Fentanyl use disorder characterized by unprescribed use of transdermal patches: a case report.

BACKGROUND: Fentanyl is a synthetic opioid with analgesic potency 75-100 times higher than that of morphine, and its analgesic effect is used for pain treatment, mostly in cancer patients. Using fentanyl patches may reduce misuse potential due to the transdermal route of administration, long-acting action, sustained release delivery property, and maintenance of steady-state serum concentration of the drug. Although there have been reports of transdermal fentanyl patches (TFPs) misuse via transmucosal, trans-nasal, intravenous, and oral routes of administration, fentanyl use disorder via the transdermal route is very rare. CASE: In this case report, we present a patient with a history of substance use disorder who developed fentanyl use disorder via transdermal route after using unprescribed TFP in order to quit opium gum. The CARE guidance was followed in the preparation of this case report. CONCLUSION: The risk of use disorder may be higher, especially in individuals with a history of substance use disorders. This risk should be taken into account when clinicians prescribe this medication.

Comparison of Individuals With and Without the Risk of Post-Traumatic Stress Disorder in Terms of Substance Use Features and Psychological Problems According to Their Substance Preferences.

Objective: There are multiple studies that show that exposure to a traumatic life event is a significant factor in the development and continuation of addiction. When post-traumatic stress disorder (PTSD) is added to an alcohol-substance use disorder, the course of treatment is negatively affected. This study aimed to compare people with and without the risk of PTSD in terms of substance use features and psychological problems on the basis of their substance preferences. Methods: The study was conducted with 614 individuals hospitalized in an addiction recovery center because of an alcohol and substance use disorder. Development of the addiction profile index (BAPI) clinical form was used to measure the addiction features and their severity, psychological condition, and some personal characteristics of the patients. The Kocaeli short screening scale for psychological trauma was used to determine traumatic life events and evaluate traumatic stress symptoms. Results: PTSD frequency of the participants with an alcohol-substance use disorder was 29.8% (n = 162). Considering the frequency of PTSD risk, 29.2% (n = 98) of the participants with opioid use disorder, 33.3% (n = 13) of the participants with cannabis use disorder, and 35.7% (n = 20) of the participants with alcohol use disorder had a risk of PTSD. Participants with PTSD symptoms had higher scores in substance use features, diagnosis, effect of substance use on life, cravings, greater addiction severity, difficulty in anger control, more excitement seeking behaviors, safe behavior deficiency, depression, and anxiety. Conclusion: Substance use features and psychological problems varied in individuals with and without the risk of PTSD. Configuration of the treatment plan considering this differentiation is significant in terms of the course of the treatment.