PAIN-relief patches 100 times more powerful than morphine have been linked to a growing number of overdoses.
Drug workers say a surge in patch use since access to them on the Pharmaceutical Benefits Scheme was widened in 2006 to include non-cancer patients is fuelling their increasing abuse.
Some facilities have even reported people "dumpster diving" for used patches that still contain amounts of the synthetic opioid fentanyl.
Drug harm-reduction group Anex said abusers were:
DISTILLING fentanyl from patches to inject as a heroin substitute.
CHEWING or swallowing patches.
PLACING multiple patches on the body.
SMOKING crystalised fentanyl.
One drug worker said using fentanyl was "a bit like Russian roulette" due to its potency.
Once distilled, the active ingredient is difficult to dilute accurately, while its fast but short-term action make it both extremely addictive and difficult to counteract.
Anex CEO John Ryan said there was mounting evidence illicit use of fentanyl was rising in Victoria.
Mr Ryan said a needle exchange worker in rural Victoria recently reported some clients were processing the patches to make an injectable solution.
Another worker in a regional city reported at least one client had overdosed and was revived in hospital.
"I have noticed that many haven't been aware of how dangerous it is because of its strength," she said.
Queensland Health last year reported four patch-related deaths and a rise in the number of addicts listing fentanyl as their "drug of choice".
Prescriptions for the patches have risen dramatically in five years.
Hundreds of thousands of prescriptions are now written each year, with the greatest growth among women and younger people.
When used as directed the patches provide slow-release pain relief for up to 72 hours for patients suffering persistent, moderate to severe chronic pain.
Each patch contains a high volume of fentanyl, with 100mcg/hr of the drug equivalent to 10mg of morphine or 75mg of pethidine, and there are often high doses left in used patches.
The ability to distill from patches a crystalised form that resembles "rock" heroin, that is often used to "boost" other illicit substances, has made them increasingly popular on the black market.
The drug's power, purity, ability to give an instant high and rapid breakdown in the body - which makes it difficult to detect - have seen its popularity with dealers and addicts grow.
The same traits make it highly dangerous when misused.
Herald Sun August 26, 2011
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