February 18, 2014 – New Fentanyl Patch Return Program Aims to Keep Drug Users and Community Safe
Thanks to the fast-acting collaboration of local healthcare providers and Peterborough Public Health, a new initiative to reduce the harm caused by fentanyl misuse is now in play for our community.
“I’m proud of how quickly physicians, pharmacists and other local partners came together to respond to this growing and very dangerous problem in our community,” said Dr. Rosana Salvaterra.
Since the government wisely chose to discontinue funding OxyContin in 2012, those who use opiates illicitly have chosen to shift their focus to other opiates, such as fentanyl. Evidence from local addictions treatment centres and the Emergency Department in 2013 suggested that incidence of fentanyl overdose was increasing. This is concerning as fentanyl is among the strongest of the opiates, being 750 times stronger than codeine.
In response to this situation, Public Health teamed up with a group of pharmacists, physicians and law enforcement officials to develop the Fentanyl Patch Return Program to minimize the harms associated with fentanyl misuse.
Under this program, individuals who use fentanyl are required to return used patches to their pharmacists before they are dispensed the next set of patches. This practice discourages diversion of used patches from which the remaining drug is harvested for illicit use.
“The success of this program requires collaboration among the prescribers, the pharmacist, and the patients. Physicians and other prescribers are being asked to discuss this practice with all patients who receive a prescription for fentanyl and to also direct pharmacists to collect used patches through an indication on the prescription,” said Dr. Salvaterra.
When dispensing the patient’s fentanyl prescription, pharmacists provide the patient with the Opioid Patch Exchange Disposal Tool along with their fentanyl patches. At the patient’s next visit, the pharmacists then collect the used patches as indicated on the prescription, ensure they are accounted for, and then dispose of them appropriately.
Opioid overdose in Ontario is a serious public health problem. Accidental opioid deaths are a leading cause of unintentional death, often surpassing fatalities from motor vehicle collisions. Although victims include those who experiment with and/or who are addicted to opioids, the majority of victims are citizens who are using opioids as prescribed. The most recent data indicates that more than 500 Ontarians (median age of 40) died in 2011 of an opioid-related overdose, and 20% of these were specifically due to fentanyl. The majority of these individuals had a prescription for an opioid dated within four weeks of their death. Local data from 2010 indicates that approximately 25% of all drug overdoses are due to prescription opioids, and anecdotally health authorities know this has increased to at least half in recent years.
Since the discontinuation of funding for OxyContin in 2012, reports indicate that individuals who use opioids are changing their drug of choice to other substances such as heroin, hydromorphone, methamphetamine, cocaine and fentanyl. Recent media reports and anecdotal data suggest that fentanyl is making its way to the street by means of finding inappropriately disposed of used patches, stealing new or used patches, or purchasing patches from those who have legal prescriptions. It is then being cut up and chewed, smoked or extracted from patches and injected, which is dangerous considering the high potency of fentanyl and that it is meant to be a slow-release drug.
For more information, please visit www.peterboroughpublichealth.ca. In the “For Professionals” section, on the webpage for “Alcohol & Other Drugs” there is a document entitled Fentanyl Patch Return Program FAQ and a copy of the Opioid Patch Exchange Disposal Tool.
For further information, please contact:
Substance Misuse Prevention Program
(705) 743-1000, ext. 223