Ask ECRI: Controlled Substance Agreements for Patients with Opioid Prescriptions

​Because of the addictive properties of opioids and their potential for abuse, providers are often wary of how they will manage opioids that are prescribed for patients for chronic pain. One practice is to enter into a controlled substance agreement with the patient. Providers often ask ECRI Institute questions about how these agreements can be structured, and what to do if patients cannot comply.

We replied that controlled substance agreements address the risks and benefits of opioid therapy and specify the need for one prescribing doctor and one designated pharmacy to limit the risk that the patient will engage in doctor- or pharmacy-shopping or get multiple medications from different doctors and pharmacies. The designated pharmacy can be chosen by the patient rather than the provider, but should be noted in the contract. Agreements may also make provisions for urine and serum drug screening when requested, prohibit early refills...