The American Civil Liberties Union of Rhode Island has urged the Rhode Island Department of Health to revise proposed regulations that would require physicians to establish written treatment agreements that, among other things, force patients to submit to drug tests on demand in order to receive their pain medication. In written testimony, the ACLU of RI said that these regulations and the department’s model agreement erode patient privacy, undermine the trust that should underlie a doctor-patient relationship, and may encourage individuals with addictions to seek their medication underground.

Under these proposed regulations, even a patient who does not have a history of drug abuse must submit to drug tests at any time merely because he or she needs pain medication. The department’s model agreement, which is available on its website and is already being used by some physicians, requires patients to waive confidentially and allow their physician to share medical records and information with law enforcement or the patient’s family. If patients do not sign the agreement or violate it in any way, they risk losing the medical care they needed. 

"Encouraging practitioners to engage in this sort of disclosure inappropriately turns health care providers into law enforcement operatives, and takes their emphasis away from patient care," RI ACLU executive director Steven Brown and Anne Mulready, supervising attorney for the RI Disability Law Center, said in the joint testimony submitted to the department Tuesday. "One can easily foresee some patients foregoing pain relief (or foregoing it through legal channels) and others refusing to be open with their practitioners about addiction or other problems they have, if they must agree to such a relinquishment of their privacy," 

The organizations asked the department instead adopt regulations barring the use of physician agreements that subject patients to random drug screening at any time or require broad waivers of their privacy rights.