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The opioid contract.

Scott M Fishman1, Paul G Kreis

  • 1Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis, Sacramento, California 95817, USA. smfishman@ucdavis.edu

The Clinical Journal of Pain
|December 14, 2002
PubMed
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Opioid contracts are common but lack standardized use and proven effectiveness. This review examines factors influencing their use in chronic opioid therapy for non-cancer pain.

Area of Science:

  • Pain Medicine
  • Clinical Pharmacology

Background:

  • Opioid contracts are frequently utilized in managing chronic non-cancer pain.
  • There is a lack of standardization in the application and content of these agreements.
  • Existing research indicates significant variability alongside common themes in opioid contracts.

Purpose of the Study:

  • To review the factors impacting the use of opioid contracts between clinicians and patients.
  • To explore the efficacy and challenges associated with opioid agreements in chronic opioid therapy.

Main Methods:

  • Literature review of studies on opioid contracts for chronic non-cancer pain.
  • Analysis of variability and core components in existing opioid contract frameworks.
  • Discussion of clinical and patient-centered implications.

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Main Results:

  • Opioid contracts exhibit considerable diversity in their structure and implementation.
  • Core elements are present across different contracts, suggesting some common principles.
  • The efficacy of opioid contracts in improving outcomes for chronic opioid therapy remains largely unestablished.

Conclusions:

  • Opioid contracts are a prevalent but under-researched tool in chronic pain management.
  • Standardization and evidence-based guidelines are needed to optimize their use.
  • Further research is crucial to determine the effectiveness of opioid agreements in clinical practice.