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Q: prescription drug abuse ( No Answer,   0 Comments )
Question  
Subject: prescription drug abuse
Category: Health > Medicine
Asked by: doctorbrian-ga
List Price: $200.00
Posted: 04 Nov 2004 17:19 PST
Expires: 04 Dec 2004 17:19 PST
Question ID: 424612
What are the current national statistics and recent statistical trends
from Western Europe on the abuse of transdermal fentanyl (including
deaths caused by the abuse of transdermal fentanyl) since the
introduction of a transdermal fentanyl patch (by Alza Corporation)
based on solid state (non-resevoir)delivery system technology?

Request for Question Clarification by pafalafa-ga on 08 Nov 2004 08:26 PST
doctorbrian-ga,

I have seen a number of individual case reports in the literature
regarding abuse of the transdermal fentanyl patch  -- as well as some
concerns expressed that introducing new forms of a patch would open up
new avenues of abuse.

But I haven't come across any statistical studies or summaries of the
prevalance/incidence of abuse.

Are the case reports of interest to you as an answer to your question?
 And if so, is it only cases from Western Europe that are relevant to
you?

Any additional clarification that you can offer on the sort of
information you need would be a great assistance in researching (and
hopefully, answering) your question.

Thanks.

pafalafa-ga

Clarification of Question by doctorbrian-ga on 08 Nov 2004 09:31 PST
Thanks for trying to answer the question.  I'm looking specifically
for any case reports of abuse of a product called DurogesicSMAT
(transdermal fentanyl product approved for use in Germany).  I'd also
be interested in any prescription drug abuse reports that cite the
above product. Another thing I'd be looking for would be any year over
year statistical comparisons of abuse of transdermal fentanyl in
Germany over the last 2 or 3 years.

Request for Question Clarification by pafalafa-ga on 08 Nov 2004 13:15 PST
Thanks for the clarification.

Again, I am not finding anything that contains statistics on the
prevelance of transdermal fentanyl abuse.

I've found at least one German case report of abuse, but it is not
specific to Durogesic.

The report is from the Zentrum fur Anasthesiologie des
Caritas-Krankenhauses -- Bad Mergentheim.  The report itself is in
German, but the abstract includes the following:


...30 year-old male who misused transdermal fentanyl. He injected the
contents of transdermal patches intravenously....During his stay in a
pain clinic he was able to obtain a total of 13 fentanyl patches from
other patients or local pharmacies. He became seriously ill with
multiple organ dysfunction in the course of an infection of his
thigh... There are some reports in the literature of misuse of
fentanyl patches. The contents may be ingested orally, or they can be
inhaled. Aspirated with a syringe the content of fentanyl patches can
also be injected intravenously, sometimes resulting in exit-us.
Prescribers must be aware of the potential for abuse of fentanyl
patches which can be stolen, sold or even removed from dead bodies...

==========

Another German study makes a vague reference along the lines that the
rate of abuse is "low", but the statement is in reference to
pain-killers in general.  The article discusses TDF, but there doesn't
appear to be specific cases of abuse mentioned.



There appears to be only scanty information available on the very
specific query you have asked -- that is, reports of abuse from a
specific type of TDF, and restricted to cases in Germany.

You may want to consider relaxing the boundaries of your question
somewhat, so as possibly include some additional information.

In any event, please let me know if I should post information about
the two German reports I mentioned above as an answer to your
question, or if I should look for other sorts of information, or if
there is any other guidance you can offer about how to proceed at this
point.

Thanks,

pafalafa-ga

Clarification of Question by doctorbrian-ga on 08 Nov 2004 15:02 PST
I don't need the case reference you cited in your latest posting.  I
have it.  In case, I'm not interested in abuse reports regarding the
older transdermal fentanyl...only DurogesicSMAT.  Is there any way you
can query law enforcement or regulatory authorities in Germany
directly?  I'm looking for some affirmative statement that abuse and
or death rates have not gone up since the introduction of
DurogesicSMAT.  If you can get me some sort of written confirmation of
what I've just mention, that'll be your answer.

Thanks

Request for Question Clarification by politicalguru-ga on 21 Nov 2004 00:53 PST
Dear Brian, 

I've written to the German authorities. However, like my colleague
here, I've found only reports regarding a case in Australia, and
general references to the drug, without any statistics.

Clarification of Question by doctorbrian-ga on 21 Nov 2004 05:13 PST
Congratulations on writing the German authorities.  I would contact
the appropriate German regulatory agency and also contact German law
enforcement authorities who handle prescription drug abuse or
diversion and ask each if they have ANY case reports or statistics on
DurogesicSMAT only -- not the resevoir patch.  I don't need case
reports on abuse of the resevoir patch.

Text of any case report (or correspondance with name of official and
name of agency (if any) will be needed.

Once you have the specific answers above, you may post the result is
an answer.  In other words, no reports of abuse/diversion of
DurogesicSMAT in Germany will be a good answer (if true).
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