New legislation
aims to curb abuse
of fentanyl patches
photo: istockphoto.com
N
ew legislation is now in effect which
aims to make it more difficult for patients to abuse or divert their fentanyl
patches.
The Safeguarding our Communities Act (Fentanyl
Patch for Patch Return Policy), 2015 requires physicians who prescribe fentanyl patches to participate in
a program which is already informally operating in
45 Ontario communities.
Under the Patch4Patch program, patients with a
prescription for fentanyl would only be given new
patches of the drug when they turn in used patches
to their pharmacist.
The bill was primarily prompted by fentanyl’s role
in the rising number of accidental overdose deaths.
Fentanyl has been blamed for 655 deaths across
Canada between 2009 and 2014, with most deaths
appearing to be the result of valid prescriptions being
abused – either by the patient or by someone using
the patches intended for the patient.
The Patch4Patch program requires close collaboration between physicians and pharmacists. For example, physicians must note on all prescriptions for
fentanyl patches where the patient intends to fill the
prescription (i.e., which pharmacy), and the physician must notify the pharmacy that each prescription
has been written (e.g., by faxing a copy). For more
specific guidance about the requirements of the leg-
islation, please read the fact sheet developed by the
College and the Ontario College of Pharmacists for
their members at www.cpso.on.ca.
Subsequent prescriptions can only be filled by the
pharmacist if the used patches from the previous prescription are returned (there are limited exceptions).
Whenever fewer patches are returned than were prescribed, the pharmacist must notify the physician.
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. If
a pharmacist suspects that a returned patch is counterfeit or has been tampered with, they are expected
to notify the prescribing physician, and may take
additional steps, including contacting the pol