Duragesic: This Patch Could Stop Your Heart

Toronto, ONThe active ingredient contained in the recalled Duragesic pain patch is a synthetic opioid analgesic that is considered to be several times more potent than heroin. The makers of the Duragesic patch containing fentanyl have recalled the patches over concern that a breach in the patch reservoir could pose an overdose hazard to both patient, and caregiver.

The potent patches are prescribed for chronic pain. They're designed to dispense a continuous, but controlled amount of potent pain relief for those suffering from severe and chronic pain. The recalled patches could have a cut on the side that could potentially leak fentanyl gel. The latter would be considered a serious health hazard for both user, and anyone who might come into contact with the patch.

Designed to administer 25 micrograms of pain relief each hour to pain sufferers conditioned to such potent medication, an unseen leak in the patch reservoir could potentially deliver an overdose of fentanyl to the patient through the skin.

However, the hazard is equally threatening to any individual who may serve as the caregiver for such a patient, or whom may come into contact with a potentially leaking patch for any reason. The latter could have dire consequences given that fentanyl, when properly prescribed, should only be used by individuals who are conditioned, and have built up a tolerance over time to such strong medication. A caregiver, on the other hand, would not be equipped with such tolerances, for whom exposure to fentanyl could pose extreme danger.

Signs of fentanyl overdose include difficult or shallow breathing; tiredness; extreme sleepiness; inability to think, talk or walk normally; and feeling faint, dizzy or confused. It is recommended that anyone who has come into contact with leaked fentanyl gel from a compromised Duragesic patch should thoroughly rinse exposed skin with generous amounts of water. Soap, or alcohol should not be used, and in fact could exacerbate the problem.

The Duragesic patch, and indeed any patch which contains the potent fentanyl analgesic, has come under scrutiny prior to this recall, which, in Duragesic's case, is the fifth recall over a 14-year period.

However, concerns over safety go beyond the potential for a breach in the patch reservoir, and the potential for fentanyl gel to leak out. Rather, there have been instances where these potent pain treatments have been prescribed to the wrong people, for all the wrong reasons.

The deaths of two teenagers from Canada were attributed to the misuse of fentanyl patches, after they were prescribed for conditions and ailments not appropriate for the potency of the drug, and to individuals not conditioned to the rigors of opioids. One teen had complained of severe headaches, while the other had a sore throat.

Both teens succumbed to fentanyl overdoses and died in 2004.

In a story eerily similar to the Oxy Contin debacle, teenagers—it seems—have discovered the merits of fentanyl patches as a potential drug for misuse, without realizing the risks. One story originating in Canada, and reported in the National Post, found a handful of teenagers to have overdosed after coming into contact with someone else's pain patch.

Sometimes the patches are used recreationally. The Ontario Chief Coroner's Office identified 54 deaths attributed to the use of fentanyl patches between 2002 and 2004. Many of those uses were, in fact patent abuses. Most had absorbed the drug through the skin, but some had injected the fentanyl, swallowed the drug or burned, and subsequently inhaled it.

In the end, it serves to illustrate just how potent these patches can be, and the importance of ensuring they are properly prescribed to the right people, for the appropriate pain and condition, and are used in the appropriate fashion.

The recalled patches have an expiry date on, or before December 2009. The last major recall of this patch was in 2005, when it was reported that 120 people had died from using the Duragesic fentanyl patch.