Duragesic Pain Patch: Having a Thick Skin Doesn't Help

New Brunswick, NJ: It has been said that the skin, is the new stomach. Thus, the reasons why transdermal patches are becoming increasingly popular for the regulated delivery of certain medicines to the human body. The problem is when this careful, regulated dosing fails, or is compromised in some fashion. Such is the case with the recent recall of the Duragesic fentanyl pain patch, after a manufacturing defect found in a select few of the patches posed a risk to patients and caregivers of coming into contact with too much highly-potent medication, at one time.

Most consumers are conditioned to taking medication orally or—in the case of a hospital setting—via an IV needle. While a needle connected directly to a blood vessel is an obvious pathway to the bloodstream, so too is the stomach. The latter, of course, is a somewhat slower pathway to the bloodstream, as the stomach needs to first break down the contents of the pill, for example, before it is ultimately transferred to the bloodstream via the digestive system.

Either way, patients have a sense that medication is, to put it one way, getting directly into their insides by either swallowing, or via injection. It's a direct pathway patients can understand, and comprehend. That explains the relative care that most patients observe when taking any kind of oral, or accepting any kind of injected meds. They ask questions—what's the safe dose, or what's it going to feel like inside when this medication flows from the bag, through the tube and the needle, and into my arm? Will it hurt? Will I feel warm? This is getting into my insides, so I'm paying attention. Will this make me sick?

It is safe to say, however, that unless a doctor explains the concept of transdermal patches, few patients would have an appreciation for the effectiveness of skin as a pathway to the interior regions of the human body, for the purposes of drug delivery.

To most, skin is not an organ but simply a covering for your flesh. Yes, a living cover—and we watch it heal thyself when a wound, such as a scrape, cut or burn is suffered. Remarkable stuff, skin is—an organ to be sure—and also porous. You know that by the sweat you produce when you run. And you know that by the wrinkling of the skin after you've been in the pool for too long. Your skin has absorbed excess moisture, hence you wrinkle up like a prune.

It is this same feature that allows for medication to be absorbed through the skin, and into your system—but without the need for the kind of specialized skill that comes into play when a doctor, or nurse inserts an IV needle into a patient's arm. And the skin does not become upset, like your stomach can if you ingest something that doesn't agree with you.

The problem, however, is the rate of absorption. Some medicines, such as the fentanyl found in Duragesic pain patches, require a carefully controlled, and slow absorption rate lest too much medication enter the human body through the skin at any one time, laying the groundwork for a potential overdose.

To most patients, however, as long as something is not swallowed or taken intravenously, precautions are not as prevalent, and they should be.

Especially, when considering something as potent as the Duragesic patch.

These patches have been recalled before. In 2005 the US Food and Drug Administration (FDA) issued a public advisory after reports of several deaths and adverse reactions. At the time, the FDA articulated that in its view patients and caregivers may not have fully understood the implications of using the patch incorrectly, and the potent characteristics of fentanyl, a strong narcotic estimated to be 100 times the strength of morphine.

And yet, there were instances of patients doubling up the patches, to try and counteract intense chronic pain—a practice that some have suggested is a death sentence. A US teen lost his life recently by doing just that—using two patches at once. There have also been reports that some doctors have prescribed Duragesic fentanyl patches for common headache, and failing to take into account that Duragesic fentanyl patients need prior conditioning to narcotic, or opioid drugs, before they can accept fentanyl with any degree of safety.

Such is the current concern over the Duragesic recall, given the possibility that a cut, or breach in the reservoir could leach out potentially lethal doses of fentanyl to patients, and even caregivers. An overdose can lead to respiratory death, or cardiac arrest.

Symptoms include labored and slow breathing, tiny pupils, cold, clammy skin, seizures, confusion, dizziness, weakness, unconsciousness or coma, fatigue. Fentanyl, as an opioid, is also highly addictive.

The recent recall of the Duragesic Fentanyl patch was taken as a precaution after a small number of patches were found to have a defect that could defeat the controlled dosing of the medication, which is integral to the safe use of this highly-potent medication.

In 2005, 120 people reportedly died from using fentanyl patches. A massive overdose can cause a patient to suddenly stop breathing, whereas a slow overdose and cause a patient to slip into a coma, and die.

If you, or a loved one has experienced loss, or injury from a malfunctioning fentanyl pain patch, you could be eligible for damages obtainable through litigation.