The purpose of this patient safety communication is to alert plastic surgeons, nurses, and patients about the risks of fentanyl-containing counterfeit prescription medications that patients can obtain outside of those prescribed by a physician, physician’s assistant, or nurse practitioner and purchased at a licensed pharmacy. This becomes a patient safety issue where unintentional fentanyl overdose and death can occur. Patients are not well-educated about these risks and how to stay safe. Children and adolescents are also at risk. We believe that a conversation with patients will save lives and prevent tragedies.
This crisis has escalated to the extent that a patient safety advisory regarding the extreme danger of illicit fentanyl has been jointly developed by ISAPS and The Aesthetic Society. The purpose of this communication is to discuss this matter in the context of patient safety and how to take actionable steps to mitigate risk for patients. Additionally, we will review the pharmacology of powerful synthetic opioids, geopolitical issues, and naloxone used to treat opioid overdose.
Unlike legitimate medications that are manufactured with tight quality controls and good pharmaceutical manufacturing processes, there is no control over how much fentanyl is contained in counterfeit medications. Only two milligrams of fentanyl is considered a potential lethal dose; it’s particularly dangerous for someone who does not have a tolerance to opioids.