Fentanyl tip

Theresa Brown, an oncology nurse, writes a nice column in the Web edition of The New York Times. I read it because she's a sensitive writer and thinker and because I like to get a glimpse of what is happening on the "other side" -- but this week I noticed a possibly useful medical tip for people, like me, who use pain patches.

Brown suggests giving a patient spiking intermittent fevers a fentanyl patch, and a doctor immediately shoots down the idea:

The doctor was referring to the fact that heat can interfere with the patch’s slow-release mechanism, causing it to “dump” a large dose of fentanyl all at once. Some patients wearing the patches have died, and some of those deaths were likely caused by a patient applying a heating pad, or because a patient had a fever.

I knew heating pads were a no-go with fentanyl (and, being under the age of 90, I don't tend to use them), but fever had never occurred to me. So it may be worth a call to nurse or pharmacist if you wear a patch and get hit with a heavy fever. You probably have enough tolerance to the narcotic to avoid actual danger -- but you might end up woozier than you'd like if the drug releases faster than normal because of the heat.