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The page below is a sample from the LabCE course The Toxicology Laboratory's Role in Pain Management. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Pain Management Contracts

When patients see a clinician to manage their pain they are, by simple definition, pain management patients. The practice of pain management is more involved than simply prescribing analgesics. We will discuss the goals of pain management in coming sections.
The concept of a "pain management contract," or an "opiate therapy plan" is important to mention. When a patient's pain is going to be managed with opiates or other prescription analgesics the patient and clinician must agree to the terms of this treatment.
Opiates are narcotics. A narcotic can refer to any drug derived from opium or opium-like compounds. These drugs have potent analgesic effects and can cause alterations in mood and behavior. Narcotics also have the potential for dependence and tolerance with repeated administrations. Since these are strong drugs, an agreement is usually signed between the clinician and patient. This agreement, or contract has these provisions:
  • Patient will not seek medications from other providers.
  • Patient will only use medications that are provided to him/her.
  • Patient will not sell or give his/her medications to others.
These contracts are important to establish trust and expectations between the clinician and the patient. These contracts will often also specify the requirements for routine urine drug testing.