Treatment Agreements, Informed Consent and the Role of State Medical Boards in Opioid Prescribing

Abstract

Prescription opioid abuse has reached epidemic proportions in the United States. As a result, states have implemented policies to help reduce prescription opioid abuse and misuse through prescribing rules enforced by state licensing boards. In at least one state, the medical board has mandated the use of treatment agreements for any patients receiving opioid medications from their physicians. These agreements require physicians to urine or saliva test patients annually for drug abuse and to engage in pill counts or other methods of determining drug abuse and allow for those findings to be turned over to law enforcement, if necessary. Treatment agreements, particularly those containing these provisions, should not be adopted by state medical boards. The negative effects on the physician-patient relationship and trust in the medical encounter and the lack of evidence to suggest agreements will be effective in reducing prescription drug abuse do not support their use as a population-based strategy to prevent prescription opioid abuse.