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Do You Need a Controlled Substance Agreement With Your Patients?

Healthcare providers are often concerned about the addictive properties of opioids and understand the risks involved in treating patients with chronic pain. Because of this, more and more providers are entering into controlled substance agreements (CSAs), also known as “Pain Contracts”, with their patients. 

A well-drafted CSA may protect patients from overuse, misuse, and other consequences from opioid use. These agreements will ensure that patients and healthcare providers understand their roles and responsibilities regarding pain management treatment and may result in improved compliance and communication between the patient and the provider.  

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A Controlled Substance Agreement (CSA) should include the following important information:

  • Identification of the risks and benefits of opioid therapy

  • Designation of one physician to prescribe opioids

  • Express consent for on-demand urine and serum screening

  • Express consent for on-demand urine and serum screening

  • Rules for obtaining refills

  • Rules regarding termination of treatment

  • Responsibilities of the healthcare provider

While these documents are an effective way to communicate expectations for treatment of chronic pain using opioids, providers are encouraged to meet with the patient to review and discuss compliance and expectations. Once the agreement is signed, an on-going review and communication of expectations is important as is documentation of all areas of non-compliance.  

Sample agreements are available online from the National Institute on Drug Abuse (NIDA) at the National Institute of Health (NIH).

Click here to download a Sample Patient Agreement Form

Samples should always be considered guidelines only.  Healthcare providers should review and customize these samples for use in their practice.


This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.