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Fatal Fentanyl: What to Know About The Drug That Killed Prince

Friday, June 03, 2016



So far, 2016 has seen an alarming number of Fentanyl-related deaths, and late popular musician Prince was confirmed Thursday as another victim of this dangerous opioid. A report from the Midwest Medical Examiner's Office identified Fentanyl overdose as the cause of his untimely death on April 21.

Though the details surrounding this event remain scarce — such as whether he was prescribed the drug or not — we already know a lot about this potent and fast-acting painkiller.

Using data from the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, OpenFDA and recent news events, HealthGrove compiled important information you should know about Fentanyl.


Death and Other Adverse Reactions by Fentanyl


Even when prescribed by a doctor, some people still experience serious adverse side effects from Fentanyl. The New York Times referred to it as heroin’s deadly cousin, an apt description given recent trends.

Fentanyl is up to 50 times more potent than morphine and dealers cut it into other drugs to sell to unsuspecting buyers. This cheap tactic gives a stronger high and keeps addicts coming back. U.S. law enforcement officials believe that much of the supply crosses the border from labs in Mexico or via mail-orders from factories in China.

In the case of prescribed usage, from Jan. 1, 2000 to Jan. 1, 2016, Fentanyl, under any and all of its brand name derivatives, has been included in 44,284 adverse reaction reports, of which 32,389 were reported as serious, according to OpenFDA. Of those, Fentanyl was the primary suspect in 17,169 of the reports.

This doesn’t necessarily mean Fentanyl caused the serious adverse reactions, though. Patients who take it are usually already on other medications, thus increasing the risk of drug interactions. However, it is an important connection to note.


Cost and Intended Purpose


Doctors prescribe Fentanyl under various brands, such as Subsys, Actiq, Fentora, Abstral and Onsolis. These are some of the most expensive analgesics on the market. Though prescriptions can be for different amounts and delivery methods, such as the lozenge, patch or pills, the data visualized below is for the most commonly prescribed size and dosage of each medication.

Fentanyl is meant to be used by cancer patients who are already on painkillers but experience “breakthrough” pain — pain that flares up even with the routine pain medication.

Though doctors are typically not advised to prescribe this drug for acute postoperative pain, some do. This can, and has, caused patient complications, including death.


Prescription Rates


Because many other analgesics carry fewer risks and successfully alleviate most pain, Fentanyl is used sparingly for those with particularly intense, chronic pain. However, it makes the top 10 most prescribed analgesic medications, according to Medicare Part D data.

Hydrocodone — which also goes by the brand name Vicodin — is still the number one prescribed drug on the list. Other drugs in this family, such as Oxycodone and Morphine, are also powerful opioids with a high potential for abuse.


State-by-State Prescription Patterns


Prescription rates vary widely by state, though. According to 2012 data from CDC, healthcare providers in the highest-prescribing state wrote three times as many opioid painkiller prescriptions per patient compared to doctors in the lowest-prescribing state. CMS data from 2013 supports this trend: of beneficiaries who received a Fentanyl prescription, Hawaii patients had on average the lowest number of claims with 4.77 while South Dakota had 8.24, nearly double the rate in Hawaii.

Though some states may have larger senior populations, which could influence whether doctor prescription rates fall above or below the mean, the CDC notes that painful health conditions do not vary much from state to state. This means other factors play into the prescription rate discrepancies.

Potential factors include a lack of physician agreement on when to prescribe opioid pain medications, increased demand from patients who use opioids for non-medical purposes and the presence of pain clinics that prescribe large quantities to people who might not actually need them (often referred to as “pill mills”).


The Future of Fentanyl


Fentanyl has already taken lives across the United States — from Maine to California, its effects reach far and wide. Recently, it has shown up cut into illicitly-obtained Norco in the Bay Area. Though drug enforcement authorities are starting to take note, Fentanyl has already taken hold of many illicit drug users and shows no sign of loosening its deadly grip.

Note: This story was updated to reflect recent news developments.

Read More: The 50 Most Dangerous Drugs


Related Slideshow: Musicians Who Passed Away in 2016

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Keith Emerson

Emerson was the founding member and keyboardist of Emerson, Lake and Palmer. The band is known for songs such as "Lucky Man," and "Tarkus."

Emerson died on March 11, 2016 at the age of 71. Police found him with a single gun shot wound to his head. Police can not yet confirm it was suicide.

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David Bowie

David Bowie was a solo artist known for songs such as "Ziggy Stardust," "Space Oddity,"  and "Fame." 

Bowie passed away on January 10 because of Cancer. He was 69. 

Photo courtesy of wikipeida

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Aaron Huffman

Huffman was a member of the band Harvey Danger and co wrote "Flagpole Sitta," in 1997. The song made it to number 38.

Huffman died of respiratory failure on March 6, 2016 at the age of 43.

Photo courtesy of Aaronhuffman.com

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Vanity (Denise Matthews)

Vanity was one of Prince's female proteges and had a number one Dance Club hit with "Nasty girl" in 1982.

Vanity died of Kidney Failure on February 15, 2016 at the age of 57.

Photo courtesy of wikipedia

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Dan Hicks

Dan Hicks was known for old time country and jazz. Hicks was part of two bands including The Charlatans and Dan Hicks and His Hot Licks.

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Photo courtesy of Wikipedia

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Maurice White

Maurice White, the vocalist and drummer of the band Earth, Wind & Fire co-wrote songs such as "Mighty Mighty," "Devotion" and others.

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Photo courtesy of Chris Hakkens/flckr

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Paul Kantner

Kantner was a vocalist and guitarist for Jefferson Airplane/Jefferson Starship and wrote the song "We Can Be Together," on the 1969 album Volunteers.

Kantner passed away on January 28, 2016 of multiple organ failure. Kantner was 74.

Photo courtesy of Wikipedia

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Glenn Frey

Glenn Frey was a vocalist and guitarist for the Eagles who co-wrote and sang some of the bands greatest hits like "Take it Easy," "Take it to the Limit," and "Hotel California."

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Photo courtesy of Wikipedia

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Clarence Reid (aka Blowfly)

Clarence Reid was a solo artist known for writing hits for Betty Wright ("Clean up Woman") and Gwen McRae ("Rocking Chair").

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Mic Gillette

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Gillette died of a heart attack on January 17. He was 64.

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Dale Griffin

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Griffin died on January 17 from Alzheimer's at the age of 67.

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Gary Loizzo 

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Loizzo died on January 16 of Pancreatic Cancer. He was 70. 

Photo Courtesy of Wikipedia

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Otis Clay 

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Clay died of a heart attack on January 8. He was 73.

Photo Courtesy of Wikipedia

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Nicholas Caldwell 

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Caldwell passed away on January 5 due to heart disease. He was 71.

Photo courtesy of The Whispers website.

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George Martin 

Martin was a producer for The Beatles, arguably the greatest band of all-time, producing over 700 records for the group. 

Martin died on March 8 at the age of 90. 

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Joey Martin Feek 

Feek was half of the country duo Joey+Rory. 

Feek died on March 4 due to cervical cancer. She was 40 years old. 

Photo Courtesy of Wikipedia

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Rusty Burns 

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Burns died on February 19 after a battle with lung cancer. He was 63 

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Joey Floyd 

Floyd was a guitarist, fiddler and banjo player in Toby Keith's Easy Money Band. 

Floyd passed away on February 14 after a battle with cancer. 

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Jon Bunch 

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Bunch passed away on February 1 at the age of 45. 

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Signe Anderson 

Signe Anderson was the original lead singer for Jefferson Airplane. She sang on the bands 1966 debut album Jefferson Airplane Takes Off. 

Anderson died on the same day, January 28, as former band mate Paul Kantner. She was 74.

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Colin Vearncombe 

Vearncombe is a British singer that is known for "Wonderful Life." 

He died in a car crash on January 26. He was 53. 

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Jimmy Bain 

Bain was a bassist for Dio and Rainbow and played alongside Def Leppard guitarist Vivan Campbell in the band Last in Line. 

Bain passed away on January 23. He was 68.

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Kevin Junior 

Junior was the frontman for the Chicago indie band Chamber Strings that formed in 1996 and released their first album in 1999 called Gospel Morning. 

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Jason Mackenroth 

Mackenroth was a member of the Rolling Band and the drummer fort he Blue Man Group. 

He passed away on January 17 after suffering from prostate cancer. Mackenroth was 46.

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Giorgio Gomelsky

Gomeisky was a former manager of the Rolling Stones and the Yardbirds.

He passed away on January 13 after suffering from cancer. He was 82.

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John Berry 

Berry was the co-founder of the indie rock band Idaho, who released their debut album Year After Year in 1993. 

Berry passed away on January 9 at the age of 51.

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Brett Smiley 

Smiley released one single, "Va Va Va Voom" during the glam rocker era in the UK. 

Smiley passed away on January 8 after a battle with HIV and hepatitis. He was 60.

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Craig Strickland 

Strickland was a singer for the Backroad Anthem, a new group looking to make a name for themselves. 

Strickland died in a hunting accident and his body was found on January 4. He was 29. 

Photo courtesy of Backroad Anthem Facebook

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Jean-Michel Delpech 

Jean-Michel Delpech was a French singer and songwriter. 

He passed away on January 2 after a battle with throat cancer. 

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