AI Article Synopsis
- * Data was collected from spontaneous notifications over several years and annual surveys by the French Addictovigilance Network, with 147 cases for transdermal and 109 for transmucosal fentanyl noted.
- * Analysis revealed distinct consumption profiles for each formulation, highlighting risks associated with misuse, including severe adverse effects and a notable incidence of involuntary intoxication.
Article Abstract
Objectives: The aim of this study was to evaluate the French use, misuse and abuse/dependence of non-injectable forms of fentanyl (transdermal and transmucosal fentanyl formulations).
Methods: Problematic use of transdermal and transmucosal fentanyl formulations was evaluated using an approach combining multiple sources of information: (1) spontaneous notifications recorded during 6 years (2010-2015) for transdermal fentanyl form and 3 years for transmucosal fentanyl forms and (2) data from annual epidemiological systematic surveys conducted by the French Addictovigilance Network during 6 years (2010-2015).
Results: In all, 147 cases were notified for transdermal fentanyl formulation and 109 cases for transmucosal fentanyl formulations. According to the galenic formulation, analysis of these cases emphasizes different profiles: for transdermal fentanyl formulation, two consumption profiles: 1/mainly for analgesic effects (74 %): women (61 %), 47 years, with addictive and/or psychiatric history (46 %), treated for chronic non-cancer related pain (93 %), 2/seeking positive psychic effects other than analgesia (26 %): men (82 %), 32 years, with addictive and/or psychiatric history (87 %) and having obtained the fentanyl patch illegally (60 %) for non-medical use. For transmucosal fentanyl formulations, only one consumption profile was observed: women (52 %), 48 years, with addictive (24 %) and/or psychiatric history (28 %), off label indication (72 %) (indications for non-cancer pain and/or no or insufficient opioid background treatment). The misuse of transmucosal fentanyl formulations implies a high risk of adverse effects: those already known of opioid-based drugs, sometimes lethal (withdrawal syndrome, respiratory and central nervous system depression…) but also serious reactions at the application site (buccal or nasal). For the transdermal fentanyl formulation, 27 cases (18 %) of involuntary intoxication were observed, of which 25 were serious. Nineteen deaths involving both forms of fentanyl have been reported (2 for the transmucosal formulations and 17 for the transdermal formulation).
Conclusion: Our results report significant and worrying misuse of transmucosal fentanyl formulations with wide off-label use and also primary dependence on fentanyl, regardless of galenic formulation, in patients treated for chronic non cancer pain. Given the significant risks of fentanyl, it is necessary to continue the monitoring of misuse, in particular, thanks to the activities of the French Addictovigilance network allowing a multisource approach and who provides information concerning cases of abuse, misuse and dependence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.therap.2019.11.002 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Fentanyl Hapten-Displaying Lipid Nanoparticle Vaccine that Non-Covalently Encapsulates a TLR7/8 Agonist and T-Helper Epitope Induces Protective Anti-Fentanyl Immunity.
Angew Chem Int Ed Engl
October 2024
Department of Pharmaceutics, Ghent University, Belgium, Ottergemsesteenweg 460, Gent, 9000, Belgium.
Opioid use disorder - particularly involving fentanyl - has precipitated a public health crisis characterized by a significant increase in addiction and overdose-related deaths. Fentanyl-specific immunotherapy, which aims at inducing fentanyl-specific antibodies capable of binding fentanyl molecules in the bloodstream, preventing their entry in the central nervous system, is therefore gaining momentum. Conventional opioid designs rely on the covalent conjugation of fentanyl analogues to immunogenic carrier proteins that hold the inherent capacity of mounting immunodominant responses.
View Article and Find Full Text PDFEvaluation of Intranasal Fentanyl and Midazolam Among Inpatient Pediatric Patients.
Hosp Pediatr
October 2024
Internal Medicine and Pediatrics.
Article Synopsis
- A study looked at how safe and helpful it is to use nose sprays of certain medicines, fentanyl and midazolam, for kids in hospitals.
- The study found that most kids received midazolam, and these medicines were often used when kids had to go through procedures like getting an IV or a lumbar puncture.
- No serious side effects were reported, but the researchers say more studies should be done before using these medicines more widely in hospitals.
Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department.
BMJ Paediatr Open
September 2024
Pediatric Palliative Care Service, Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy.
Background: Despite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes.
Methods: A multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group.
Intranasal Fentanyl Versus Morphine in Fracture Reduction in a Pediatric Trauma Center.
J Am Acad Orthop Surg
December 2024
From the Emergency Department, Paris Saint-Joseph Hospital Group (Bisso), the Paediatric Emergency Department, AP-HP, Robert Debre Hospital University, Paris University (Tielli), and the Paediatric Emergency Department, AP-HP, Necker-Enfants-Malades University Hospital, Paris University, Paris, France (Lopes).
Purpose: Pain management in orthopaedic manipulation in the emergency department (ED) is crucial to decrease fracture reduction performed in the operating room. This study compared intranasal fentanyl (INF) with oral morphine in time of care and effectiveness on pain during the reduction of bone fractures in a pediatric trauma center.
Methods: A before-and-after INF implementation study was conducted in a pediatric ED with a trauma center on children with a confirmed displaced closed fracture on radiographs with reduction and casting performed in the ED.
The use of intranasal sufentanil and/or s-ketamine for treatment of procedural pain in children in an ambulatory setting: A retrospective observational study.
Acta Anaesthesiol Scand
November 2024
Pain Treatment Service, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Background: Minor but painful medical procedures are often handled at the operating room. If safe and effective treatment options are available many procedures may be performed outside of the operating room.
Objective(s): The objective of this study is to assess the adverse events of intranasal s-ketamine and/or sufentanil alone or as part of a multimodal analgesic regime for medical procedures outside of the operating room.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!