The word “contract” in regard to patients with chronic pain is dated, perceived negatively and not preferred. Newer and more appropriate terminology with this patient population is “signed patient agreements.”

In addition, please consider using the more accurate “opioids” rather than “narcotics.” —  Susan Pendergrass, MSN, MEd, FNP, Columbia, Mo. (161-8)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.