HARMS Program – Disclaimer

The HARMS Program, START-IT and this manual were developed in Marathon, ON and have been used clinically at the Marathon Family Health Team. All information contained herein is intended for use by qualified clinicians and as educational tools to assist in fair and practical interpretation of urine drug testing results. Further, UDT should be seen as a way of making opioid prescribing more informed and is not intended for punitive action against any patient. Clinical judgement is important, and thus this is not meant to be followed blindly. Final analysis and recommendations must be evaluated for each individual patient and use of the information for final patient care decisions must be carefully weighed by the treating clinician and should be discussed with the patient before implementing medication or therapeutic changes. If you are unsure we highly recommend consulting your local clinical biochemist or a specialist in the area.

The HARMS Program addresses one aspect of opioid management for chronic non-cancer pain (the UDT component for monitoring safety). HARMS does not attempt to standardize and systematize the other important components (history and physical, non-opioid management, etc.) This manual is not meant to imply that these other facets are un-important, only that they are more difficult to work into a clinic-wide program with various practice styles, time availability, etc. HARMS intentionally addresses one aspect of prescribing opioids for chronic pain (UDT) and aims to do it effectively and efficiently.

The authors of this manual have done their best to incorporate best-evidence into this program. The authors of HARMS/START-IT and this manual cannot guarantee their accuracy or completeness and the information obtained by the use of these is not a substitute for clinical judgement. The authors take no responsibility for the actions you take based on this manual – clinical judgement and evaluation in your specific clinical setting, and incorporating specific patient scenarios, supersede any general recommendations given here. Clinical application of the information obtained by use of any part of this manual, or any of the tools described herein, is the sole responsibility of the user.

If you do not agree to any of these terms, do not use this manual. By using this manual, you acknowledge that (A) The authors assume no liability regarding the use of information obtained by the use of HARMS, START-IT and this manual, (B) you agree not to hold the authors, any of its affiliated companies, or any of their respective directors, officers, employees, agents, suppliers or partners, liable in anyway for the use and/or outcomes brought forth by the use of any information obtained by the use of HARMS/START-IT and this manual, and (C) you agree to indemnify and hold the authors harmless from and against any and all damages, losses, liabilities, costs and expenses incurred by any of them arising out of or related to your use of HARMS/START-IT and this manual.

HARMS/START-IT and this manual are without warranty of any kind, express or implied, including, but not limited to, the implied warranties of merchantability and fitness for a particular purpose, and any warranties implied by any course of performance or usage of trade, all of which are expressly disclaimed. Without limiting the foregoing, the authors and their affiliated companies and each of their respective directors, officers, employees, agents, suppliers and partners, do not warrant that (A) HARMS/START-IT will be secure, available at any particular time or location or uninterrupted or error free; (B) any defects or errors can or will be corrected; or (C) the results of using HARMS/START-IT will meet your requirements.