Journal of Pain & Palliative Care Pharmacotherapy. http://PainExhibit.com
J Law Med Ethics. 2009 Winter;37(4):841-5. doi: 10.1111/j.1748-720X.2009.00455.x.
The use of opioid contracts, which often require patients to submit to random drug screens, have become widespread amongst physicians using opioids to treat chronic pain. The main purpose of the contract is to improve care through better adherence to opioid therapy but there is little evidence as to its efficacy. The author suggests the use of opioid contracts and random drug testing destroys patients' trust which impacts health outcomes, and that physicians' motivation for their use are concerns about prosecution, medication abuse and misuse, and addiction. Statistics are provided to counter fears, and evidence is offered suggesting opioid contracts are unenforceable and lack efficacy; random drug testing is often inconclusive, and a patient's trust improves adherence to treatment.
使用阿片类药物合同，通常要求患者接受随机药物检测，已在使用阿片类药物治疗慢性疼痛的医生中广泛使用。该合同的主要目的是通过更好地坚持阿片类药物治疗来改善治疗效果，但几乎没有证据表明其疗效。作者认为，使用阿片类药物合同和随机药物检测会破坏患者的信任，从而影响健康结果，而医生使用这些合同和检测的动机是担心被起诉、药物滥用和误用以及成瘾。提供了统计数据来消除人们的担忧，并提供了证据表明阿片类药物合同是不可执行的，缺乏疗效；随机药物检测往往也不确定，而患者的信任则会提高对治疗的依从性。
