Title: Recommendations

Context:
Route of Administration/Delivery: The systematic evidence review for this CPG did not find any studies that compared alternative delivery  systems (e.g., fentanyl transdermal, fentanyl buccal) to other delivery systems (e.g., oral, intravenous)  (information on transdermal and sublingual buprenorphine is included in the following section on  Buprenorphine for Pain). The concomitant use of oral and transdermal opioids or oral and intrathecal pumps should be approached with extreme caution and warrants specialty consultation. Discussions of  intrathecal pumps are beyond the scope of this guideline.

Question: What should be approached with extreme caution and warrants specialty consultation?

Answer: The concomitant use of oral and transdermal opioids or oral and intrathecal pumps