Evidence status: CURRENT STATE STATUTE. Pennsylvania Act 112 of 2019, codified in 35 Pa.C.S. Chapter 52B, requires a signed opioid treatment agreement before the first prescription in a new single course of chronic-pain treatment with a controlled substance containing an opioid.
When the agreement is required
Before issuing the first prescription in a single course of treatment for chronic pain with a controlled substance containing an opioid, the prescriber must review and sign a treatment agreement with the patient and obtain written consent for the prescription.
Required agreement subjects
- Treatment goals.
- Consent to targeted drug testing when medically necessary.
- The prescriber’s medication policies, including taking medication as prescribed and not sharing medication.
- Disclosure of other controlled substances prescribed or taken by the patient.
- Reasons opioid therapy may be changed or discontinued.
- Appropriate disposal methods for unused opioids.
Required form information
The agreement maintained in the medical record must include the opioid’s brand or generic name, quantity and initial dose; a statement that controlled substances have abuse potential; certification that the required counseling occurred; and the patient’s signature and date. Electronic consent and signature methods are permitted.
Required counseling before prescribing
The prescriber must assess whether the patient is taking a medication for treatment of substance use disorder and discuss addiction and overdose risk, increased risk associated with mental-health or substance-use conditions, dangers of combining opioids with benzodiazepines, alcohol or other central nervous system depressants, and applicable non-opioid treatment options.
Existing treatment plans
Department of Health guidance states that Act 112 does not require a new treatment agreement for a patient whose existing opioid treatment plan was established before November 27, 2019.
Primary sources
Reviewed: October 4, 2026.
Evidence boundary: The statute establishes the minimum agreement. A practice may impose additional conditions, but those are not automatically statewide requirements.