FENTANYL CONSIDERED ONE OF MOST ADDICTIVE DRUGS

Fentanyl was synthesized in Belgium in the late 1950s and introduced into
clinical practice in the 1960s as a narcotic painkiller for heart surgery.

By the mid-1970s, it was being abused.

Today, fentanyl, used in operating rooms around the country, is considered
one of the most addictive and dangerous drugs around.

From anesthesiologists who steal vials of it from hospital pharmacies to
teen-agers on the street who buy $20 stamp bags of a powdered form, drug
counselors say, fentanyl's use is proliferating.

"Fentanyl happens to be the most recent drug of choice," said Tim Grealish,
director of community services for Greenbriar Treatment Center.

Grealish said 35 of the patients at his 54-bed drug and alcohol treatment
facility in Washington County say they used heroin. But he said what
they've really been using is a form of fentanyl.

"It's cheaper than what everyone used to know as heroin," he said, "and
it's three to five times more powerful. Anybody who works in treatment
anywhere will tell you the same thing."

Most of Grealish's clients are under age 25, but in the past five years, he
has seen a spike in the number of nurses, dentists, pharmacists and
anesthesiologists seeking treatment for fentanyl addiction.

Chemical dependence has become an occupational hazard for physicians,
particularly anesthesiologists, the specialists who are responsible for
pain control during surgery.

Anesthesiologists make up about 4 percent of the country's 813,770
physicians. But according to a study by Talbott Recovery Campus, a
well-known drug treatment center in Atlanta, they make up 12 percent to 15
percent of the program's physician patients.

A separate study published in the Journal of the American Medical
Association in 1992 found that psychiatrists were most at risk for drug
abuse, followed by emergency room physicians and anesthesiologists.

"The most potent mood-altering drugs in medicine are used by
anesthesiologists," said Dr. William P. Arnold III, an associate professor
of anesthesiology at the University of Virginia Health System and chair of
the American Society of Anesthesiologists task force on chemical dependence.

Fentanyl is an extremely effective pain reliever, and the opioid of choice
among anesthesiologists during procedures, Arnold said. The danger is the
lure of its euphoric, addictive high and the physicians' sense that they
can "handle" the drug.

Studies by the American Society of Anesthesiologists have shown a lower
mean age of death among anesthesiologists than internists and a risk of
drug-related suicide that's more than twice as high. Both are related to
fentanyl use.

Statewide, the Foundation of the Pennsylvania Medical Society, through the
Physicians' Health Program, helps addicted physicians with intervention,
referral to treatment, monitoring and other services, including licensure
hearings before the state boards of medicine and osteopathic medicine.

Director Greg Gable said 50 to 70 new cases were referred to the program
annually, and 70 percent were drug-related. Generally speaking, he said,
anesthesiologists "are a little higher represented."

Arnold said he had found that most anesthesiologists are not able to ask
for help because they're worried about losing their medical licenses.

But, he said, "There's a lot more to lose than your license. There's your life."