Prescription pain patch abuse

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Prescription pain patch abuse blamed for increase in deaths

01 Jul 2005 Medical News Today

Drug abusers are increasingly turning to a slow-release form of a

powerful painkiller for a quick and dangerous high, University of

Florida researchers warn. The trend is raising alarm as the number of

people dying from an overdose of the drug fentanyl, an opioid 100

times more potent than morphine, rises.

Addicts are misusing a clear patch that transfers a controlled dose

of fentanyl through the skin into the bloodstream over the course of

a few days, UF experts say. The adhesive patch is typically

prescribed to treat postoperative pain or chronic pain conditions,

but in some cases is being misused, often with deadly consequences.

" Because the patch is a sustained release form of the drug, if one

withdraws the 72 hours' worth of drug and uses it in a form that it

wasn't designed to be used for, then it can rapidly result in death, "

said the study's lead researcher, Bruce Goldberger, Ph.D., director

of toxicology and an associate professor in the departments of

pathology, immunology and laboratory medicine and psychiatry in UF's

College of Medicine.

Patients who are prescribed the patch must be made aware of the

potential dangers of misuse, Goldberger added.

Florida Department of Law Enforcement records cited in the UF study,

presented this month in Orlando at the annual meeting of the College

on Problems of Drug Dependence, show abuse of the patch resulted in

the death of 115 people in Florida last year.

While the number of fatalities linked to the patch is still one-

quarter the number associated with other drugs abused, such as

methadone or hydrocodone, the number of sudden deaths from overdosing

on fentanyl has been on the rise during the past few years - not just

in Florida but also nationwide, researchers found.

" We have seen an increased use and abuse of the patch form of

fentanyl for the past five years or so, " Goldberger said. " This is a

recent finding related to the prescription of fentanyl patches. "

In many cases, people who died from overdosing on the drug were able

to easily remove the full dose of fentanyl from the patch and take

the entire three-day amount at once, either by injecting, ingesting

or smoking it.

In some cases, the deceased sought a state of euphoria by applying

multiple patches simultaneously.

It is not always clear from the law enforcement records where people

who overdosed obtained the drug, whether from a prescription of their

own or from one that had been stolen or otherwise not used according

to doctor's instructions, the group reported.

" Oftentimes we don't know where the patch comes from. Sometimes it is

from someone who had a prescription or it was purchased on the street

or acquired from a friend, so it has been diverted to them, "

Goldberger said.

Goldberger's team, which includes Mark Gold, M.D., a distinguished

professor with UF's McKnight Brain Institute and chief of the

division of addiction medicine, has been focused on the use and abuse

of prescription drugs. In the past few years his team has seen

increased abuse of methadone, and now fentanyl.

" Based on our study we're recommending that physicians better educate

their patients on the use of the patch, and, as a result, we might

see lower numbers in fentanyl-related deaths in the state of

Florida, " Goldberger said.

Albert Ray, M.D., medical director of Pain Medicine Solutions in

Miami and a past president of the American Academy of Pain Medicine,

said that the UF study brings necessary attention to the importance

of physician and patient education regarding addictive disorders.

" There is nothing wrong with the patch, the problem is with addictive

disorders, " Ray said. " Any drug has the potential for abuse. This

study is useful for raising awareness of the need for educating

prescribing physicians on the importance of screening and monitoring

their patients for addictive disorders in order to help decrease the

abuse of the patch. "

University of Florida

http://www.ufl.edu