by Raca Banerjee
“Mary is a 55-year old patient with terminal breast cancer. She suffers from severe pain and her doctor suggests that she consider using a fentanyl transdermal patch to help alleviate her symptoms. In response, she exclaims: ‘Fentanyl? The stuff that killed Prince? No thank you!’
“Current Prescribing Perilous
“This anecdote reflects society’s changing attitude toward opioids, but brings up another important point. How, while our nation battles an opioid epidemic, do we ensure that patients are open to taking narcotics when needed, or have access to pain medication? It is difficult to manage opioid prescribing in a way that prevents abuse while meeting patients’ needs. This becomes twice as hard when prescribing for the aging population, including older adults who have advanced-stage illness or who are at the end of life.
“Barriers that limit access to appropriate opioid treatment include patient fear, physician reluctance to prescribe and strict pharmacy controls or insurer preauthorization restrictions. While these last three issues are important to curbing the opioid epidemic, they may inadvertently lead to under-treatment of pain.”