example.com . . . Chronic pain, as it persists or returns regularly for months, is regularly affected by more than a quarter of American adults. However, the treatment of pain can be very difficult, in part because they cannot be measured with instruments. It is in the eye or neck or articulation of the viewer.
This attitude is probably shared by many people with chronic pain, experts say. “Most patients who come here just want relief,” says Will Rowe, executive director of the American Pain Foundation, a consumer protection group. “You don`t want to hear about the public health problem of opioid abuse.” But there is a catch: although very effective, these drugs are dangerous and addictive. The main danger is that they can cause respiratory depression: if you take too much, the breathing slows down and can finally stop. And because they cause euphoria, opioids are popular targets for abuse and abuse. In 2007, 11,499 people died from opioid overdoses in the United States, according to the Centers for Disease Control and Prevention. This was more than the number of deaths from overdose combined with heroin and cocaine.