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5/17/2018 6:03:00 PM
When administered properly, fentanyl can be safe, doctor says

Stuart Hirsch, Herald Bulletin

ANDERSON — Madison County is not immune from the scourge of drug overdose deaths that have overtaken communities across the country.

Fentanyl, a more potent and faster acting synthetic compound that’s cheap to manufacture, is being mixed with traditional heroin, which is derived from poppy plants.

And the mix can be deadly.

The number of drug overdose deaths in Madison County climbed to 53 in 2017, compared to 46 in 2016, an increase of 15 percent.

Madison County Coroner Marian Dunnichay said there were likely another 20 cases where opioids were a contributing factor.

Since 2013, the death toll attributed to drug overdoses more than doubled from 23 to 53, according to data compiled by the Madison County Health Department.

Dr. Charles Howe, a pain management doctor who has practiced in Anderson since 1983, said fentanyl was originally designed as an anesthesia drug that is powerful and shortacting, and is intended to be used in operating rooms.

“For the use in anesthesia, it is one of the most invaluable agents that we have there,” Howe said.

The problem with fentanyl comes about when it’s used topically in the form of patches used for extended periods of time. It’s only used for chronic pain, such as cancer pain.

In the past few years, however, Howe said fentanyl has been useful for patients who cannot take medicine orally. He said older patients are the people who do well with fentanyl.

“In my practice it is very useful,” he said. “The issue is the use of high-dose fentanyl for chronic use, which I don’t think is tenable.”

Howe said there’s no reason why anyone in their 20s or 30s should be taking fentanyl in the treatment of chronic pain, and he doesn’t prescribe the drug to those individuals.

He said heroin addicts prefer that high to fentanyl, but their illicit drug suppliers prefer fentanyl because it’s less expensive and easier to produce.

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