The Department of National Defence is in the market for 3,000 lozenges containing fentanyl, the powerful pain-killing opioid that — in its illicit street form — has been blamed for hundreds of overdose deaths across Canada.
The department issued a tender notice Thursday morning for 100 boxes of 30 “fentanyl citrate trans mucosal lozenges” to be delivered by Aug. 15, 2017.
There’s an optional top-up of 134 more boxes, and the contract extends to April 2021.
Each of the lozenges, which are also known colloquially as fentanyl ‘lollipops,’ will contain 800 micrograms of the drug in solid form.
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They are placed in the mouth on the end of a short stick, and dissolve slowly to release the painkiller into the patient’s system.
“The fentanyl citrate trans mucosal lozenges are for use abroad on deployed operations,” confirmed DND spokesperson Jennifer Eckersley.
The department did not provide any additional details, but did confirm that the new drugs are being ordered to re-stock an existing supply.
The Canadian Forces aren’t the only ones using this type of painkiller in the field, and other countries offer a clue as to when and why the drugs are administered.
A 2009 story in Wired magazine noted that the ‘lollipops’ were used by the United States Air Force Pararescue combat medics to provide quick pain relief to soldiers injured on the battlefield.
It can take about 3,000 micrograms of fentanyl to kill an adult male (although any size dose can kill someone who is intolerant of the drug), so the 800-microgram dosage is within limits. The drugs ordered by DND will also be manufactured in a controlled environment, unlike the illicit forms circulating on the streets.
Mallinckrodt Pharmaceuticals is one of several companies that manufactures the type of lozenge DND is looking to purchase. On the company’s website, it warns that the drug, like other opioids, can be habit-forming.
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The lozenges also carry a risk of “fatal respiratory depression” if the dose is not managed properly, the website notes, and they are specifically intended for acute pain in cancer patients.
They are “contraindicated” (not advised) for “the management of acute or postoperative pain including headache/migraine and in opioid non-tolerant patients.”
Fentanyl, which is 50 to 100 times more powerful than morphine, is still used in hospitals and prescribed for pain management in Canada, in spite of the fact that it can be highly addictive.
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The over-prescription of opioids has been cited by numerous experts as one of the root causes of the current overdose epidemic, which has been particularly severe in Vancouver.
The street version of fentanyl is often contaminated after being manufactured in clandestine labs, and is frequently combined with other drugs. The drug has proven extremely deadly. Many users are also unaware they are consuming fentanyl, suffering repeated overdoses.