Opiate written behavioral agreements: A case for abandonment

Paul Helft, Jessica R. Williams, Robin J. Bandy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Written behavioral agreements (WBAs) are gaining popularity as part of the effort to manage the alarming increase in prescription drug abuse. The rationale for increased use of WBAs in managing patients with chronic pain is that they are believed to increase adherence to agreed-upon behaviors, reduce addiction to or diversion of prescription drugs, and satisfy informed consent requirements. However, there are no high-quality data to support their widespread use in any of these areas. The evidence used to support the use of WBAs is insufficient to justify their unfairness and the high risk of harm they pose to the doctor-patient relationship. Instead, we contend that WBAs are being used to provide leverage for severing relationships with some of our most challenging patients. We propose that physicians treating patients for chronic pain abandon the use of WBAs. Alternatives include open communication, detailed informed consent processes, carefully documented discussions, and most important, commitment to ongoing relationships even with difficult patients.

Original languageEnglish
Pages (from-to)415-423
Number of pages9
JournalPerspectives in Biology and Medicine
Volume57
Issue number3
StatePublished - 2015

Fingerprint

Opiate Alkaloids
Informed Consent
Chronic Pain
Prescription Drug Diversion
Prescription Drug Misuse
Communication
Abandonment
Physicians

ASJC Scopus subject areas

  • History and Philosophy of Science
  • Issues, ethics and legal aspects
  • Health Policy

Cite this

Opiate written behavioral agreements : A case for abandonment. / Helft, Paul; Williams, Jessica R.; Bandy, Robin J.

In: Perspectives in Biology and Medicine, Vol. 57, No. 3, 2015, p. 415-423.

Research output: Contribution to journalArticle

Helft, Paul ; Williams, Jessica R. ; Bandy, Robin J. / Opiate written behavioral agreements : A case for abandonment. In: Perspectives in Biology and Medicine. 2015 ; Vol. 57, No. 3. pp. 415-423.
@article{633ceb10c76c4f9aaa6fce5aa595531e,
title = "Opiate written behavioral agreements: A case for abandonment",
abstract = "Written behavioral agreements (WBAs) are gaining popularity as part of the effort to manage the alarming increase in prescription drug abuse. The rationale for increased use of WBAs in managing patients with chronic pain is that they are believed to increase adherence to agreed-upon behaviors, reduce addiction to or diversion of prescription drugs, and satisfy informed consent requirements. However, there are no high-quality data to support their widespread use in any of these areas. The evidence used to support the use of WBAs is insufficient to justify their unfairness and the high risk of harm they pose to the doctor-patient relationship. Instead, we contend that WBAs are being used to provide leverage for severing relationships with some of our most challenging patients. We propose that physicians treating patients for chronic pain abandon the use of WBAs. Alternatives include open communication, detailed informed consent processes, carefully documented discussions, and most important, commitment to ongoing relationships even with difficult patients.",
author = "Paul Helft and Williams, {Jessica R.} and Bandy, {Robin J.}",
year = "2015",
language = "English",
volume = "57",
pages = "415--423",
journal = "Perspectives in Biology and Medicine",
issn = "0031-5982",
publisher = "Johns Hopkins University Press",
number = "3",

}

TY - JOUR

T1 - Opiate written behavioral agreements

T2 - A case for abandonment

AU - Helft, Paul

AU - Williams, Jessica R.

AU - Bandy, Robin J.

PY - 2015

Y1 - 2015

N2 - Written behavioral agreements (WBAs) are gaining popularity as part of the effort to manage the alarming increase in prescription drug abuse. The rationale for increased use of WBAs in managing patients with chronic pain is that they are believed to increase adherence to agreed-upon behaviors, reduce addiction to or diversion of prescription drugs, and satisfy informed consent requirements. However, there are no high-quality data to support their widespread use in any of these areas. The evidence used to support the use of WBAs is insufficient to justify their unfairness and the high risk of harm they pose to the doctor-patient relationship. Instead, we contend that WBAs are being used to provide leverage for severing relationships with some of our most challenging patients. We propose that physicians treating patients for chronic pain abandon the use of WBAs. Alternatives include open communication, detailed informed consent processes, carefully documented discussions, and most important, commitment to ongoing relationships even with difficult patients.

AB - Written behavioral agreements (WBAs) are gaining popularity as part of the effort to manage the alarming increase in prescription drug abuse. The rationale for increased use of WBAs in managing patients with chronic pain is that they are believed to increase adherence to agreed-upon behaviors, reduce addiction to or diversion of prescription drugs, and satisfy informed consent requirements. However, there are no high-quality data to support their widespread use in any of these areas. The evidence used to support the use of WBAs is insufficient to justify their unfairness and the high risk of harm they pose to the doctor-patient relationship. Instead, we contend that WBAs are being used to provide leverage for severing relationships with some of our most challenging patients. We propose that physicians treating patients for chronic pain abandon the use of WBAs. Alternatives include open communication, detailed informed consent processes, carefully documented discussions, and most important, commitment to ongoing relationships even with difficult patients.

UR - http://www.scopus.com/inward/record.url?scp=84928985053&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928985053&partnerID=8YFLogxK

M3 - Article

C2 - 25959353

AN - SCOPUS:84928985053

VL - 57

SP - 415

EP - 423

JO - Perspectives in Biology and Medicine

JF - Perspectives in Biology and Medicine

SN - 0031-5982

IS - 3

ER -