Fentanyl related cases. The situation in Greece

Abstract

Objective: Fentanyl is used as a pre-anesthetic medication and it is also prescribed for the management of chronic pain through the delivery method of transdermal patches. It is used or abused, as a recreational drug, worldwide. As a result, a significant number of fentanyl related deaths have been recorded in many countries, as well as in Greece. The aim of this paper is to present the current situation in Greece through the report of specific fentanyl related cases and to discuss the different aspects of fentanyl abuse. Methods: A gas chromatography-mass spectrometric method was developed, validated and applied for the determination of fentanyl in biological fluids during the investigation of fentanyl related cases. Results: Eight cases, lethal or not, have been recorded the last four years in Greece, where fentanyl blood concentration was found up to 22.7 ng/mL. Five of the cases concerned therapeutic use of fentanyl and three were related to abuse of the drug. Furthermore, six of these cases concerned fentanyl transdermal patches. Conclusions: The commercial success of transdermal fentanyl is impressive and ensures that the drug will remain in market for years to come. The litigation surrounding the use and abuse of fentanyl patches is a major concern today. Warning and information to users and practitioners about the possibility of adverse effects, even death, law enforcement action, prescribing regulations, and availability of rapid and accurate analytical methods for the determination of fentanyl in biological specimens, must be under deliberation.