A night getting high on prescription pain medication patches led to the deaths of two Athens, Tenn., men who had been abusing the powerful painkiller fentanyl.
Police found 48-year-old Harold "Marty" Coleman Jr.'s lifeless body Friday in the driveway of his mobile home at 1004 S. Jackson St., a fentanyl patch in his mouth.
A few minutes later, authorities found Coleman's friend, 46-year-old Donald Sturdivant, unresponsive in the laundry room of the mobile home.
"They were having a pain patch party and they just overdid it," Athens Police Department Detective Sgt. Fred Schultz said. "From the information we got, they were wearing them and they were chewing them."
Fentanyl was responsible for 21,196 emergency room visits in the U.S. in 2010 -- the fourth most commonly overdosed painkiller behind oxycodone, hydrocodone and methadone, according to the U.S. Department of Health and Human Services.
Dr. Gregory Ball, an anesthesiologist and pain management specialist for Consultants in Pain Management in Chattanooga, said a single fentanyl patch contains enough medicine to last patients 72 hours.
"Fentanyl is a very powerful pain medicine. Until probably 20 years ago, it was just available in IV form, and it's the most commonly used pain medicine in anesthesia," Ball said.
Fentanyl patches come in strengths ranging from 12 micrograms to 100 micrograms to be absorbed through the skin and into the bloodstream, where it is delivered throughout the body for patients who have chronic pain.
"A 50-microgram fentanyl patch -- 50 micrograms of fentanyl per hour -- would be the equivalent of between 60 and 100 milligrams a day of morphine by mouth," he said.
That would be like taking six to 10 10-milligram hydrocodone tablets a day.
Using pain patches to get high is not a new phenomenon in the Athens area.
During the first weekend of April, a high school-age boy was talking with friends in the driveway of a house in Athens "and he just passed out," Schultz said. The boy's friends called for an ambulance, and medical officials at the hospital discovered the boy had overdosed on a fentanyl patch.
Like the cases of the two dead men, police believe the teen had been chewing the patch.
But he survived.
Schultz said Coleman had a prescription for the patches that he had filled just three days before his death. He apparently shared them with Sturdivant.
The time-release patches deliver the pain medication over time, "but if you chew them -- if they get damaged or broken -- then you get it all at once," Schultz said.
Coleman also had a prescription for other narcotics found inside the home. Schultz said the two men might have been mixing the patches with other medications as well, increasing the likelihood of problems.
While emergency medical officials were preparing to transport Coleman, officers found unconscious but breathing, the detective said. Sturdivant died a couple of days later at a Chattanooga hospital.
Coleman's wife, Pam, and 32-year-old Amanda Haney, who was staying with the Coleman couple, were at the mobile home at the time of the party, Schultz said.
Pam Coleman told authorities her husband and Sturdivant were outside together Friday night sometime before 4 a.m., supposedly to get Sturdivant home, Schultz said.
"Sturdivant came back in and said, 'He's sick,' and Pam said he was probably having one of his seizures," he said.
Pam Coleman told Sturdivant to take a pillow to her husband and put it under his head to keep him from hurting himself. The man then lay there as sunrise approached.
"The boyfriend of Haney comes home from work at about 4 a.m. and he sees [Coleman] out there and talks to him and he's fine then," Schultz said. "He [Coleman] said he was just going to lay out there."
But when someone checked on Marty Coleman after daybreak, he was still lying in the driveway but was unresponsive and struggling to breathe, Schultz said.
That was when a call was made for an ambulance. It was just before 9 a.m.
Less than five minutes later, officers arrived to find Marty Coleman had stopped breathing, he said.
Once it was determined Coleman was dead, officers were able to go inside the mobile home where they found Sturdivant. Haney was locked in a bedroom.
Haney was found in possession of pills that didn't match the prescription on the bottle they were in, and she had a violation of probation warrant for her arrest, according to authorities.
In Tennessee, fentanyl is the sixth most commonly prescribed narcotic painkiller, according to a recent report from the state health department. While rates of hydrocodone and oxycodone use have climbed steadily in the last five years, fentanyl prescriptions have remained relatively steady since 2007.
Dr. Robert Hamilton, Erlanger Health System's chief of emergency services, said the hospital "rarely" sees intentional or accidental overdoses from fentanyl specifically.
This particular kind of overdose with the chewed patches is unusual, said Dr. Louie Meier, an emergency medicine physician at Memorial Health System. But the drug is one of a group of opiates causing an increasing number of overdoses, he said.
"It's part of the larger problem we have with opiate abuse," Meier said.
Parkridge Medical Center Emergency Department physician Dr. Pulin Patel said, "We don't typically see fentanyl patch overdoses; however, we do see a handful of prescription narcotic overdoses -- some intentional, some unintentional -- each month."
Prescribers in pain management work hard to make sure their patients correctly use their medicine through frequent drug screens, said Ball, the anesthesiologist and pain management specialist.
"The big message is fentanyl patches aren't for oral use and they're designed to be put on the skin, changed every three days," he said. "Don't tamper with the delivery system."
Staff writer Kate Harrison contributed to this story.
Contact staff writer Ben Benton at email@example.com or 423-757-6569.