Evidence status: CURRENT CHRONIC-PAIN MONITORING REQUIREMENTS. Delaware’s statewide opioid regulation pairs the signed Treatment Agreement with mandatory prescription-monitoring, drug-testing, and risk-assessment requirements.
PMP review
For chronic-pain patients, the practitioner must query the Delaware Prescription Monitoring Program at least every six months, more frequently when clinically indicated, and whenever the patient is also being prescribed a benzodiazepine.
Additional PMP triggers
The practitioner must also query the PMP whenever the patient is assessed as potentially at risk for substance abuse or misuse or demonstrates behavior such as lost prescriptions, early-refill requests, or similar concerns.
Fluid drug screening
The practitioner must administer a fluid drug screen at least once every six months.
Risk assessment
The practitioner must conduct a risk assessment using a tool appropriate for the patient. Delaware’s regulation gives examples such as SOAPP, the Opioid Risk Tool, or SBIRT-type assessment approaches.
Alternative treatment record
The medical record must document alternative treatment options that have been tried, including non-pharmacological treatments, and whether those alternatives provided adequate pain management.
Specialist review in defined cases
The regulation allows the practitioner to seek case review or addiction-specialist consultation when there is evidence such as an adulterated drug test, medication diversion, or undisclosed controlled substances identified through PMP data.
Primary source
Reviewed: October 5, 2026.
Evidence boundary: The six-month PMP and fluid-screen requirements are statewide regulatory duties for covered chronic-pain treatment. A clinic may impose more frequent monitoring, but that additional frequency should be labeled as clinic policy unless another authority requires it.