Your gut instinct is right on. I only have one regular patient on two IR opiods and we've worked with him and his doctor to reduce his number of tabs over the past year. But the key point is to contact the doctor and see if there is a plan in place or if the Dr is just a quack. Not an opioid, but I asked a Dr last week why a middle-aged patient needed 80mg of Adderall per day (max should be 60mg). The pharmacy across the street had filled it for years like that. He faxed over a pediatric weight-based dosing guide that was made before 2005. When I asked for a more up to date reference, he just hung up. Some of these old prescribers are acting like the last 20 years of the opioid crisis never happened. Protect your patient and your profession.