Opioid Treatment Agreements and Patient Accountability

Opioid treatment agreements are written agreements between physicians and patients enumerating the risks associated with opioid medications along with the requirements that patients must meet to receive these medications on an ongoing basis. The choice to use such agreements goes beyond the standard informed consent process and has a distinctive symbolic significance. Specifically, it suggests that physicians regard it as important to hold their patients accountable for adhering to various protocols regarding the use of their opioid medications. After laying out a taxonomy of accountability relations between physicians and patients, I argue that opioid treatment agreements are justifiable for physicians to use in their provision of care only if they improve patient or public health outcomes, which has yet to be demonstrated.