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Pain management is handled by having each patient who is prescribed a narcotic medication sign a pain management agreement beforehand, and they are also referred to the pain clinic for comprehensive case management. The pain management agreement basically outlines the rules for continued narcotic prescribing including random urine-tox checks, pill-counts, etc. Any time the contract is breached, we can pull out the signed agreement, and show the patient that they agreed to these conditions as part of their pain management plan.