03 Sep 2013
A 12-year-old girl from Clinton, Missouri was found dead in June 2013 after a suspected overdose of the Fentanyl patch. Destiny Spilter died after she stuck a used fentanyl patch on her thigh. The patch had been previously worn by her grandmother who, once done with it, threw it in the trash.
Fentanyl is an extremely strong opioid used to manage pain. It is 100 times more potent than morphine and 40 times stronger than heroin. Overdoses, some even fatal, are common.
Many patients are prescribed Fentanyl when other types of narcotic pain medications no longer offer relief. In most cases, this is because the body has developed tolerance to the pain killer, and it needs more and more of the substance to offer the same type of relief. Since many medications are lethal at such high doses, doctors must look to a different medication altogether instead of just increasing the dose of the current prescription. Fentanyl is a favored tool in the pain-management arsenal.
Use with Extreme Caution
Despite its benefits, however, Fentanyl must be used with extreme caution as even patients who have topped out of their traditional pain medications have found it to be too strong to tolerate. The patch, even at its lowest dose, has the potential to reduce respiration to the point of death.
The Fentanyl patch was created to offer continuous relief to patients in chronic pain, but over a period of several days. If a person were to ingest that amount of Fentanyl all at once, it would likely be fatal. Given its high potency, there are a number of safety advisories and side effect warnings regarding use of the drug. One of the FDA warnings recommends flushing the patch after use so that unintended recipients do not ingest the remaining residue — either accidentally or on purpose. Even though the Agency recognized that there may be some environmental concerns about flushing, it felt that the risk associated with accidental exposure far outweighed any potential risk to the environment or water sources.
Tragedy – Too Often
Destiny’s grandmother, who was using the patch to manage her chronic back pain, did not follow these fairly simple instructions. Not surprisingly, the curious young girl found the patch and put it on, perhaps mimicking the behavior she previously observed in her grandmother. Even after the patch is used for three days, studies show that it could still contain more than 50 percent of the original Fentanyl dose. Her body was unable to handle even the amount of Fentanyl that remained in the patch and she died.
Unfortunately, accidental overdose is not uncommon for the Fentanyl patch — especially in children. Children may be initially attracted to the patch, thinking that it is a sticker. And because the patch is meant to stay on the skin for up to 3 days, there is typically plenty of glue remaining to keep it securely on the child’s skin. If they place it in an area that is hidden by clothing, caretakers may not notice it until the damage has been done.