is not the patient need.

It is a problem because DOCTORS are prescribing this patch carelessly, to
opiate naive patients and improper counseling/screening of patients before use.

Sending doctors letters, warning of improper use of drugs has shown to
be a poor way to correct a problem.
Doctors ignored the letters on Propulsid (leading to its withdrawal from the market), they ignore the warnings on Topamax, and these are just two recent examples.

One can visit the FDA and read pages and pages of letters sent to doctors.
I have a link to that site in the Medications sticky here.

I personally am concerned about the poor manufacturing practices of the plants making these patches. The recalls all revolve around poorly made product. Patch technology is very fragile and complex. The more patches become commonly used, the numbers of people increase and statistical variance then becomes acute. It just so happens with fentanyl, that tiny
changes in the patch or ANY improper use, may dump the drug into the
body quickly resulting in a negative outcome. Fentanyl is very potent, and has a narrow margin of safety.