opioids
track of the number of patches they have in order to
decrease the risk of accidental misuse by others, including children and pets. Keeping the patches in a secure
location will also reduce the risk of having them stolen.
Some communities have been particularly hard hit
with fentanyl deaths. For example, North Bay has had
15 fentanyl-related deaths since 2007, the majority
of which were the result of people taking patches that
had been prescribed to someone else, said Police Chief
Paul Cook. He also said that emergency departments
were seeing “a lot of very close calls” with an increasing number of people wheeled into ERs “flatlining”
from a fentanyl overdose.
As such, North Bay has become the first city to
implement a program developed by the Ontario Association of Chiefs of Police. The initiative is an effort
to ensure that all fentanyl patches are used, and used
properly, by the intended patient.
The program’s supporting document Patch4Patch
(P4P) Initiative: Fentanyl Abuse Prevention – A Shared
Responsibility was developed with input from a number of community partners, including the CPSO, the
Ontario College of Pharmacists, and the Ministry of
Health and Long-Term Care.
The program works as a collaboration between physicians and pharmacists. Physicians write on fentanyl
prescriptions that no further patches should be dispensed until the used ones are returned to the pharmacy. The pharmacist then receives the used patches and
dispenses a new patch for every used patch returned.
Unlike other opioids, abuse of fentanyl (by smoking, burning, or cutting it up) destroys the patch. In
theory, a patient who has abused or sold their patches
will not be able to return them to the pharmacy.
Physicians will determine from their patients which
pharmacy they use for their medication management.
The physician should write on the prescription the actual pharmacy and location in which the prescription
will be dispensed. Whenever, possible the prescription
will be faxed to that pharmacy.
The P4P program has received significant support
from physicians and pharmacists in North Bay, said
Chief Cook. Although, it has led to challenges – including reports that some patients are returning fake
used patches – it appears to have reduced the abuse of
fentanyl, and North Bay police officers have noted that
addicts appear to be finding it much harder to obtain
Fentanyl patches.
The program is also being considered in other communities, which is encouraging news for Chief Cook. He
said that the success in North Bay is limited by those who
import fentanyl from neighbouring communities.
The College is supportive of any initiative that curbs
opioid abuse – including na