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Dear Pharmacist
WARNING – MISUSE OF FENTANYL PATCHES
Key Messages
- Fentanyl is a highly potent synthetic opioid
- One fentanyl 100mcg / hour patch applied every 3 days is the equivalent of 300mg of morphine orally daily
- Fentanyl can be extracted from patches and misused
- The risk of drug dependence on fentanyl patches is high
- Fentanyl misuse is an emerging problem
- Pharmacists should check the validity of fentanyl prescriptions, especially if on private prescriptions or for multiple packs.
Use of fentanyl patches carries a number of risks of overdose, with a small margin between an appropriate therapeutic dose and a toxic dose. Use of fentanyl patches requires care when commencing treatment and is only appropriate in patients in whom opioid analgesic treatment is well established. Use in opioid naïve patients is rarely if ever/never justified. It is recommended that a patient’s drug and alcohol history is assessed before any opioid is prescribed.
Misuse of fentanyl patches
A number of deaths have been associated with the misuse of fentanyl patches, including multiple patches applied for an intoxicating effect and the injection of fentanyl extracted from fentanyl patches.
Fentanyl patches have a high illicit value and are subject to trafficking. In Australia the main source of fentanyl patches used illicitly is from those obtained on prescription.
Careful scrutiny of prescriptions for fentanyl patches required
It is important to check the validity of any prescriptions presented for dispensing, especially for multiple packs and as private prescriptions. Any concerns about the appropriateness of prescriptions for fentanyl patches, including the directions for use, should be addressed with the prescriber in the first instance. If still concerned about patient safety or diversion risk, pharmacists can refuse to dispense and should report their concerns to NSW Health’s Pharmaceutical Regulatory Unit.
NSW Health Contact Details
More information is available on the NSW Ministry of Health Pharmaceutical Services website:
https://www.health.nsw.gov.au/pharmaceutical/Pages/fentanylmisuse.aspx
Telephone: (02) 9391 9944
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