I honestly don't know what would make a fentanyl pill better than another opioid. The patch delivery system is generally better than oral drugs as it keeps the level constant and this means you usually can get by on a lower overall dose. It's true that drugs are not tested well. You know, everyone is always so afraid of narcotics, but they have been around for centuries and at least we know what they do. But drugs like Neurontin and Lyrica.... we have no idea what the long term effects are. I do take Lyrica in addition to the fentanyl patch because I haven't found another way to get tolerable relief. But I'm not happy about it. I'm getting ready to make an all out effort to loose weight and see if I can't tolerate some exercise of some sort -- I'm going to try water aerobics again and maybe Yoga.