[Excessive use of fentanyl patches as the only means of suicide].

Due to the increasing prescription there are more and more cases of abuse and accidents related to fentanyl patches. The use of fentanyl patches (e.g. Durogesic) for committing suicide is rare, however. In our case, we describe a suicide with an amount of fentanyl patches never mentioned in the literature before. A depressive 63-year-old man was found dead in his apartment. On the body of the decedent 20 nearly symmetrically arranged fentanyl patches (Durogesic) of different strength with a total dose of 1350 microg/h were found. According to the results of the police the fentanyl patches were part of the pain therapy of his late wife, who had died one year before. Neither the autopsy nor the histological examinations revealed a cause of death. The chemical-toxicological investigation showed the following fentanyl concentrations: 94.9 ng/g (femoral vein blood), 45.9 ng/g (blood of the left heart), 74.8 ng/g (blood of the right heart), 101 ng/mL (urine), 468 ng/mL (bile), 745 ng/mL (stomach contents), 78.4 ng/mL (cerebrospinal fluid), 133 ng/mL (vitreous humor). The blood concentrations were in the upper range of the concentrations found in similar cases published. Hints for a postmortem increase of the fentanyl concentration because of the long postmortem interval of nearly 8 days were found.