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Oral Transmucosal Abuse of Transdermal Fentanyl

Eginition Hospital Department of Psychiatry, Athens, Greece., drugfree{at}hol.gr

N. P. Dimopoulos

Athens Psychiatry Hospital ‘Dafni’ Haidari, Athens, Greece.

E. Mellos

Eginition Hospital Department of Psychiatry, Athens, Greece.

O. E. Gitsa

Laiko Hospital, Department of General Practice, Athens, Greece.

A. I. Liappas

University of Central Lancashire, School of Biological Sciences, Preston, UK.

A. D. Rabavilas

Eginition Hospital Department of Psychiatry, Athens, Greece.

Transdermal fentanyl is an opioid analgesic that is effective on chronic pain, and which appears to be advantageous due to several factors such as ease of administration, the relatively stable serum concentration and long dose intervals. Nevertheless, the danger of abuse and dependence exists among patients who are prescribed fentanyl patches. We present a case of transdermal fentanyl abuse, where the administration route of the drug was changed. Our patient, who had no history of substance abuse and who suffered from chronic nonmalignant pain, used the fentanyl transdermal patches as oral transmucosal medication, raising the dose by ten-fold. This abuse of the drug was only for analgesic purposes without seeking anxiolysis and/or euphoria. After treatment and progressive reduction of fentanyl, the patient remains in good condition, and is currently taking the initial dose of the drug transdermally, without having experienced any withdrawal symptoms.

Key Words: abuse • fentanyl • oral • transdermal • transmucosal

References

• Berens A I L, Voets A J, Demedts P (1996) Illicit fentanyl in Europe . Lancet 347: 1334-1335
• Brennan M, Passik S, Kirsh K (2003). Pharmacologic management of breakthrough or incident pain [available electronically at www.medscape.com]
• Dellemijn P L, van Duijn H, Vanneeste J A (1998) Prolonged treatment with transdermal fentanyl in neuropathic pain . J Pain Symptom Manage 16: 220-229 [CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• DeSio J M, Bacon D R, Peer G, Lema M J (1993) Intravenous abuse of transdermal fentanyl therapy in a chronic pain patient . Anesthesiology 79: 1139-1141 [Web of Science][Medline] [Order article via Infotrieve]
• Herz A, Albus K, Metys Jet al. (1970) On the central sites for the antinociceptive action of morphine and fentanyl . Neuropharmacology 98: 539-551
• Hibbs J, Perper J, Winek C L (1991) An outbreak of designer drug-related deaths in Pennsylvania . JAMA 265: 1011-1013 [Abstract/Free Full Text]
• Jeal W, Benfield P (1997) Transdermal fentanyl. A review of its pharmacological properties and therapeutic efficacy in pain control . Drugs 53: 109-138 [Web of Science][Medline] [Order article via Infotrieve]
• Joranson D E, Ryan K M, Gilson A M, Dahl J L (2000) Trends in medical use and abuse of opioid analgesics . JAMA 283: 1710-1714 [Abstract/Free Full Text]
• Kramer C, Tawney M (1998) A fatal overdose of transdermally administered fentanyl . J Am Osteopath Assoc 98: 385-386 [Abstract]
• Kronstrand R, Druid H, Holmgren P, Rajs J (1997) A cluster of fentanyl-related deaths among drug addicts in Sweden . Forensic Sci Int 88: 185-193 [Medline] [Order article via Infotrieve]
• Marquardt K A, Tharratt R S (1994) Inhalation abuse of fentanyl patch . J Toxicol Clin Toxicol 32: 75-78 [Web of Science][Medline] [Order article via Infotrieve]
• Muijsers R B R, Wagstaff A J (2001) Transdermal fentanyl. An update review of its pharmacological properties and therapeutic efficacy in chronic cancer pain control . Drugs 61: 2289-2307 [CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Radovanovic D, Pjevic M, Malbasa Z, Stokic A (2002) The use of transdermal fentanyl in the treatment of cancer pain . Archive Oncol 10: 263-266
• Reevers M D, Ginifer C J (2002) Fatal intravenous misuse of transdermal fentanyl . MJA 177: 552-554
• Streisand J B, Varvel J R, Stanski D R, Le Maire L, Ashburn M A, Hague B I, Tarver S D, Stanley T H (1991) Absorption and bioavailability of oral transmucosal fentanyl citrate . Anesthesiology 75: 223-229 [Web of Science][Medline] [Order article via Infotrieve]
• Varvel J R, Shafer S L, Hwang S S, Coen P A, Stanski D R (1989) Absorption characteristics of transdermally administered fentanyl . Anesthesiology 70: 928-934 [Web of Science][Medline] [Order article via Infotrieve]
• Ward C F (1992) Substance abuse . Anesthesiology 77: 619-622 [Medline] [Order article via Infotrieve]

Journal of Psychopharmacology, Vol. 18, No. 2, 277-280 (2004)
DOI: 10.1177/0269881104042634


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Liappas, I. A. Articles by Rabavilas, A. D. Search for Related Content PubMed PubMed Citation Articles by Liappas, I. A. Articles by Rabavilas, A. D. Social Bookmarking                   What's this?