troublesome side effects of oral morphine, hydromorphone, or oxycodone.When using the transdermal patch, patients must be careful to minimize or avoid external heat sources (direct sunlight, heating pads, etc. ), which can trigger the release of too much medication and cause potentially deadly complications. Combat medicine
USAF Pararescue combat medics in Afghanistan used fentanyl lozenges in the form of lollipops on combat casualties from IED blasts and other trauma. The stick is taped to a finger and the lozenge put in the cheek of the person. When enough fentanyl has been absorbed, the (sedated) person generally lets the lollipop fall from the mouth, indicating sufficient analgesia and somewhat reducing the likelihood of overdose and associated risks. Dyspnea
Fentanyl can also be used for patients in whom morphine is not tolerated, or whose breathlessness is refractory to morphine. Fentanyl is especially useful for concomitant treatment in palliative care settings where pain and shortness of breath are severe and need to be treated with high strength opioids. Other
Some routes of administration such as nasal sprays and inhalers generally result in a faster onset of high blood levels, which can provide more immediate analgesia but also more severe side effects, especially in overdose. The much higher cost of some of these appliances may not be justified by marginal benefit compared with buccal or oral options.
In British Columbia, Canada, where there are environmental concerns about toilet flushing or garbage disposal, pharmacists recommend that unused patches be sealed in a child-proof container that is then returned to a pharmacy. In the United States where patches cannot always be returned through a medication take-back program, flushing is recommended for fentanyl patches because it is the fastest and surest way to remove them from the home to prevent them from ingestion by children, pets or others not intended to use them. Notable deaths
Wilco guitarist Jay Bennett died on 24 May 2009 from an accidental overdose of fentanyl, shortly after he publicly revealed that he needed hip replacement surgery which he could not afford due to his health insurance considering the situation a "pre-existing condition." Slipknot bassist Paul Gray died on 24 May 2010 from an overdose of morphine and fentanyl. Medical examiners concluded that musician Prince died on 21 April 2016, from an accidental fentanyl overdose. Fentanyl was among many substances identified in counterfeit pills recovered from his home, especially some that were mislabeled as Watson 385, a combination of hydrocodone and paracetamol. Author & journalist Michelle McNamara died on 21 April 2016, from an accidental overdose; medical examiners determined fentanyl was a contributing factor. Canadian video game composer Saki Kaskas died of a fentanyl overdose on 11 November 2016; he had been battling heroin addiction for over a decade. American rapper Lil Peep died of an accidental fentanyl overdose on 15 November 2017.