Publication Highlights

The availability of controlled-released formulations of fentanyl and advanced delivery methods has seen substantial increases in the use of fentanyl worldwide since the 1990s.

Although fentanyl related deaths are still relatively rare the frequency has been increasing.  Between July 2000 and December 2012, a total of 123 deaths reported to Australian coroners were associated with fentanyl misuse. Over this time period the frequency of deaths per year increased from 10 between 2000 and 2007 to 42 in 2012.

In the wake of concerns about increases in the misuse of fentanyl and increases in unintentional fentanyl related deaths researchers from the National Drug and Alcohol Research Centre (NDARC) at the University of New South Wales have examined fentanyl use across Australian communities, in the first nationwide study of its kind.

Using wholesale data of fentanyl items sold through 5,450 pharmacies (and excluding those supplied in hospitals), the team led by NDARC’s Dr Natasa Gisev pieced together a profile of people who use fentanyl and how. The review found that:

• Transdermal patches accounted for the 99 per cent of fentanyl sales
• South Australia had the highest rate of utilisation per person
• Rates of fentanyl use were higher in areas that were less populated
• They were higher among over 65s
• They were higher in areas with low-income households and where people were working in jobs requiring physical labour

“In addition to higher rates of opioid use, those residing in more remote areas are also over-represented in both dependence on pharmaceutical opioids  and unintentional overdose deaths due to pharmaceutical opioids,” the authors write.

“Although still representing a relatively low proportion of all pharmaceutical opioid related deaths (approximately 3%), of particular importance is that more than three-quarters of all fentanyl-related deaths resulting from misuse were unintentional. More than half of all deaths were due to misuse of fentanyl patches (either through use of multiple patches or diversion of their contents), signifying that attempts to reduce the misuse of fentanyl in the community are clearly warranted.”