Georgia written pain-treatment agreements, documented from the rule outward
Status: Georgia evidence build reviewed through October 4, 2026. This library is for Georgia patients, clinicians, attorneys, journalists, and researchers who need to distinguish what Georgia actually requires from what individual practices add.
Georgia’s current legal baseline
Georgia Composite Medical Board Rule 360-3-.06 treats written treatment agreements as part of the state’s minimum standards of practice in defined chronic-pain prescribing. For a physician prescribing a Schedule II or III controlled substance for 90 consecutive days or greater for chronic pain arising from a nonterminal condition, outside the rule’s nursing-home and hospice context, the physician must have a written treatment agreement with the patient.
The rule defines chronic pain as pain requiring treatment that has persisted for 90 days or greater in a year, excluding perioperative pain treated in connection with surgery.
| State requirement | What Georgia requires |
|---|---|
| Written treatment agreement | Required in the covered Schedule II or III chronic-pain prescribing circumstances described in Rule 360-3-.06(2)(f). |
| Clinical review | Generally at least every three months while treating for pain, with limited rule-based exceptions allowing at least annual review for documented substantial hardship or MEDD of 30 mg or less. |
| Monitoring | The rule defines monitoring broadly and requires random bodily-fluid testing as part of monitoring. The current rule says covered patients should be randomly monitored at least annually by bodily-fluid analysis. |
| Abnormal results | The physician must respond to abnormal monitoring results and document that response. |
| PDMP | Separate Georgia PDMP rules generally require review the first time a controlled medication is prescribed and at least every 90 days thereafter, subject to listed exceptions. |
What Georgia does not prescribe in the agreement text
Rule 360-3-.06 requires the written agreement but does not itself prescribe a statewide list of mandatory agreement clauses such as one pharmacy, no replacement for lost medication, immediate discharge after a positive test, cannabis prohibition, pill-count deadlines, generic-only medication, or missed-appointment dismissal. Those may appear in practice agreements and must be classified separately.
Georgia Board interpretation
The Georgia Composite Medical Board’s current pain-rule FAQ reinforces that monitoring applies to covered chronic-pain treatment. It also states that whether a physician withholds pain medication because a patient under a narcotic agreement used an illicit substance, including cannabis, depends on professional judgment and risk. That is important when separating a clinic’s automatic-termination language from what the Board itself says the rule requires.
Georgia state-level records
- Georgia Written Treatment Agreement Requirement — controlling scope, timing, monitoring, and limits of Rule 360-3-.06.
- Georgia Pain-Rule Monitoring and Board Guidance Record — current monitoring rule, PDMP layer, and Board FAQ.
- Georgia Contract-for-Care Authority and Rulemaking Record — current Board leadership and the formal petition route under Rule 360-33-.01.
Documented Georgia practice records
- Athens Spine Center — Controlled Substance Agreement — currently linked from the practice’s live Office Policies page; form revised October 18, 2016.
- North Georgia Pain Clinic — 2026 Pain Medication Policy — current 2026 patient packet with refill, pill-count, CBD, drug-screen, and termination provisions.
- Eastside Orthocare — Controlled Substance Agreement and Narcotic Contract — currently distributed practice forms; older explanatory language is preserved with a date/context warning.
Current Georgia agreement terms seen in the record
| Example term | Verified example | Classification |
|---|---|---|
| No early replacement for lost or stolen medication | Athens Spine Center | Clinic term; not stated as a statewide agreement clause in Rule 360-3-.06. |
| Controlled substances only from the treating clinic | Athens Spine Center | Clinic term; must be separated from the statewide requirement to have an agreement. |
| Random pill counts and drug screens | Athens Spine Center | Clinic implementation overlaps with Georgia’s separate monitoring rule; the precise clinic procedure is not identical to the rule text. |
| Possible discharge after two missed appointments | Athens Spine Center | Clinic consequence, not a universal Georgia agreement clause. |
| Narcotic Contract and Prescription Refill Policy | Eastside Orthocare | Practice policy layered onto Georgia’s regulatory minimums. |
Formal rule-change route
Georgia law gives an interested person a formal route to petition for promulgation, amendment, or repeal of an agency rule. Georgia Composite Medical Board Rule 360-33-.01 specifies the petition requirements for this Board: the petition must be in writing, verified under oath, identify the requested rule text and changes, state the reasons and pertinent facts, and cite supporting legal authority. Within 30 days after receipt, the Board must either deny the petition in writing with reasons or initiate rulemaking.
If your Georgia agreement is missing
Use the Georgia Contract for Care submission guide. Blank copies are best. Preserve the entire packet, revision date, clinic identity, testing/refill policies, and any addenda.
Primary Georgia authorities
- Georgia Composite Medical Board Rule 360-3-.06 — Pain Management
- Georgia Composite Medical Board Chapter 360-38 — Prescription Drug Monitoring Program
- Georgia Composite Medical Board — Questions About Georgia Pain Rule
- Georgia Composite Medical Board Chapter 360-33 — Petition for Promulgation, Amendment, or Repeal of Rules
Reviewed: October 4, 2026.
Evidence boundary: Georgia’s rule requires a written treatment agreement in defined circumstances. That does not make every clause selected by an individual practice a separate statewide mandate.