Fentanyl lozenge story part 2: from military procurement to package

This paper describes the selection of fentanyl as a replacement for morphine as the United Kingdom Ministry of Defence’s first-line battlefield analgesic agent. It is a detailed review of the 6 year journey from selection to eventual roll-out in October 2017. It concentrates on the procurement and governance process of the deployment of fentanyl for individual issue and self-use. It highlights the significant differences in military and civilian legislation, the specialist environment we work in and the safety concerns surrounding controlled drugs in the austere environment. The lessons learnt can be applied to other organisations working in specialist environments that are looking to improve patient care through novel or off-license techniques that meet legislative resistance.

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