Fentanyl transdermal patch: The silent new killer?

Background: Transdermal fentanyl patches represent an excellent alternative for the treatment of chronic and cancer-related pain, but can lead to death due to their incorrect use or increasing abuse. Purpose: Present an overview of literature regarding fentanyl patch related fatalities. Methods: Literature research into PubMed database for all types of publications. Search terms were “fentanyl”,“patch” and “death”. Additional publications by manual examination of references of the PubMed results were included. Results and conclusions: To date 29 publications about transdermal fentanyl patch related deaths are available onPubMed and their time span is of 26 years. A total of 674 deaths related to fentanyl were found, 658 associated with transdermal fentanyl patch. Use of patches was more frequently in males (68 %) than in females (32 %) and in the 31–40 and 41–50 decades. The most frequent route of administration was the transdermal route, followed by oral and intravenous route. Cause of death was in 63.5 % of cases drug abuse, followed by accidental death (16.2 %), death unrelated to fentanyl (13.3 %) and suicide (2.8 %). The use of concomitant drugs was reported in 19 of the 29 publications and antidepressant followed by benzodiazepines and ethanol were the most frequent discovered drugs. In conclusion, fentanyl transdermal patch misuse and abuse is a major problem and still need to be completely addressed.