Rectal Insertion of Fentanyl Patches: A New Route of Toxicity

Coon, Troy P.; Miller, Michael A.; Kaylor, Dave; Jones-Spangle, Karen

doi:10.1016/j.annemergmed.2005.06.450

Cited by 45 publications

(25 citation statements)

References 3 publications

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“…In the 1990s fentanyl transdermal patches were introduced for widespread palliative use and access extended from clinicians to include patients. As a result, reports of overdoses caused by the misuse of fentanyl transdermal patches emerged in the 1990s and continued into the early 2000s (Rose et al, 1993;Marquardt and Tharratt, 1994;Flannagan et al, 1996;Edinboro et al, 1997;Kramer and Tawney, 1998;Frolich et al, 2001;Reeves and Ginifer, 2002;Tharp et al, 2004;Coon et al, 2005;Teske et al, 2007). In 1994, the FDA issued a warning regarding the dangers associated with fentanyl patches, expressing that it should only be prescribed to those with severe pain that cannot be managed by less potent opioids (Wyman, 1994).…”

Section: Study Selectionmentioning

confidence: 99%

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

et al. 2018

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Section: Study Selectionmentioning

confidence: 99%

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

et al. 2018

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“…[29] Other routes of abuse that have been reported for transdermal fentanyl formulations include application of multiple patches, [38] placing the patch in the mouth, [39][40][41] chewing or sucking, [42][43][44] swallowing whole, [45,46] injection of extracted patch contents, [47][48][49] smoking [50,51] and rectal insertion. [52] Patches may also be boiled to make a "tea", which can be ingested or injected. [53][54][55] Available data suggest that injection is the most common route of abuse for buprenorphine, [56][57][58][59][60][61] although abuse via inhalation has also been reported.…”

Section: Differences In Routes Of Abuse Between Formulationsmentioning

confidence: 99%

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Gąsior

Bond

Malamut

2015

Postgraduate Medicine

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Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

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“…These were cases leading to intoxication or death and published in medicolegal or emergency medicine journals. It is not known that whether dependence was present in these cases or not (3)(4)(5)(6).…”

Section: Discussionmentioning

confidence: 99%

Fentanyl dependence associated with the use of transdermal fentanyl in a cancer patient: a case report

Sarısoy¹,

Korkmaz²,

Özturan³

et al. 2013

Dusunen Adam

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Fentanyl dependence associated with the use of transdermal fentanyl in a cancer patient: a case report Fentanyl is a syntetic narcotic analgesic that is available for the management of chronic cancer and noncancer pain. Its analgesic potency is 75-100 times greater than that of morphine. Apart from the lipofilic nature and the high potency, fentanyl is characterized by low molecular weight and thus, is suitable for transdermal use. The transdermal fentanyl patches are designed to deliver fentanyl at a constant rate for periods of 72 hours. Patches with a delivery rate of 25, 50, 75 and 100 µ/h are avaiable. Transdermal fentanyl is effective and safe in many cancer patients. Abuse/misuse of fentanyl patches has been increasingly reported along with different routes of administration such as intravenous, oral, rectal, inhalational use.However, there are two reports associated with transdermal fentanyl dependency in literature. Here, we report a case of fentanyl dependence associated with the use of transdermal fentanyl in a cancer patient.

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Rectal Insertion of Fentanyl Patches: A New Route of Toxicity

Cited by 45 publications

References 3 publications

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Fentanyl dependence associated with the use of transdermal fentanyl in a cancer patient: a case report

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