title: Oral transmucosal abuse of transdermal fentanyl.
abstract: 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.
authors.affiliation: Eginition Hospital, Department of Psychiatry, Athens, Greece. drugfree@hol.gr
authors.forename: I A
authors.initials: IA
authors.lastname: Liappas
authors.forename: N P
authors.initials: NP
authors.lastname: Dimopoulos
authors.forename: E
authors.initials: E
authors.lastname: Mellos
authors.forename: O E
authors.initials: OE
authors.lastname: Gitsa
authors.forename: A I
authors.initials: AI
authors.lastname: Liappas
authors.forename: A D
authors.initials: AD
authors.lastname: Rabavilas
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D002908:Chronic Disease; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019263:Dysthymic Disorder / Q000150:complications / Q000175:diagnosis; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D005473:Fluoxetine / Q000627:therapeutic use; D006115:Greece; D006801:Humans; D009061:Mouth Mucosa / Q000187:drug effects; D010146:Pain / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D010842:Pica / Q000150:complications; D011081:Polychondritis, Relapsing / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D012646:Self Administration / Q000379:methods; D019966:Substance-Related Disorders / Q000209:etiology*
chemical_list: D005473:Fluoxetine; D005283:Fentanyl