Abusing a painkiller patch may lead users on a one-way trip

By JIM BROOKS
Nelson County Gazette

Monday, March 17, 2008, 11:55 p.m. -- The call over the scanner is becoming all to common: A dispatcher's voice cuts through the silence, requesting an EMS squad to respond to a suspected overdose, and the patient is unresponsive.

The overdose may have been accidental, but in an increasing number of cases the goal was the same -- to get high by abusing a commonly available prescription painkiller patch called Fentanyl.

Fentanyl is a powerful synthetic opiate whose chemical structure is similar to that of morphine and heroin. Fentanyl is a pain medication used after surgery or for chronic fatal illnesses. When misused, drug abusers can feel the same effects as heroin, though Fentanyl is hundreds times more powerful than morphine.

As a painkiller, Fentanyl is prescribed in patch form under the name brand Duragesic. Each patch delivers the narcotic through the skin, and is available in dosages from 25 to 100 mcg/hour. The patch can provide pain relief to the user for up to 72 hours.

But when it is misused, Fentanyl can quickly be deadly. Abusers who seek a quick high simply pop the patch in their mouth and chew on it to release the narcotic -- creating a nearly instantaneous overdose.

An overdose of Fentanyl kills the abuser by inducing hypoventilation, where the victim simply stops breathing. Fentanyl abuse is thought to be responsible for several drug overdoses in recent weeks in Nelson County.

Fentanyl has been available in patch form since the 1990s. Deaths from its abuse have been increasing since first reported several years ago. The number of overdoses and deaths from Fentanyl abuse continue to climb each year.

One reason for an increase in Fentanyl abuse may be the crackdown on another popular painkiller, OxyContin.

"The abuse of oxycodone and the fear of litigation is enough to scare doctors from prescribing it. Duragesic is in vogue, as we've seen over the last year and a half and two years," said Dr. John Brandt, a chronic-pain specialist at the University of Florida in 2006 interview with the Associated Press.

In addition to chewing the patches, abusers may also extract the gel from the patch, dry it and then smoke the remaining residue.

Fentanyl is hundreds times more potent and typical opiates. Only small amounts of the drug are required to manage a patient's pain.

The street value of a Fentanyl patch is $25 to $40. The patches may be stolen from pharmacies and patients, but abusers are also rummaging through hospital and medical center trash cans and Dumpsters because used patches will still contain significant amount of the potent drug.

Individuals who are prescribed the patches are urged to cut them into small pieces before disposing of them.