What is a narcotic agreement, how does it work?

Home Health Columnist / Guide · Apr 2, 2011

narcotic agreements are being increasingly used as a tool to document conditions under which a physician, physician assisitant or nurse practitioner may prescribe narcotic pain medicines for chronic pain patients, education provided to patients re med side effects, understanding risks of addiction, the patients responsibilites to receive such meds, need to keep followup appointments, not abuse meds/sell them + conditions refills will be provided.

webmd: pain treatment agreement for chronic pain treatment has good explanation and sample form

examples:

controlled substance (narcotic) agreement

narcotic agreement narcotic agreement

informed consent agreement for treatment of intractable pain with

police requests for patient narcotics agreements

EmergencyNrse · Apr 2, 2011

Most of the applications I have seen are for circumstances surrounding "narcotic seeking behavior". Patients that have been tagged as "frequent fliers" in ER's requesting narcotic pain medicines.

Before they enter into a pain management program they must sign an agreement that the clinic will be the one responsible for managing pain. The terms of the contract are that they stop the ER visits in order for the clinic to manage their pain. There are exceptions for acute conditions and breakthrough pain but it usually means they can't go to the ER for narcs or they are kicked out of the clinic program. Sometimes it works... sometimes it doesn't.

Most of the ER's I have worked in refuse to give methadone. This seems to be a staple among pain management regimens. For one reason or another patients miss their clinic appointment and try to get a dose from us. (Nope, sorry. Inadequate or poor planning on your part doesn't constitute a crisis on ours.) They don't miss many after that.