• Agree to obtain all of your medications at one pharmacy, which you must name, and give your consent for the physician and pharmacist to exchange information about you. This is because abusers sometimes try to obtain prescriptions from multiple doctors and fill them at different pharmacies. With all prescriptions being fed into computers now, interconnected databases make this much more difficult to get away with.
• Understand that lost, stolen or destroyed prescriptions and medications will not be replaced under any circumstances. It's essential that you keep track of your medications and make sure no one else has access to them.
• Agree to inform your pain management physician of all other medications you are taking.
• Agree to inform your other health care providers of the pain medications you are taking and of the agreement you have signed. This includes emergency care providers.
• Agree not to request any pain medications or controlled substances from other health care providers.
• Agree not to use illegal drugs, street drugs, or another person's prescription.
• Agree to keep all your scheduled appointments. Your agreement may require 24-hours notice to cancel an appointment and/or have a maximum number of appointments you can reschedule and still continue to be treated. Canceling an appointment at the last minute isn't fair to the doctor, who doesn't have time to fill that slot with another patient. But, perhaps more importantly, they don't want you cancel appointments because you've been using your medications improperly and are afraid you wouldn't pass a drug test.
In addition to the above, you may be required to agree to participate in any medical or psychological assessments recommended by the doctor, or to participate in any program designed to improve your function, whether it be physical, social, psychological, daily activities or work activities. You may also have to agree that, if you have or develop an alcohol or drug addiction problem, you will follow through with any addiction program you're asked to enter.
