If it is not possible to contact the previous prescriber or pharmacist, consider whether the request may be fraudulent.If not possible, check with the purported pharmacy where the opioid is usually dispensed. If the patient is an ‘inherited’ patient (seeking continuation of established prescribing), seek independent verification of the purported previous prescriber.Take a ‘universal precautions’ approach by routinely using the above precautions with all patients, and if necessary explaining that this is recommended best practice.Generally the long term prescribing of a Schedule 8 opioid exceeding an oral morphine equivalent daily dose (OMEDD) of 60mg daily should be in accord with the written support of an appropriate specialist physician, such as a pain specialist, and in accordance with a clearly documented therapeutic plan.Arms can be inspected when checking blood pressure, and other common sites (groin, legs or neck) can be checked in the course of a full examination. Assess drug and alcohol use, and examine the patient for evidence of injecting drug use.

Establish by history and examination a genuine need for the opioid sought and decide on the best pain management plan for the individual.

Check the identity, using photo ID if possible, of any patient presenting and requesting a prescription for an opioid, including fentanyl transdermal patches.Recommended action by prescribers Check the patient

Non gel fentanyl patches extraction