Scores Of Deaths Blamed On Abuse Of Painkiller Patch

Rutland Herald ^ | June 16, 2006

[Wolfie]

Scores Of Deaths Blamed On Abuse Of Painkiller Patch

ST. LOUIS -- Justin Knox bit down on the bitter-tasting patch, instantly releasing three days' worth of a drug more powerful than morphine. He was dead before he even got to the hospital.

The 22-year-old construction worker and addict was another victim in an apparent surge in U.S. overdoses blamed on abuse of the fentanyl patch, a prescription-only product that is intended for cancer patients and others with chronic pain and is designed to dispense the medicine slowly through the skin.

"I cannot tell you the amount of people I've seen and the creative ways they abuse this drug," said Dr. Scott Teitelbaum, director of the Florida Recovery Center in Gainesville, Fla. "Fentanyl has been abused for years. But recently there has been an increase. I've seen more chewing, squeezing of the drug off the patch and shooting it up."

Fentanyl, a synthetic narcotic, was introduced in the 1960s, but it was not until the early 1990s that it became available in patch form. Last year, the first generic versions of the patch hit the market.

At least seven deaths in Indiana and four in South Carolina since 2005 have been blamed on abuse of the fentanyl patch, along with more than 100 deaths in Florida in 2004. About a week after Knox's death in Farmington, Mo., in March, a second man in the same county was prescribed the patch legally and died after injecting himself with the gel that he had scraped from it.

Emergency-room visits by people misusing fentanyl shot up nearly 14-fold to 8,000 nationwide between 2000 and 2004, according to the U.S. Department of Health and Human Services. The figures do not indicate how many of those ER visits were because of the patch.

( In recent months, more than 100 deaths have been reported from Chicago and Detroit to Philadelphia among drug addicts who overdosed on heroin mixed with fentanyl. And federal drug agents believe fentanyl is being made in clandestine labs in Mexico and elsewhere. )

The first fentanyl patch was Duragesic, made by Johnson & Johnson. Sales more than tripled from 2000 to 2004, according to the Pacific Law Center in La Jolla, Calif. Worldwide sales were more than $2 billion in 2004, and half of that was in the U.S., according to the J&J's Web site.

More than 5.7 million prescriptions were written in 2003 for the Duragesic patch, according to IMS Health.

Mark Wolfe, spokesman for PriCari, the J&J unit that oversees Duragesic, said the product comes with strong "black box" warnings about the dangers of abusing Duragesic.

One theory is that addicts are turning to the fentanyl patch because of a government crackdown on abuse of another powerful prescription painkiller, OxyContin, or oxycodone.

"The abuse of oxycodone and the fear of litigation is enough to scare doctors from prescribing it. Duragesic is in vogue, as we've seen over the last year and a half and two years," said Dr. John Brandt, a chronic-pain specialist at the University of Florida.

In Missouri, the man accused of illegally selling the fentanyl patch to Knox has been charged with murder.

"The awareness is just not out there. I had never heard of this patch," said Knox's mother, Rose Marler. "There's a new generation of drugs and people just need to be aware."

[VeritatisSplendor]

Darvon? non-stop vomiting. Fentanyl, now, that's good stuff.

Mrs VS

[csvset]

Mother warns others of deadly drug
Justin Knox dies of drug overdose from pain patch
By TERESA RESSEL\Daily Journal Staff Writer
Justin Knox, 22, died March 11 after trying to get a quick high from a Duragesic patch. His mother, Rose Marler, said Justin knew he had a problem with pain pills and had tried to get help.

FARMINGTON - Rose Marler remembers her 22-year-old son as a young man who always had a smile on his face even when things were bothering him.

She said Justin was an outgoing person who never met a stranger. He loved having get-togethers with his family and friends. He also loved being a dad to his 2-year-old daughter, McKinzie.

“He was such a great person,” Rose said. “... I guess he just got lost for awhile.”

On March 11, just a few weeks after he had been to a local treatment center, Justin died of a drug overdose.

Justin Knox, a graduate of Farmington High School, had become addicted to pain pills.

“I don't know how it started,” she said, adding she found out about it within the last six months.

She said he realized he had a problem. She said he was reaching out for help but he decided he could do it on his own. He was given a patch to help with withdrawals.

And then Justin took another kind of patch, Duragesic, which ultimately took his life on March 11.

She's not sure how he got it, but Duragesic is a fentanyl transdermal patch used for chronic pain. Fentanyl, a narcotic analgesic, has an analgesic potency of 80 times that of morphine and is often used for terminal cancer patients.

She believes he chewed on the patch, which caused his respiratory system to fail.

“The chances of waking up after doing this are very slim,” she said.

Rose wants parents, grandparents, schools, and any person thinking about trying it to be aware that “this is a deadly drug.”

She said the patch is a “quick high for them” but it also causes a quick death.

“So many people don't know about this,” she said. “This drug is really something that needs attention.”

Justin's uncle, Jack Marker, is the assistant director of nurses at Mineral Area Regional Medical Center. He said the patch is good for those who need it, but it is something that should not be abused.

Duragesic delivers fentanyl, a pain medication, slowly into the body through the skin where it works to relieve pain for up to three days.

Jack said it is something that can not be abused safely. He said even pharmacists can't figure out a way to just get a little bit of the drug.

Jamie Barton, a pharmacist at Mineral Area Regional Medical Center, said it's “like playing Russian Roulette every time you attempt to abuse it.”

“You don't know where the drug is concentrated in the patch,” Barton said.

Barton isn't sure how people are getting the patches. Some are using used patches that she said can still contain enough medicine to potentially kill two people, if used improperly. Others may be stealing or buying patches from friends or family members.

Jack said the teeny tiny patch has the equivalence of 80 vials of morphine. Used, it still has 2.8 milligrams of active fentanyl from overfill.

Joe Easter, director of nurses, said people have been getting narcotics illegally for a long time.

“This is like going from stealing firecrackers to dynamite,” he said.

Barton believes those abusing the patch to get a quick high are chewing or sucking on the patch, or drinking or injecting the contents of the patch.

“You can't hardly get away with playing with it, without ending up here (in the emergency room),” Jack said.

Barton said in a two week period, the hospital had four patients in the hospital from using the patch. Two patients died .

“The other two were lucky,” she said.

Barton said because of the concerns of the abuse of this patch, the hospital has changed their policy on disposal of the patches. She said she would recommend other people do the same thing.

She said there should be a witness to the disposal of the patch, used or unused, and the patch should disposed in a way that it could not be used again.

She recommends patients dispose of their patches by folding it in half, with the sticky side together, and flushing it down the toilet.

Benefit

Friends are hosting a benefit for Justin's family. The benefit will be held from noon to midnight today at the Farmington Amvets.

There will be an all-you-can-eat chili dinner for $2.50. The dinner includes chili, a hot dog, a beverage and a dessert. Children, 10 and under, eat for free.

Evening entertainment will include bluegrass and country bands, followed by rock and roll bands. The cover charge is $5.

There will also be door prizes and give-aways.

Updated Friday, Apr 07, 2006 - 08:29:09 pm CDT

http://www.dailyjournalonline.com/articles/2006/04/08/community/news1.txt

Copyright © 2000-2006 Daily Journal

[Tijeras_Slim]

Uh, okay...but how big of a fool do you have to be to try to eat a dermal patch?

It's like those suppository things, for all the good they did me I could'a shoved 'em up my....

[Dont Mention the War]

Justin Knox, 22, died March 11 after trying to get a quick high from a Duragesic patch.

Trying? Sounds like he was successful beyond his wildest dreams.

[tacticalogic]

I've had both oxy- and hydro-codone based scripts, mostly for a back injury. I like the stuff if I'm in pain, but beyond that I've never understood the fascination with being groggy and constipated.

[Mogollon]

Fentanyl is a very potent synthetic narcotic, a typical dose is:

Analgesia/anaesthesia:

Adults

Initially- 50-200mcg in patients with spontaneous respiration; 300-3500mcg in patients with assisted ventilation
Supplemental- 50mcg in patients with spontaneous respiration; 100-200mcg in patients with assisted ventilation

(1 mcg=1 microgram or 1/1000 of a milligram).

Respiratory depression is what causes death in overdose situations.

[Waco]

Take note LIBS/RATS: Bite down hard, it's worth it. (To be rid of ya.)

[daybreakcoming]

Even though my mother, who has cancer, has used this patch, I didn't realize it was a big "get" for drug addicts until I read a story (fiction) couple weeks ago about an addict who would slip into nursing homes and steal the patches right off of patients' skin.
sorry about the run-on sentence

[Tax-chick]

I have never been prescribed those. Post-partum pain is short-term, and I usually get 10 narcotic tabs for use in the first week. Darvon and Percodan give a slightly fuzzy, but bright and cheerful, feeling.

[Extremely Extreme Extremist]

LOLOLOL

[ApplegateRanch]

The 22-year-old construction worker and addict was another victim in an apparent surge in U.S. overdoses blamed on abuse of the fentanyl patch,

A dead addict is a good addict. At least it was his choice, and he died happy.

In Missouri, the man accused of illegally selling the fentanyl patch to Knox has been charged with murder.

And that makes it a happy twofer.

[Nathan Zachary]

I was on fentynol patches for a year.
I don't know why anyone would want to eat the stuff or shoot it up. The stuff kept you groggy on regular prescribed doses.
Fentynol was hard to quit as well. I was sick for days from withdrawal symptoms.

Thank goodness for oxycontin, it's a much better drug, and not addicting (IF USED PROPERLY).

If Heroine addicts are using it and dying from it, they deserve it. Fentynol slows the heart and respirations, drops your blood pressure. Combine that with heroine, addicts are just begging to die.

[Nathan Zachary]

I was on fentynol patches for a year.
I don't know why anyone would want to eat the stuff or shoot it up. The stuff kept you groggy on regular prescribed doses.
Fentynol was hard to quit as well. I was sick for days from withdrawal symptoms.

Thank goodness for oxycontin, it's a much better drug, and not addicting (IF USED PROPERLY).

If Heroine addicts are using it and dying from it, they deserve it. Fentynol slows the heart and respirations, drops your blood pressure. Combine that with heroine, addicts are just begging to die.

[Kimmers]

Yeah, it makes you feel like you are on cloud nine while watching ten go by......A patient told me that once....always thought that was rather telling and funny

[Jumpmaster]

"I doubt it. That seems a high bar to get over."

Really? Clinton's FDA boss (kept on from Bush I because he LIKED regulation) banned an protein supplement.

[hinckley buzzard]

Uh, okay...but how big of a fool do you have to be to try to eat a dermal patch?

I'd put it right up there with trying to smoke a rock.

[Nathan Zachary]

I was on 3-100mg patches. They were on a three day rotation.
The first day you put on one patch. the second day you put on another, and the third day you put on the third. Then on the forth day you remove the first one and put on a fresh one, Fifth day remove and replace the second, etc etc. (I was in alot of pain) It cost $1600.00 a month as well. It worked good, but it madew you very groggy. You could fall asleep anywhere, anytime.

Now I just use oxcontin 80 mg pill 3 times a day. Very good pain control, and no more groggyness. The only bad thing about it is constipation, but proper diet gets around that.
It isn't cheap either, it costs $800 a month.

[thoughtomator]

Sounds like another lost fatherless "child".

[hinckley buzzard]

Yep. "A sick victim of a sick society." Ah, for the 70's...

[Rev. Pogo]

We were just talking about this