Fentanyl Dangerous Both in the Right and the Wrong Hands

Midland, MIFentanyl is a dangerous adversary at the best of times—which represents those occasions when the planets align and everything goes right. Even when the drug is appropriately prescribed and managed, and the patient monitored during use of a properly functioning Duragesic Fentanyl patch, there are risks. Sadly, when such a potent pain medication is involved, there is so much that can go wrong…

Fentanyl is an opioid painkiller, classed as a narcotic and designed for patients dealing with serious and chronic pain. Strong medicine for the worst kind of pain—and for whom fentanyl was designed, the drug and the way in which it is delivered can allow a chronic pain sufferer to function. The Duragesic patch is designed to administer controlled levels of fentanyl transdermally through the skin.

Given that fentanyl is far more potent than morphine or even heroin, the ability for the patch to do what it's supposed to do is integral to not only good health, but also ultimate survival—given the potential damage that can be wrought should a patch fail.

Which is exactly what happened surrounding the Fentanyl patch recall, which resulted from a finding that some of the patches were compromised by minute tears or breaches in the reservoir within the patch containing the potent fentanyl opioid.

But there are other dangers with fentanyl—and it starts with the initial prescription. Fentanyl is so potent, it can only be safely prescribed to a patient who already possesses a tolerance for opioids. In other words, someone who has been exposed to lesser opioids in an effort to acquire a certain tolerance for them.

Then there is the risk of hypoventilation, also known as respiratory depression. The Duragesic product label—an official document approved by the US Food and Drug Administration (FDA), warns "serious or life-threatening hypoventilation may occur at any time during the use of Duragesic especially during the initial 24–72 hours following initiation of therapy and following increases in dose.

"Because significant amounts of fentanyl are absorbed from the skin for 17 hours or more after the patch is removed, hypoventilation may persist beyond the removal of Duragesic. Consequently, patients with hypoventilation should be carefully observed for degree of sedation and their respiratory rate monitored until respiration has stabilized."

There are also concerns surrounding the condition of the skin to which the patch is applied. If the skin is broken, not only can the fentanyl irritate the skin, but broken skin may facilitate its transference more quickly. Heat will also speed absorption of fentanyl, which should be avoided at all costs. Were a patient, feeling ill and out of sorts and perhaps experiencing chills, to turn on the electric blanket, the consequences could be dangerous.

The potential for fentanyl addiction is also hardly surprising given the characteristics and personality of the opioid, and represents one of the more damning and dangerous Duragesic side effects. A 36-year-old man named Jason who posted to an addiction recovery forum on eHealthForum.com noted that he had tried everything, and attempted to wean himself from every addictive drug there is since the age of 16, when he started abusing.

Writing about fentanyl, Jason said in November of last year, "The detox from [fentanyl] is the hardest I have done and I have kicked everything. The anxiety that comes from this addiction is almost inhumane and I just can't seem to get through it. I feel like shooting heroin was easier to get off than the [fentanyl] patches are."

Sadly, fentanyl patches are also finding their way into the street-drugs pipeline and available to adolescents eager to try something new but having no idea—lacking the prescribing information—what they are getting into.

That's what happened to Grant Edward Neeb. Just about two months shy of his 18th birthday, he experimented with a fentanyl patch. Without knowing the issues or the consequences inherent with this extremely potent drug, he died on February 3, 2009. Fentanyl patches are that dangerous…especially in the wrong hands.