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    Area of Science:

    • Pharmacology
    • Toxicology
    • Dermatology

    Background:

    • Transdermal fentanyl patches provide continuous drug delivery but systemic uptake is influenced by subcutaneous blood flow.
    • External heat sources can significantly alter drug absorption rates from transdermal patches.
    • Patient education on the risks of heat exposure with fentanyl patches is crucial.

    Observation:

    • An elderly woman with multiple comorbidities died after using a fentanyl patch while in a sauna.
    • Elevated postmortem fentanyl blood concentration (15 μg/L) was detected.
    • The autopsy identified fatal fentanyl poisoning exacerbated by external heat exposure.

    Findings:

    • Sauna-induced heat increased fentanyl absorption from the transdermal patch.
    • This led to an accidental fatal fentanyl overdose.
    • The case underscores the critical role of environmental factors in transdermal drug delivery.

    Implications:

    • Healthcare providers must thoroughly educate patients about the dangers of heat exposure when using fentanyl patches.
    • Awareness of environmental risks is essential for safe transdermal opioid therapy.
    • This case highlights a potentially underrecognized mechanism of opioid toxicity.