16 N.J. Doctors' Offices Investigated As Statewide Alert For Deadly Drug Issued

Sixteen New Jersey doctors' offices were investigated, and a statewide alert was issued this week for a painkiller that officials say caused at least one death.

The state issued the public alert after filing an action seeking the temporary license suspension of a New Jersey doctor who prescribed the drug to a non-cancer patient who later died from “adverse effect of drugs.”

Attorney General Christopher S. Porrino and the Division of Consumer Affairs warned the public about the "grave risks" involved in using the potent prescription painkiller Subsys for anything other than its approved use, which is to treat cancer patients already on around-the-clock opioid painkillers, according to a release from the Office of Attorney General.

Prescribing Subsys for anything other than its approved use, a practice known as “off-label” prescribing, carries an increased risk of misuse, abuse, addiction, overdose and death, authorities said.

Last week, investigators with the Division of Consumer Affairs inspected patient records at six doctors’ offices statewide and subpoenaed patient records from 10 others in connection with an investigation for off-label prescribing of the medication. Inspections and investigations of the off-label prescribing of Subsys will continue, authorities said.

Subsys is the brand name of one of six fentanyl medications that instantly deliver the drug through the oral membranes. Subsys is a spray version of fentanyl, which is typically administered under the user’s tongue. Fentanyl is the drug officials say was involved in the overdose death of the legendary musician Prince earlier this year.

The doctors who were investigated were not identified, except for Dr. Vivienne Matalon, who has offices in Cherry Hill and Camden.

Matalon allegedly prescribed Subsys to three patients who did not meet that criteria for receiving the drug, according to authorities. One of those patients, a 32-year-old woman, died in March from “adverse effect of drugs,” according to her autopsy report.

“Given that opioid overdoses are killing more people in New Jersey than car crashes, it is appalling that a doctor would willfully disregard the federal restrictions placed on this extremely potent drug, and abdicate her professional obligation to keep her patients safe,” Porrino said in a statement. “Dr. Matalon’s actions demonstrate a level of professional misconduct that requires immediate intervention to protect the health, safety, and welfare of the public.”

The medicine is not intended for use in opioid non-tolerant patients because life- threatening respiratory depression and death could occur at any dose in patients not taking chronic opioids.

“We’re warning everyone – doctors and patients alike – that Subsys is a fast-acting, extremely powerful drug approved only for a singular narrow purpose - to relieve breakthrough cancer pain,” Porrino said. “Given this risk, I have instructed the Division of Consumer Affairs to investigate the potential misuse of this highly addictive medication by other providers.”

Fentanyl generally is a powerful synthetic opioid painkiller that is similar to morphine but is 50 to 100 times more potent. Recently, fentanyl has increased in popularity as a recreational drug, diverted from its legal use as a Schedule II pain medication, and is often either used by itself or in connection with heroin.

Fentanyl, in both diverted and illegal analog forms, now results in thousands of overdose deaths every year nationally, according to the release.

Patients who believe they were prescribed Susbys in violation of the FDA restrictions should contact the Division of Consumer Affairs at 1-800-242-5846 (toll-free within New Jersey) or 973-504- 6200.

Patch file photo