Fentanyl linked to 11 deaths in NZ

Powerful painkiller fentanyl has been linked to thousands of deaths overseas, and now 11 in New Zealand.

Coronial reports released to Stuff under the Official Information Act, showed the opioid had claimed 11 lives since 2011, with a further six active cases still before the coroner.

In most instances the deaths were ruled as ‘‘accidental’’ or ‘‘inadvertent’’ drug overdoses or the result of ‘‘multiple drug toxicity’’. Three people selfadministered fentanyl intravenously or by inhaling it, accidentally overdosing.

Among those was Arrowtown chef Nils Scott, who died after obtaining and inhaling an acquaintance’s discarded fentanyl patches.

Last month, drug-testing body KnowYourStuff announced it found fentanyl being distributed n a white powder form at a festival.

It was the first time the drug – which killed Prince and Tom Petty – had been identified in a recreational drug in New Zealand, sparking fears we could soon fall victim to the opioid epidemic sweeping North America, Canada and the United Kingdom.

Fentanyl is used for pain relief and anaesthesia, often prescribed for cancer patients and in palliative care. It is 100 times more potent than morphine and 50 times stronger than heroin, according to the US Drug Enforcement Agency.

It has been available in New Zealand for several years but was originally available under special authority only, meaning doctors had to apply to prescribe it, before becoming fully funded in 2011.

Since then prescribing rates have more than doubled. In 2011, 3410 people were prescribed fentanyl compared with 8368 in 2017.

Like morphine, fentanyl works by binding to the brain’s central nervous system receptors, driving up dopamine levels, creating a state of euphoria and relaxation. But these receptors also control breathing rate: high doses can cause breathing to stop.

Used properly, it is a useful and ‘‘relatively safe’’ medication, particularly in people who cannot tolerate morphine, Royal NZ College of General Practitioners medical director Dr Richard Medlicott said.

The high potency of fentanyl increases risk of overdose, especially if a person is unaware of what they are taking.

‘‘Because it’s so powerful it’s being mixed in with things, and people don’t know what they’re getting which is really dangerous,’’ Medlicott said.

A lethal dose of heroin is equivalent to about 30 milligrams - but just 3 milligrams of fentanyl could be fatal.