Fentanyl and pharmacy students’ knowledge and attitude about the uses, safety and black box warnings

Purpose: This study investigates pharmacy students’ knowledge, perceptions, and experiences related to fentanyl's black box warnings, which underline its significant risks of addiction, life-threatening respiratory depression, and potential interactions with other medications. Considering fentanyl’s high potency, rapid onset of action and its complex safety profile, it is imperative that pharmacy students acquire sufficient background knowledge on the uses and adverse effects of this important opioid. Methods: A survey was administered electronically to 42 to 44 Doctor of Pharmacy students, and data were collected on demographics, professional background, and prior awareness of black box warnings. The survey incorporated both knowledge-based and opinion-based questions to comprehensively assess participants' understanding of fentanyl’s pharmacological properties and their perspectives on its clinical risks. Descriptive statistical analysis was employed to identify trends and gaps that may inform educational priorities in pharmacy training. Results: An overall average of 66.6% correct response rate was recorded on knowledge-based questions. Survey participants scored an impressive 75% to 84% correct answers to questions on pharmacokinetics, mechanism of action and metabolism questions. They fared low (42 to 50%) on classification and relative safety of fentanyl relative to morphine. Opinion-based responses revealed a strong consensus on the importance of considering fentanyl’s pharmacokinetic properties—such as its high potency, short half-life, and addictive potential—when making therapeutic decisions, highlighting a shared recognition of the drug’s risks. Implications: These findings emphasize the need for targeted educational interventions in pharmacy programs to bridge identified knowledge gaps and enhance safe opioid management practices. Integrating case-based learning, clinical scenario analysis, and practical training on black box warnings can strengthen future pharmacists' competencies in handling high-risk opioids like fentanyl. By bolstering their readiness to navigate the complexities of fentanyl's use, pharmacy education can play a pivotal role in advancing patient safety and mitigating opioid-related harms.