Evidence status: HISTORICAL NEW MEXICO INSTITUTIONAL IMPLEMENTATION RECORD. Northern Navajo Medical Center in Shiprock, New Mexico developed and used a universal controlled-substance agreement for chronic opioid therapy. This is historical implementation evidence, not a claim about the center’s current 2026 form.

Universal controlled-substance agreement

Published Indian Health Service material describes a universal controlled-substance agreement placed in patient charts for patients receiving chronic narcotics. Patients signed and initialed agreement provisions, and the agreement was designed to make chronic-opioid expectations visible across clinicians, nurses, pharmacists, and other care-team members.

How the system used the agreement

  • Patients receiving chronic-use narcotics were placed on pain agreements.
  • Pharmacy and clinical teams used New Mexico and Arizona prescription-monitoring information to identify outside controlled-substance prescribing.
  • Potential agreement violations could be referred to a multidisciplinary pain-review committee.
  • The patient’s primary-care provider was invited into the review process.
  • The agreement operated as part of a larger pain-clinic and opioid-stewardship system rather than as a standalone signature page.

Later federal audit context

Federal oversight later reviewed opioid practices at Northern Navajo Medical Center among a group of Indian Health Service hospitals. That history is useful for understanding how agreement-based opioid stewardship was implemented and scrutinized in New Mexico, but it should not be confused with current state law or a current hospital policy.

Sources

Reviewed: October 4, 2026.

Evidence boundary: This is historical institutional evidence. The controlling 2026 New Mexico requirement is found in current professional rules such as 16.10.14.9 NMAC.