Evidence status: DOCUMENTED RULEMAKING ORIGIN. Delaware’s modern statewide chronic-pain opioid agreement framework was developed through Controlled Substance Advisory Committee rulemaking in 2015-2017 and became effective in 2017.

2015-2016 proposals

Delaware proposed new safe-opioid-prescribing regulations to address prescription overdose, abuse, and diversion. The proposals defined chronic pain, treatment agreements, risk assessments, PMP review, acute-pain supply limits, and chronic-care monitoring requirements.

Final 2017 rule

The final rule published in April 2017 required covered chronic-pain practitioners to query the PMP, administer periodic drug screens, obtain a signed Treatment Agreement, conduct a risk assessment, document alternative treatments, and address comorbidities.

Treatment Agreement definition

The rule defined the agreement as a written document signed by practitioner and patient or proxy and placed in the medical record. It identified optional agreement terms involving lost prescriptions, early refills, treatment discontinuation, one-practitioner prescribing, unauthorized substances, consequences of violations, and periodic drug screening.

Later updates

Subsequent amendments refined wording and administration, including the use of fluid drug screens and other technical changes, while retaining the chronic-pain signed-agreement requirement.

Why origin matters

The statewide Contract for Care requirement is administrative regulation adopted under the Uniform Controlled Substances Act. Its repeal or amendment therefore runs through Delaware’s regulation-making process rather than requiring repeal of a statutory agreement clause.

Sources

Reviewed: October 5, 2026.