Posted: Aug 26, 2009 11:43 AM by Andy Koen
When used properly, Fentanyl pain patches can bring relief to cancer patients and people suffering with chronic pain. When they are misused the results can be deadly. El Paso County Coroner Dr. Robert Bux says far to many people are ending up in his morgue after over-dosing on the pain medicine.
"Fentanyl, certainly in the last few years, has come under our radar screen because we're seeing a number of deaths every year, not only from this county but the other counties that we [serve] in the region," Bux said.
Like nicotene patches for smokers, Fentanyl patches are designed to deliver small amounts of medicine, over an extended period of time, directly to a person's body. But when the patches are misused, problems begin.
Werner Jenkins, the chief of toxicologist for the coroners office says one reason is because pure Fentanyl is "much, much stronger than morphine."
"Some people have said 50 to 75 times stronger than morphine," Jenkins said.
Jenkins and Bux have seen Fentanyl addicts who have manipulated the patches by dissolving them in a solution, others chew the patches, some even remove the medicine and smoke it.
All the manipulations can increase the potency of the drug delivered, and all can be deadly.
"We still see our fair amount of cocaine and methamphetamine and heroin deaths, but again you expect those" Jenkins said.
"This is a therapeutic drug that you wouldn't expect to see deaths."
Abuse of prescription pain medicines is a wide spread problem. Doctor Marilyn Gifford, the emergency department director for Memorial Hospital, says "there isn't an emergency department in the nation that doesn't have a problem with drug seeking behavior."
ER docs generally don't prescribe something as strong as Fentanyl to patients off the street. But because they prescribe other pain pills Gifford says hospitals have to be especially careful not to unknowingly support addicts.
"There are people who are determined to get drugs and they will do a lot to get them," Gifford said, including injuring themselves.
She recalls one patient who came in with a twisted ankle and requested strong pain medicine as part of their treatment. The doctors became suspicious and only gave the person a low level pain medicine. The same patient later returned to the ER with multiple fractures caused from intentionally jumping off the roof of a building.
Coroner Bux is concerned that such extreme addictive behavior can be especially problematic when coupled with the potency of a drug like Fentanyl.
"They've used morphine, they've used heroin, they've used everything else they can get their hands on and then they get their hands on this and they don't do well."
In order to fight prescription drug abuse, the pharmaceutical companies have created a registry in Colorado for doctors and pharmacists to access and see a patient's drug history. The goal is to curb addiction by recognizing heavy use patterns.
Dr. Gifford says the system is limited because it doesn't report a patient's aliases and there is currently no requirement to furnish a photo ID in order to receive narcotics. That said, Gifford believes there is a shared responsibility in the medical community to spot addiction.
"I know that there are patients who are in pain that don't happen to have a photo ID with them when they're in pain and I think they probably deserve the benefit of the doubt, but by the third or fourth time they arrive we should've been able to solve that."