Once more NURSE in headlines.

[P_RN, ADN, RN]

You have probably read this already. But count the number of times he mentions NURSE in this article.

http://www.washingtonpost.com/wp-dyn/articles/A32804-2002Mar28.html

By David B. Caruso

Associated Press Writer

Thursday, March 28, 2002; 6:16 PM

PHILADELPHIA -- A Pennsylvania nurse has been accused of slipping into two nursing homes where he used to work and stealing medicated pain-relief patches off the backs of elderly patients in what federal figures show is an increasingly common type of drug abuse.

"It's terrible to think that someone would stoop that low," said Gary Dobias, the district attorney in Carbon County, about 70 miles north of Philadelphia.

U.S. prescriptions for the Duragesic patches and their reservoir of the powerful painkiller fentanyl increased 33 percent between 2000 and 2001 and with the drug's popularity have come more reports of abuse, especially among health care workers.

"For many years, fentanyl was actually the drug of choice of the addicted anesthesiologist," said Dr. Joel Nathan of the Addiction Recovery Institute in New York. "Outside of that, we are probably talking mostly about low paid people in the nursing industry, like nursing aides and other uncertified health care workers."

Nationwide, at least 512 people were treated for fentanyl abuse in hospital emergency rooms in the first six months of 2001, according to the federal Substance Abuse and Mental Health Services Administration.

While complete 2001 data is not yet available, the numbers trend toward a major increase over 2000 when 576 people were treated in emergency rooms and the 337 emergency room visits recorded in 1999. Only 28 fentanyl-related hospitalizations were recorded in 1994.

Behind the numbers are the abusers - many of whom have access to the drug at work and know how to extract fentanyl from the patch and inject or inhale it.

Paul Colasurdo, a licensed practical nurse, was charged last week with stealing patches from elderly patients in two nursing homes. Colasurdo boiled the patches in water to extract the fentanyl, then injected it, Dobias alleges. Colasurdo denies taking the drugs and is being held on $250,000 bail.

In January, John David Needles, 32, former administrator of a nursing home in Cedar City, Utah, pleaded guilty to three counts of elderly abuse for tearing patches off of female residents.

In Massachusetts, nurses' aide Ruth S. Rowe, 26, pleaded guilty in November to stealing a fentanyl patch off the back of a 90-year-old patient, extracting the potent drug and drinking it.

Police said Dr. Jonathan Ludwig Koukal, 43, an anesthesiologist in Jeannette, Pa., committed suicide in Niagara Falls in August after he was charged with stealing fentanyl from a hospital and replacing it with sterile water. The watered-down drug was given to several patients during surgery.

Jamey Phillip Sheets, 32, former co-owner of a Pleasant Hill, Calif., pharmacy was found dead Tuesday with six fentanyl patches stuck to his body. His wife said he was depressed that his pharmacy license was suspended in connection with a meningitis outbreak.

Doctors note that reports of fentanyl abuse still pale in comparison to abuse of other narcotic painkillers.

By comparison, nearly 11,000 people were treated in hospital emergency rooms in 2000 for abuse of oxycodone, the drug sold under the brand-name OxyContin. More than 7,800 people overdosed on oxycodone in the first six months of 2001.

Dr. Yusuf Mosuro, attending physician in Temple University Hospital's pain clinic, said that while fentanyl abuse hasn't become "epidemic," like OxyContin, it has the potential to become a bigger problem unless doctors carefully control who gets the drug.

"The problem with OxyContin is that it was being marketed to primary care physicians to treat all sorts of severe pain, and these doctors were not always trained properly on how to make sure that the medication wasn't abused," he said.

The Duragesic patch, which is made by Janssen Pharmaceutica, has been marketed far less vigorously than OxyContin, Mosuro said, and is prescribed most by specialists in hospitals, where it is kept under lock and key.

Still, the Drug Enforcement Agency considers fentanyl a potential drug of abuse, that can come in doses more than 100 times as powerful as heroin.

Janssen spokesman Greg Panico said the company monitors reports of abuse, and urges doctors to prescribe the drug responsibly.

[4XNURSE]

"Still, the Drug Enforcement Agency considers fentanyl a potential drug of abuse, that can come in doses more than 100 times as powerful as heroin. "

Sad part about an article like this is it tells more people where to get more drugs. Tell someone not to publish this information, and they start screaming about freedom of the press. Wonder how we can preserve our rights, and still curtail some of the info that gets published.

just my $ .02

ken

[krusey]

I must have been naive. I have been nursing for 15years. I have heard of pethidine subsitution, but never the taking of fentanyl patches, bit sad to be taking them from the elderly. I must be working too hard to heard what the media has to say, eh?

Pray for us all that we never fall into this trap. krusey

[SKM-NURSIEPOOH, BSN, RN]

Working in LTC, I never even thought about the possibility of people taking used fentanyl patches right off the backs of the elderly patients.

That's really low - I thought that it's bad enough that us nurses have to count the narcs in the first place because of drug abuse, now we should have to check & verify that any fentanyl patches that are placed remain there for their expected number of days.

Now if a patch should come off during a shower, then the aide should bring it up to the nurse & the nurse should have an second nurse verify that it came off so that the patch could be replaced. Sounds quite silly to have all these checks & balances, but unfortunately, we live in a world were checks & balances are needed.

[P_RN, ADN, RN]

Also about ten years ago here, there were several college students who were breaking into home of cancer patients who had died and stealing the patches and other meds left over. They'd read the obits and break in during the funeral times.

They were found out ONLY when two of them were found DEAD having been in the process of CHEWING the patches to get High.

[jschut, BSN, RN]

How sad....

Julie:o