Pain patch has killed three drug abusers
5/15/2008 12:52 AM


By KAREN DAILY Staff writer

With a potency of nearly 80 times that of morphine, abuse of a commonly prescribed pain patch has already claimed the lives of three people this year.

Between January 2006 and May of this year, 11 Aiken County residents have died from either injecting, scraping, chewing or even overloading on fentanyl pain patches.

Pharmacist Raj Tamrakar explained the drug is an opioid, a synthetic narcotic similar to opiates. Fentanyl is a hallucinogen and is designed to deliver medication slowly over the course of several hours.

Scraping a patch and injecting it with a solvent amounts to taking 40 times the dose typically prescribed, said Aiken County Coroner Tim Carlton.

Late last year, the Food and Drug Administration, spurred by patient deaths and life-threatening side effects, issued its second warning in as many years, cautioning about misuse of the skin patches, which are sold under the brand name Duragesic and in four generic products.

The warning was specific to fentanyl patches, not other forms of the drug, and applies to the brand name and the generic fentanyl. The patches must be prescribed.

Removing the patch will not reverse the effects because the drug builds off the drug, and often times it strikes so quickly there isn't time to call for help.

Of the most recent 11 death, none of patients were prescribed the patches.

"In the past we have seen people take them from family members, but right now we are finding they are obtaining them illegally," the coroner said.

Aiken County Sheriff's Office investigators are aware of the illegal sales in the area, but the agency's spokesperson, Lt. Michael Frank, said no cases have been made yet.

While the FDA warns of the symptoms of a fentanyl overdose such as trouble breathing, a slow heartbeat, severe sleepiness, trouble walking and feeling faint or dizziness, often death has come suddenly.

"People haven't had time to call EMS," Carlton said.

In February, the FDA announced a voluntary nationwide recall of 14 lots of Actavis, a generic fentanyl pain patch, because of a defect that may have resulted in leakage.

That recall followed a similar one the week prior by PriCara and Sandoz, also with concerns that leakage could potentially expose patients and/or caregivers to fentanyl gel.

Carlton said the coroner's office has investigated each of the recent 11 deaths and none of those who overdosed were using recalled patches.

Additional warnings have been issued by the federal government, cautioning those who wear the patches that alcohol increases the risk of an overdose.

Those who have an increase in body temperature or are exposed to heat from hot tubs, saunas, heating pads, electric blankets and heat lamps also suffer increased odds of death.

First synthesized in Belgium in the late 1950s, fentanyl was introduced into medical practice in the 1960s as an intravenous anesthetic.

Illicit use of pharmaceutical fentanyls first appeared in the mid-1970s in the medical community. The biological effects of the fentanyls are indistinguishable from those of heroin, with the exception that the fentanyls may be hundreds of times more potent, according to the FDA.

Carlton said the public should be aware that those who have died cross all demographic groups. Some were seemingly healthy young people and lived in various parts of the county.

2006

January -- 40-year-old male

January -- 55-year-old female

March -- 43-year-old male

May -- 51-year-old male

July -- 61-year-old female

August -- 54-year-old female

2007

November -- 52-year-old male

December -- 47-year-old male

2008

February -- 42-year-old male

March -- 25-year-old female

March -- 26-year-old male

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