Philadelphia Doctor Creates Pain Medication ‘Contracts’ With Patients

PHILADELPHIA (CBS) – A Philadelphia doctor is taking some extra steps to make sure patients getting painkillers from him don’t become addicted.

In recent years, highly publicized cases of painkiller addiction (including Rush Limbaugh and Brett Favre) have highlighted the need for health care professionals to take extra measures to ensure that their patients are protected from this potential hazard.

Dr. Mitchell Freedman, director of physical medicine and rehabilitation at the Rothman Institute, says he has patients sign a contract before he prescribes certain painkillers.

freedman mitchell side Philadelphia Doctor Creates Pain Medication Contracts With Patients

(Dr. Mitchell Freedman. Photo provided)

“Before I give chronic narcotics, I’ll have them sign a narcotic agreement defining what their role in the process is as well as mine, and what both of our responsibilities are,” Dr. Freedman (right) tells KYW Newsradio. “They can only get medicine from me — we make that clear. I only do this when we see each other face to face.  I don’t order it by phone, and I see them at regular intervals to make sure I’m succeeding with the medicine I’ve prescribed.”

Freedman says he wants to make sure these patients aren’t on any other narcotics, and in cases of patients who are taking an opioid drug like Oxycontin for an extended period of time, he may order periodic urine tests to monitor levels.

And Freedman says the use of opioid drugs is up in this country but says and it has nothing to do with an aging population.

“In the 1990s and early 2000s it became very popular (to say) that pain was the ‘fifth vital sign’ and we have to take pain away,” he notes.  “Well, we are not going to take all pain away. I think opioids are a tool to take an edge off.”

Freedman says if the medicine removes 40 percent of a patient’s pain, he considers that successful.

Reported by Michelle Durham, KYW Newsradio 1060.

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  • Mark D.

    Having worked at Dana-Farber Cancer Institute (as an administrator) it was a real eye opener for me to learn about the the high level of narcotics prescribed for people with terminal cancer OR chronic acute pain, to properly treat them.

    The FDA does not seem to recognize that some people need large amounts of narcotics every day just o get out of bed.

    For a doctor, risking your narcotics license to treat chronic pain is a real risk. MD’s who prescribe lots of narcotics come under scrutiny, when the doctor is simply trying to alleviate pain. I just wish some regulators had a better sense about what constitutes adequate pain management for those who suffer terrible pain.

    With that said, some people abuse drugs. Our Emergency Rooms are under constant and expensive “attack” by drug seekers who go from hospital to hospital with “back pain”, or who claim to be allergic to non-narcotic pain relievers because they want narcotics.

  • Laurie

    Any Doctor who thinks taking away 40% of the pain from a patient is a success is a Doctor who has never experienced chronic pain and is not a very intelligent Physician to think that chronic high pain levels are acceptable for people’s overall health. I do however completely agree with the “contract”, As a patient in Oregon we used them for e very primary pain management doctor. They do however have a firm mission that patients should not have to live in pain.

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