Though appealing, drug patches can be dangerous
Reported August 27, 2007
WASHINGTON Army Master Sgt. Harold Kinamon entered a military hospital in Ohio for routine respiratory surgery to help him sleep better. The operation, in October 2005, progressed smoothly. He went home with nothing more than a raw throat and a painkiller contained in an adhesive patch on his skin.
That night, Kinamon, 41, died in his sleep killed by an overdose of the drug delivered through the patch.
What made his death even more tragic was that the dangers of using skin patches to administer the particular painkiller he received, an opium-like drug called fentanyl, were clearly understood at the time. Only three months earlier, the Food and Drug Administration responding to a rash of similar deaths had issued a strong warning: Although beneficial under appropriate conditions, fentanyl patches should be used with great caution, and not for postoperative pain relief.
But Kinamon’s death reflects more than an individual misfortune. Health care providers nationwide are still not getting the message as fentanyl patches continue to be implicated in scores of deaths.
Failure to solve the problem is all the more serious because the use of medicinal patches is spreading to other drugs painkillers, birth control drugs and medications for children with attention deficit disorder.
Drug-safety experts are urging the FDA to re-examine the whole issue of medicinal patches. One primary problem seems to be how to get the right dose of a drug through a patch for different patients under differing conditions.
The appeal of the patches over more traditional methods of administering medications is clear: Unlike injections, they don’t hurt. Unlike pills, they don’t have to be swallowed.
Those advantages are real, medical experts say, but they are not the whole story.
Sales of Ortho Evra, the first birth-control patch, plunged last year after the FDA cautioned that it exposed women to higher levels of a hormone linked to dangerous blood clots than did oral contraceptives.