[Opioid dependent patient with two prescribers]

Area of Science:

• Pharmacology
• Medical Ethics
• Patient Safety

Context:

• Rising opioid use, particularly in surgical patients.
• A specific case involving a fentanyl-dependent patient prescribed oxycodone.
• Patient refusal to allow communication with other healthcare providers.

Purpose:

• To analyze a pharmacist's ethical dilemma regarding conflicting opioid prescriptions.
• To explore professional values under pressure in clinical practice.
• To reflect on optimal strategies for managing polypharmacy in opioid use.

Summary:

• A pharmacist faces a dilemma with a fentanyl-dependent patient presenting an oxycodone prescription from a new prescriber.
• The patient objects to the pharmacist contacting their existing prescribers, complicating medication reconciliation.
• The case prompts reflection on professional responsibility, patient autonomy, and medication safety.

Impact:

• Highlights the need for improved communication and collaboration among prescribers.
• Underscores the importance of clear prescribing practices to prevent medication errors.
• Informs best practices for pharmacists managing complex opioid use cases and polypharmacy.