The Sometimes Murky World of Fentanyl Patches

May 21, 2011, 1:30PM. By Gordon Gibb

Bristol, GAIn the sometimes murky waters that flow between powerful prescription pain medications such as Duragesic fentanyl and the possibility of deliberate or accidental abuse are the lives and tragic deaths of people who somehow get caught in the middle.

The Duragesic patch is a potent narcotic many times more powerful than morphine. Developed for patients with chronic pain, the patch is designed to be worn on the skin. A reservoir in the patch containing the robust fentanyl medication is designed to release trace amounts of the medication in a controlled fashion over time—allowing for the continual application of pain-busting fentanyl for those patients to whom the fentanyl has been prescribed—and for which they have been properly conditioned.

But sometimes things can go wrong. The Fentanyl Duragesic patch was recalled in recent years due to a breach in the reservoir that had the potential for releasing more of the narcotic than was considered safe. Only a few of the patches were thought to be compromised in this way. However, a patient or caregiver could never know if a patch being applied was sound or problematic.

And there have been tragic incidents.

The Florida Times-Union of Jacksonville reported May 11 on the indictment of Clinton Deloach Jr. following a head-on crash in February that killed a child abuse investigator. A Pierce County grand jury issued the indictment to Deloach, who has been charged with first-degree vehicular homicide and driving while under the influence in a February 10 crash that killed Doreen Myers.

Deloach had not been drinking. However, Georgia State troopers have been investigating the possibility that Deloach may have been under the influence of at least one fentanyl pain patch. It is not known if the patches at issue are the Duragesic pain patches.

The fact remains, however, that patients of such pain patches that deliver round-the-clock relief will continue to perform their jobs, continue to drive—whether they should be or not…

Could Deloach's patch have failed?

In another tragic story, a 28-year-old Bloomington man died after chewing on part of a fentanyl patch to get high. He passed out in the lap of his girlfriend and failed to regain consciousness. A 51-year-old woman who traded the pain patch for marijuana pleaded guilty to second-degree manslaughter.

Duragesic side effects—as is the case with any other pain patch from another manufacturer—can only be avoided when use of such a potent medication is tightly controlled or when the patch itself is intact and without compromise. Sadly, this is sometimes not the case.