GUIDELINES IMPOSED ON POWERFUL PAIN PATCH

Health Canada has imposed a series of new warnings for a pain-relief patch that has killed several Canadian teenagers who were either mis-prescribed the powerful medication or abused patches that belonged to others.

Changes are being made to the socalled product monograph and a letter has been mailed out to doctors stressing that the drug is inappropriate for many patients, and should be stored carefully to avoid misuse.

The action was welcomed by a Saskatchewan couple whose daughter was prescribed Duragesic, only to suffer cardiac arrest and die after the morphinedrug surged into her veins.

Even at the time, labelling for the product said it was not supposed to be used by children under 18, or by people who are “opioid naive” — not already taking some form of the drug.

It seems physicians are unaware of the potency and dangers of the drug, Fentanyl, released by the patch, said Carol Whitter of Prince Albert, whose daughter, Tiffany, died in October, 2003, when the family was living in Winkler, Man.

“When this happened to our daughter, both the doctor and the pharmacist, who was a close personal friend of ours, were puzzled that such a thing could happen, were shocked that they didn’t have more information available,” she said.

“But really they did. We were able to find the information.”

Tiffany was prescribed the patch after suffering chronic headaches. The morning after it was affixed, her breathing had become shallow and forced. Hours later, her heart stopped.

Health Canada has also received reports of three or four teenagers who died in abuse cases after ingesting patches they had found in medicine cabinets.

It is possible that physicians prescribing the patch are not always aware of its risks, said Dr. Barbara Raymond of Health Canada.

“ The longer that products are available on the market, the prescribing of them may become more commonplace or matter of fact,” she added.

The new labelling information expands a section on abuse of the patches, noting that used patches still contain significant amounts of drug and should be immediately flushed down the toilet.

There are also new instructions that the patch be given to people who have already been on at least 60 milligrams a day of some other kind of opioid, up from the previous 45 mg.