Long-Term Controlled Substances Therapy for Chronic Pain: Sample Agreement
Consent form on which patient agrees to follow policies related to long-term use of opioids because these drugs have potential for abuse or diversion.
This collection of tools and resources is for providers, staff, and patients who offer or use services to address substance use, and other interested stakeholders. This collection was originally established following an environmental scan on implementing medication-assisted treatment (MAT) for opioid use disorder (OUD) in rural primary care. (See PDFs of Volume 1 [PDF 0.69 MB] and Volume 2 [PDF 1.28 MB] of that scan). Items have been continuously added to this collection since then, and the collection has expanded to cover substance use more broadly, rather than just MAT for OUD.
Consent form on which patient agrees to follow policies related to long-term use of opioids because these drugs have potential for abuse or diversion.
Guides healthcare professionals through an initial assessment of patient pain. Includes diagrams of the human body to help patients locate the pain they experience, as well as questions to prompt the patient to describe the intensity, quality, causes, effects, and contributing factors of the pain.
Provides a score indicating the severity of dependence on opioids using a 5-item questionnaire.
A site for finding high-quality addiction treatment and taking a self-assessment to find which treatment is right for different people.