A fatality involving an unusual route of fentanyl delivery: Chewing and aspirating the transdermal patch

Legal Medicine

Volumn 12, Issue 3, 2010, Pages 157-159

  Carson, Henry J ^a   Knight, Laura D ^b,c   Dudley, Mary H ^a,d   Garg, Uttam ^e  

^a Office of the Jackson County Medical Examiner   (United States)

^b Medical Examiner's Office   (United States)

^c State University New York College of Environmental Science and Forestry   (United States)

^d UNIVERSITY OF MISSOURI KANSAS CITY SCHOOL OF MEDICINE   (United States)

^e CHILDREN S MERCY HOSPITAL   (United States)

Author keywords

Drug abuse; Fentanyl; Methamphetamine; Transdermal patch

Indexed keywords

FENTANYL; METHAMPHETAMINE;

ADULT; ARTICLE; AUTOPSY; CASE REPORT; DRUG ABUSE; DRUG MISUSE; FOREIGN BODY; HUMAN; MALE; MASTICATION; MORBIDITY; TOXICOLOGY; TRANSDERMAL PATCH;

ADMINISTRATION, ORAL; ADULT; BRONCHI; FENTANYL; FORENSIC PATHOLOGY; FORENSIC TOXICOLOGY; HUMANS; MALE; MASTICATION; METHAMPHETAMINE; NARCOTICS; RESPIRATORY ASPIRATION; SUBSTANCE-RELATED DISORDERS;

EID: 77950354529     PISSN: 13446223     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.legalmed.2010.03.001     Document Type: Article

References (19)

1. Scott G., Thomas S.D., Pollack H.A., and Ray B. Observed patterns of illicit opiate deaths in Chicago, 1999-2003. J Urban Health 84 (2007) 292-306
2. Degenhardt L., Roxburgh A., and Barker B. Underlying causes of cocaine, amphetamine, and opioid related deaths in Australia. J Clin Forensic Med 12 (2005) 187-195
3. Martin T.L., Woodall K.L., and McLellan B.A. Fentanyl-related deaths in Ontario, Canada: toxicological findings and circumstances of death in 112 cases (2002-2004). J Anal Toxicol 30 (2006) 603-610
4. Kramer C., and Tawney M. A fatal overdose of transdermally administered fentanyl. J Am Osteopath Assoc 98 (1998) 385-386
5. Marquardt K.A., and Tharratt R.S. Inhalation abuse of a fentanyl patch. J Toxicol Clin Toxicol 32 (1994) 75-78
6. Tharp A.M., Winecker R.E., and Winston D.C. Fatal intravenous fentanyl abuse: four cases involving extraction of fentanyl from transdermal patches. Am J Forensic Med Pathol 25 (2004) 178-181
7. Reeves M.D., and Ginifer C.J. Fatal intravenous misuse of transdermal fentanyl. Med J Aust 18 (2002) 552-553
8. Ashburn M.A., Ogden L.L., Zhang J., Love G., and Basta S.V. The pharmacokinetics of transdermal fentanyl delivered with and without controlled heat. J Pain 4 (2003) 291-297
9. Woodall K.L., Martin T.L., and McLellan B.A. Oral abuse of fentanyl patches (Duragesic): seven case reports. J Forensic Sci 53 (2008) 222-225
10. Teske J., Weller J.P., Larsch K., Tröger H.D., and Karst M. Fatal outcome in a child after ingestion of a transdermal fentanyl patch. Int J Legal Med 121 (2007) 147-151
11. Otis J., and Rothman M. A phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain. Curr Med Res Opin 22 (2006) 1493-1501
12. Kornick C.A., Santiago-Palma J., Moryl N., Payne R., and Obbens E.A. Benefit-risk assessment of transdermal fentanyl for the treatment of chronic pain. Drug Saf 26 (2003) 951-973
13. Thomas S., Winecker R., and Pestaner J.P. Unusual fentanyl patch administration. Am J Forensic Med Pathol 29 (2008) 162-163
14. Schecther N.L., Weisman S.J., Rosenblum M., Bernstein B., and Conard P.L. The use of oral transmucosal fentanyl citrate for painful procedures in children. Pediatrics 95 (1995) 335-339
15. Karch S.B. Chapter 3 synthetic stimulants. In: Karch S.B. (Ed). Karch's pathology of drug abuse. 4th ed. (2009), CRC Press, Boca Raton FL 261-311
16. Karch S.B., Stephens B.G., and Ho C.H. Methamphetamine-related deaths in San Francisco: demographic, pathologic, and toxicologic profiles. J Forensic Sci 44 (1999) 359-368
17. Molina D.K. Handbook of forensic toxicology for medical examiners (2010), CRC Press, Boca Raton, FL
18. Fentanyl citrate (Fentanyl Citrate) injection, solution. National Library of Medicine, National Institutes of Health. Daily Med. April 2007. Available from: http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=4059 [accessed 14.01.10].
19. Chemical and Other Safety Information. The Physical and Theoretical Chemistry Laboratory, Oxford University. Safety data for dl-methamphetamine hydrochloride, October 30, 2009. Available from: http://msds.chem.ox.ac.uk/ME/dl-methamphetamine_hydrochloride.html [accessed 14.01.10].