{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T18:51:43Z","timestamp":1781290303302,"version":"3.54.1"},"reference-count":65,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T00:00:00Z","timestamp":1672444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Fentanyl is a synthetic L-opioid receptor agonist, approximately 100 times more potent than morphine, that is experiencing an upward trend in the field of abuse. Fentanyl patches\u2019 abusive consumption can occur either by transdermal absorption or through other atypical and ingenious routes. In the present case, a 29-year-old man with a history of illicit drug use was found dead in a suburban neighborhood of an Italian city. At autopsy, lungs appeared increased in weight and showed minute subpleural hemorrhages. Airways contained abundant reddish foamy material; in addition, a fentanyl patch protective film was found inside the left main bronchus. Toxicological analysis revealed the presence of morphine, fentanyl, BEG and ethyl alcohol in peripheric blood; 6-MAM was also revealed in urine. Findings collected during post-mortem investigations allowed us to identify fentanyl consumption as the cause of death. Fentanyl consumption presumably took place by chewing of a transdermal patch, with subsequent aspiration of the protective film. The pathophysiology of death can be identified as combined respiratory failure\u2014both central suppression and a fentanyl-induced increase in muscular stiffness; a further minor contribution may be identified in the mechanical airflow obstruction caused by the presence of the protective film at the bronchial level.<\/jats:p>","DOI":"10.3390\/toxics11010046","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T03:08:59Z","timestamp":1672628939000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Atypical Fentanyl Transdermal Patch Consumption and Fatalities: Case Report and Literature Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Federico","family":"Manetti","sequence":"first","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0976-5504","authenticated-orcid":false,"given":"Maria Chiara","family":"David","sequence":"additional","affiliation":[{"name":"Ministry of the Interior, Department of Public Security, Health Central Directorate, State Police, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9507-8155","authenticated-orcid":false,"given":"Sara","family":"Gariglio","sequence":"additional","affiliation":[{"name":"DIFAR\u2014Department of Pharmacy, University of Genova, 16148 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Consalvo","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2452-7926","authenticated-orcid":false,"given":"Martina","family":"Padovano","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7259-3090","authenticated-orcid":false,"given":"Matteo","family":"Scopetti","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Grande","sequence":"additional","affiliation":[{"name":"Department of Public Security, Anti-Crime Central Directorate, Scientific Police Service, 00174 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-3719","authenticated-orcid":false,"given":"Alessandro","family":"Santurro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1007\/s40265-017-0727-z","article-title":"Fentanyl Formulations in the Management of Pain: An Update","volume":"77","author":"Schug","year":"2017","journal-title":"Drugs"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1097\/00000542-199902000-00034","article-title":"A review of the use of fentanyl analgesia in the management of acute pain in adults","volume":"90","author":"Peng","year":"1999","journal-title":"Anesthesiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.forsciint.2018.05.042","article-title":"Abuse of fentanyl: An emerging problem to face","volume":"289","author":"Grzonkowski","year":"2018","journal-title":"Forensic Sci. 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