Evidence status: CURRENT STATUTORY AND REGULATORY REQUIREMENT. New Hampshire law requires professional boards to impose written treatment agreements for chronic-pain opioid treatment, and the Board of Medicine’s current rule implements that mandate.
Statutory mandate
RSA 318-B:41 requires the professional boards regulating opioid prescribers to adopt chronic-pain standards that include the mandatory use of written treatment agreements. The statute states that the agreement must include conduct that triggers discontinuation or tapering of opioid prescriptions.
Physician rule
Under Med 502.05, when opioids are clinically appropriate for chronic pain, the prescriber must use a written treatment agreement kept in the medical record. The agreement must specify conduct that can trigger titration, discontinuation, or tapering based on ongoing objective evaluation of the patient’s condition.
Minimum agreement subjects
The physician agreement must address at least:
- Safe medication use and storage.
- Obtaining opioids from only one prescriber or practice.
- Consent to periodic and random drug testing.
- The prescriber’s responsibility to be available or to have clinical coverage available.
Informed consent and treatment planning
New Hampshire separately requires written informed consent addressing risks including addiction, overdose and death, physical dependence, side effects, hyperalgesia, tolerance, and crime victimization. A treatment plan must address pain management, restoration of function, safety, treatment duration, and consideration of nonpharmacological and non-opioid therapy. The informed-consent document and treatment agreement may be combined.
Statutory and regulatory scope
The chronic-pain rules do not apply to cancer pain or terminal disease in the same way. Additional exemptions to the agreement and testing requirements are addressed separately in the monitoring/exemptions record.
Primary sources
- RSA 318-B:41 — Rulemaking for Prescribing Controlled Drugs
- New Hampshire Board of Medicine — Med 502 Opioid Prescribing
Reviewed: October 4, 2026.
Evidence boundary: New Hampshire requires a written treatment agreement in covered chronic-pain opioid treatment. Clinic-specific additions remain separate unless another authority independently requires them.