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pain medicine contract

bigcat90bbigcat90 Posts: 1,012
edited 12/11/2013 - 6:11 AM in Pain Management
Here is a link to a standard pain contract. http://www.sdcpms.com/pdf/form_sample_opiate_contract.pdf


  • That looks close to the one I signed with my GP, who for now handles my pain medication.
  • I have been seeing a PM Dr. for about 6 years now and I have never even seen a contract like that. I hear all about them, just never seen one.
  • Someone should have proof read that pain medicine contract!!!!! Looks like a ten year old wrote that.
  • "Guilty until proven innocent".

    Anyone notice you sign-away your basic human rights?:
    " I agree to waive any applicable
    privilege or right of privacy or confidentiality with respect to these

    or that in a "contract", both sides state what they will do and in this case, the doc promises nothing except to kick ur azz out?

    contract: "an exchange of promises between two or more parties"

  • Mt Dr has one and it is actually very good and informative. They need to do it to protect themselves. I am close to some of my Dr assistants and they have hundreds of calls and requests for medications and get bombarded with more and more patients who do not have chronic pain but an addiction. It really does hurt the people who need the services of pain mgmt not psychiatrists or addiction rehab
  • I don't have a pain specialist...but was wondering...do they really have you bring in your unused meds at EVERY visit?? Is that so they can count them to see where you are in your script? Just wondering cuz that would seem kind of intrusive...especially since we have probably ALL been there where we need to take maybe an extra or two a day...then even out the next.
  • I'm not required to bring in unused pain medicine. I was surprised to read that you can have alcohol if you're not driving. On my contract, we're forbidden to have it at all. This is fine b/c you cannot mix alcohol with muscle relaxers or opoids, and I haven't had one drink in 3 years in fear of getting sick.
  • I had my surgery in Oct of 2007, I was fused from L3 to S1 with 8 screws two vertical rods and one horizontal rod. I attempted to return to work in Feb 08 with the Postal Service. It was not pleasant at all. On March 10 they had me unloading mail and a container of mail fell on me and knocked me to the floor. Since this I have torn muscle on my left side of my incision that seems to not be healing. I also injured my tailbone in this accident. I am still having pain and now have no reflex in my right leg. My surgeon won't see me because he does not want to be involved with worker comp with the government. I am not sure how to go about getting help and finding out that I don't have any reflex in my right leg is kind of scaring me. Is it normal to not have reflexs after a surgery like this? My pain management doctor is telling me I may have a failed fusion.
  • I have 2 ruptured discs (L5-S1 I think) scoliosis, degenerative disc disease, and stenosis. I am not a candidate for surgery because I am allergic to steroids that are given during surgery and because I am also allergic to all pain medications. I have been in anaphylactic shock 4 times (3 of those were in the hospital because of medicine they gave me)and when I had a hip replaced I was put on morphine the first day. I had hallucinations and absolutely no pain relief. It was the worst day of my life. Finally they gave me codiene and valium and I was fine. Since then I have become allergic to codiene and to Tylenol, among other drugs, so it looks like the electrodes are all that is left.

    I want someone to tell me they work wonderfully! Or if they don't work the first time they can keep trying until they do.
    thanks so much!
  • i had to sign CONTROLLED SUBSTANCE AGREEMENT with dr. cant drink or use illegal drugs, randum urine test to see if you are takin meds and if your taking other street drugs, random pill counts. they can call you anytime for any reason and you have to go down that day and submit to test or pill count, but they are very good about it so far. usually there has to be a red flag. i also have to inform them right away if another dr, give meds. and i have to tell other dr,s that im on this and who im seeing.
  • i am a paramedic and for last number of years i have miss lots work due to my bulging disc l 4/5 .sometime it really gets me down just like to have a normal life again.
  • i am a paramedic and for last number of years i have miss lots work due to my bulging disc l 4/5 .sometime it really gets me down just like to have a normal life again.
  • i go the the link.it's really usefull link .thanks for the link
  • I had surgery in oct fusion 1-4 with decompression and have a big problem with my pain both muscular and spinal the pain meds im on 15mscontin twice daily does not help me going back to therapy monday took a break cause of the pain there was popping with pain in my back does anyone have a clue?
  • Do you believe my dr had me sign a pain contract, then yesterday he said he is cutting back on giving people pain meds and will be slowly tapering people off pain meds , he doesnt want to loose his license. He told me to go the pain management clinic at the Hospital, unreal! I have documentation for having Fibromyalgia, degenerative disc disorder, spinal arthritis and other things. Currently i am taking percocet 10 mg maybe two times a day up to 4 times if i need it. And soma a muscle relaxer. Has anyone just been cut off by their Doctor. Isn't a dr supposed to help people keep from being in severe chronic pain? I guess i will have to go to the pain clinic or find another Doctor. I cant believe this crap, Its not like im a new patient with no documentation. I have been tried on other drugs and they either dont work or im allergic to them. When i find something that works for me, hes taking it away!
  • Unfortunately a lot of family doctors are turning their chronic pain patients over to a pain mgt clinic because of all the drug abuse and stigma related to prescribing narcotics. There is nothing wrong with going to a pain clinic- a lot of us do. In them, qualified doctors are able to treat you with many kinds of medications, spinal injections, or even try you out on neurostimulator or morpine pumps to control your pain. A PCP isn't able to do all this. Yes, we have to sign contracts and pee in a cup once in a while, but this protects them and keeps them open and it helps to build trust between them and us. Not everyone is a fan of this but this is a sign of the times we're living in. If you end up going to a pain clinic, you will have access to many treatments and hopefully it will benefit you and bring relief.
  • You can bet somewhere, somehow, there was an a-hole lawyer behind all of this. The damn doctors are running scared. They are afraid to do anything these days for fear of being sued. Why else would all of the ambulance chasers have the ads running non-stop on TV? I quit my pain doc because he became a robot. He said many times that he was worried and was no longer able to practice the "art" of helping people in pain. I finally jumped ship and went back to a doc I knew would be serious about treating me. He is aggressive and straight forward. The old doc gave me DOZENS of shots over the years. Then he would just shove a script for vicodin in my face and give me the bum's rush. Out of the office in less than 10 minutes... AFTER I waited an hour & a half PAST my appointment time to get in. He no longer wanted to treat patients that weren't "easy" fixes. I'm sure he could run 10 regular patients through the office in the same time it would take to spend the proper time with a chronic case. I liked the guy, but not enough to waste the rest of my life waiting for him to quit pissing around. Good riddance.
  • My back injury happened at work so I see a workmans comp doctor to check my progress.In the beginning he had me sign a pain management contract.I was unable to get controlled substances prescribed by any other doctor or be thrown into a pit leading straight to hell.
    This led to major problems as I have serious chronic mental health issues and refractory rls/pld which have been treated with opioids/benzos or tranqs successfully for over 5 years with no abuse.
    When I presented for my spondylolithesis and herniated disc with xray and MRI still I was looked at as suspicious.
    I am a hard working,competent and had been a productive human being.
    After I signed the contract I was prescribed percocet and then oxycontin but I lacked the other necessary drugs to keep me functioning.
    Once I had my surgery my surgeon understood my situation and agreed to continue low dose opioids (vicodin) as I wanted to stay away from percocet.Unfortunately Im still in agony but I am able to get my necessary medications from my sleep specialist and psych. Which helps keep me from wallowing in depression and 5 out of 7 nights a week I am able to sleep.
    The CT showed issues and now the doc has ordered an MRI and lidocaine injections as he believes the screws are causing my constant pain.
    I fear the surgeon will be reluctant to continue helping control my pain as he is the only one willing at this time as I can not follow the rules of a pain contract by the workmans comp doctor.
    It just really grinds my gears being in such discomfort and the doctors are skeptical and reluctant to help.
    As a certified veterinary technician we have learned that if you do not limit pain you are limiting healing.I am sure the same goes for humans. I am just truly disappionted in the care and pain management as a whole. I just wish there were better drugs that didn't come with such a stigma and didn't suck the life out of yah.
  • I had to sign a narcotics contract, for the first time this year, after using Vicodin for pain, since 2006, without abusing it.

    These contracts do not protect patients at all, and I will treat my new relationship with my doctor as adversarial.

    After years of being so careful with my medications I feel that I should switch over to a complete narcotic instead of using the codeine/acetaminophen combination, since a narcotics contract will be required in either case. No point in trying to manage without complete pain relief anymore. If I will be treated like a drug addict, I'm not going to worry about it anymore.

    On a more proactive note, as anyone tried presenting their own medication contract to a doctor? I'd like to create one that incorporates a pain patient's bill of rights!
  • When presented with the contract I went through it with the doctor, before signing it. I made sure to note that any testing will be limited to blood tests to check liver function (acetaminophen), and made a couple of other notes that the doctor then initialed and we BOTH signed.

    While I have yet to use marijuana-medical or otherwise, but will now look into it since it is legal in my state and it's obvious the medical community thinks less of me regardless of my history, I've never had a urine test that wasn't justified by the presence of infection and have never submitted a sample to get a job or for any other "monitoring" exercise.

    It is an insult, plain and simple. One should NEVER sign a contract of any sort, without going through the finer points and making adjustments where warranted.
  • I'll tell you right now who is pushing this, the DEA. They scare the doctors by revoking their license for prescribing too much pain medication. It's not my fault that there are abusers out there. We also have a double standard, if a police officer or high ranking politician needs pain medication they are not questioned. This country is forcing people to have an us against them mentality. It's the have's against the have nots. This is not a good way of treating people in a so called democracy. Punish the people who are abusing and leave the rest of us alone, we have enough problems as it is. This is what you get when you have idiots running the country.
  • cpgdna59 said:
    I'll tell you right now who is pushing this, the DEA. They scare the doctors by revoking their license for prescribing too much pain medication. It's not my fault that there are abusers out there. We also have a double standard, if a police officer or high ranking politician needs pain medication they are not questioned. This country is forcing people to have an us against them mentality. It's the have's against the have nots. This is not a good way of treating people in a so called democracy. Punish the people who are abusing and leave the rest of us alone, we have enough problems as it is. This is what you get when you have idiots running the country.
    I agree with you that actions of the DEA is what is prompting a lot of doctors to resort to "contracts."

    I respectfully disagree with your statement about law enforcement! There are a lot us that are law enforcement officers on this site (and I am federal by the way), and we too have to SIGN THEM! Please do not lump all into such a broad category, as that is just like saying because others are abusing that are between 18 and 90 and have x color hair are, so you must be too? One of the predicate offenses I enforce (cross designated)is the interdiction of illegal smuggling of all manner of drugs - and even I don't lump people as such.

    Your closing sentence, couldn't agree more. Take care and stay safe.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • dilaurodilauro ConnecticutPosts: 10,291
    can seem unreasonable. Sure, with all the talk about pain medications in the news, its no wonder that doctors need to be careful.

    But being careful and refusing to write scripts for a patient is something else.

    There are many of us that need a good amount of narcotic pain medication to see us through the day.

    Then when that situation becomes compromised, the doctor doesnt like your set of medications and/or wants to try something different.

    Everyone has to answer to someone. The doctors need to answer to their review boards as to why or why not did they prescribe various pain medications.

    Its an up hill struggle to get to the right medium so that your needs are addressed as well as your doctors
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I'll apologize for lumping groups together, you're right. Sometimes I get frustrated and go off on a tangent, (just ask my wife). We are all in the same boat together. Really didn't mean to offend anybody, I worked for twenty years and don't have any income, I'm angry with this country right now.
  • Hi charliesgurl~
    I haven't had reflexes in either leg for about 10 years...several years before any of my surgeries...and now after having 3 of them I still don't. Don't know what this means...I have just gotten used to it...! I pray you can find a Dr. that will work with Workmans Comp...perhaps you could ask your former Dr if he can recommend a"good" surgeon that will...praying for you~
  • Good Morning~
    I signed my pain med contract years ago and have never, ever heard of a pill count. Now, my Dr will from time to time make me do a urine test to make sure I am taking the drugs and not selling them. Also...one time when he changed me from my Percocet to a Fentanyl Patch I had to give him my unused percocet before he would give me the fentanyl script. I wouldn't of had to do this if I had chosen to wait until the script ran out but I wanted the patch right away. I really made every one in the office mad as when I brought the pills in I made them do a count and give me a receipt for how many pills I had turned in. :D They said they had never had a patient do this...well...I am sorry, but I don't intend to turn in x-amount and then they disappear...I mean for one thing someone there could turn around and sell them and tell the Dr I hadn't turned them in! The main thing that bothered me about my contract was that no matter what I can't get drugs anywhere else...I mean what if I am in a serious car wreck or something??? Confusing to say the least!
  • There is no standard of practice that says doctors have to treat all patients the same, regardless of whether they have signs of misuse of opiates or do not. In fact, standards of practice say exactly the opposite.

    I do not want to have to be treated with suspicion when I am a tough cookie and have never once misused my medications. Yes, I have signed a contract and have taken an entrance test. Past that, I'd hope doctors would base their actions on my actions. Until there are signs that things have changed, show some trust.
  • and it seems like every 2 years I get the urine test.I don't care,I am not doing anything wrong and it is stated in my contract.I also have to bring all my meds to each and every appointment.My p.m. left and I followed him to his new office.At the old place,I took in "old" meds from being switched to new ones and they counted,made me sign, they signed and destroyed them in front of me.That was wierd!!

    I have had other surgeries not due to my spine and given narcotics.Just let your pm doc know about it,a simple message on the nurse line,and that's it.It's tough all over for everyone.I guess I've just been in this so long,nothing surprises me anymore.Injured in 1997
  • I signed a pain contract with my PM in Octoboer 2010. I have been on Vicodin and Soma since April of 2010. I just recently decided to have a more experienced surgeon put in my SCS. My doctor's office called a few days later and said it would be unethical for him to treat me if I was going to allow another doctor to do the surgery. They refused to refill my meds with no warning. I've never broken the contract. I've never abused my meds, if anything I typically go over the time allowed for the presc. How is it that doctors are just allowed to dump you when the realise they can't make the most money off of you? How is it ethical to drop a patient off their meds with no safe withdrawl? No recommendation for another doc? NOTHING! I understood the need for the contract with them. What about the contract with me? Who makes them abide by the rules?
  • When I started a pain management in February 2010 I had to sign a very similar contract. I felt like I signed my life away. I basically gave up my rights to give input on my own treatment.

    I was 20 at that time so right off the bat I was labeled as a possible teenage drug seeker. I was taken off the percocet that my PCP gave me and switched to Norco. I also was told to start PT (they had their own private PT in the same office).
    After about a month or 2 of me complaining that PT was very painful, I was taken off Norco and given MS Contin 15mg twice a day.

    That dosage eventually got increased to 3 times a day, then to 30mg twice a day, for a total of 60mg a day. Throughout the months of him prescribing me MS Contin I told him repeatedly that I refuse to take them when I have to work. He always just shrugged it off.

    Then one day he started making his new PA see me (apparently he didn't want to be bothered with me). By then I had stopped PT due to increasing pain. Long story short: after 2 appointments with his PA (and me still telling them I refused to take the medication when I had to work) the PA made me flush more than half of my prescription down the toilet (which I had paid $90 for) and I was basically accused of being a drug dealer.

    I definitely was not selling or sharing my medication and the random drug tests throughout my treatment should have showed them so. In July 2010 the PA just discontinued medication. She prescribed 7 15mg MS Contin to ween me off from 60mg a day. She said that since I wasn't taking it properly I wouldn't have side effects. She was very wrong. I had horrible withdrawal symptoms.

    So the point of this story is: if you don't comply with every aspect of your treatment in pain management , even if you disagree with the treatment, too bad because you signed a contract.

    Oh and a little side note: the reason the PT was so painful was because they were treating the wrong problem. When I asked if they could give one injection to confirm their diagnosis of SI disfunction (it only takes one epidural to rule in/out) he said there was no need because he was sure it was the SI joint.

    Now after being treated by a few spine specialists since August, it was suggested I start pain management again. I don't think I'm signing that contract this time!
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