We saw AA a week after his rotation was initiated. He claimed that the fentanyl was the “best thing” he had ever used, yet he was receiving none of the opioid prescribed. A urine toxicology screen at the time did not identify any opioids in his system. When he was informed of the incorrect application of the patch, his pain escalated very rapidly and was eventually titrated to a 75 mcg/h patch to adequately cover his pain control needs. We prescribed opioid medication to control his pain as he described, the same way he was prescribed high dose oxycodone prior to his transfer of care to our clinic. The patient had legitimate radiological findings that explained his severe chronic pain condition.
Have you experienced a similar situation in your practice? Have you seen the power of suggestion provide relief to patients in pain? Share your experience in the Comments section below. Dr Pacheco will be available to provide insight and feedback to your comments in this moderated forum.