Duterte has fallen ill five times this year

By Raïssa Robles

In the early morning hours of Tuesday, President Rodrigo Duterte indicated to a roomful of businessmen that he was highly dependent on the drug Fentanyl to manage his pain.

Duterte explained he was taking Fentanyl “to relieve the pain” he was feeling in various parts of his body. He described his pain:

“I had a bad sleep, the last one was this. And I hit the…I have a lot of issues with my spinal. My doctor would want to operate but you know my wife was a nurse and she used to work in the States, United States, and she said, since a lot of operations for the spinal that went awry, that went wrong. So that if you guys see me always with a sad mode, I am actually pushing a nerve here to relieve the pain. And even if when I’m doing my arms sa kimbo and sometimes I do this…It’s actually pushing something here to relieve the pain.”

Fentanyl is a synthetic opioid, a substance which the British newspaper The Guardian described as “50 times more powerful than heroin”. It was an accidental overdose of Fentanyl that caused the death of the legendary musical star Prince in April this year. Here is an article in The Scientific American which explains why the painkiller Fentanyl can be “especially dangerous”.

Fentanyl is not on the Philippine list of banned drugs, but it is a dangerous legal prescription drug that can give a high and also be abused. You can read more about Fentanyl abuse here.

Forbes magazine’s website said Prince was using Fentanyl for pain management: “Prince had been known to suffer severe hip pain due to decades of energetic performances. He may have become physically dependent on opioids after long-term use of legitimately prescribed opioids.”

You can also read more about the deadly high that Fentanyl gives its users in this New York Times article.

During the Wallace Business Forum held in Malacañang Palace, President Duterte denied he was taking Fentanyl because he had cancer: “Fentanyl, it’s a pain killer. It’s being used by patients with cancer.”

In his case, Duterte said, the dosage the doctor prescribed him to take was much lower: “I was only given a fourth of that square thing,” referring to a transdermal patch that is used to delivery the drug through the skin.

However, he said, there was a time he over-medicated himself and was taking four times the dose his doctor had prescribed. And, “Of course, my doctor learned that I was using the whole patch because I felt better. When he knew it, he made me stop and he said, stop it. The first thing that you would lose is your cognitive ability.”

His doctor scolded him, Duterte narrated to the businessmen present: “And if you are noticing it, he said, because you are, you know, abusing the drug.”

From Duterte’s narration, it is not clear whether he has totally stopped using Fentanyl because he added, “Take, use it but I have a pain also with the…I have a Barrett…” Barrett refers to another physical ailment he has.

According to the Mayo Clinic, “Barrett’s esophagus is most often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus. Only a small percentage of people with GERD will develop Barrett’s esophagus.”

The Mayo Clinic adds:

“Barrett’s esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, it’s important to have regular checkups for precancerous cells. If precancerous cells are discovered, they can be treated to prevent esophageal cancer.”

During his speech and the open forum with businessmen afterward that lasted past 1 a.m. yesterday, Duterte blurted out when he challenged his detractors that he now suffers from severe headaches everyday: “Oust me, good. Assassinate me, better. I have this migraine everyday.”

Duterte would have to clarify this point, whether he continues to take Fentanyl, but in the prescribed dose, for his daily migraine.

Substance abuse not only involves using shabu or cocaine. It can also take the form of abusing legal, prescription drugs. In Duterte’s case, he disclosed that he once took more Fentanyl than he was allowed to, in order to cope with pain caused by various ailments.

Besides his “slipped spinal disc” and Barrett’s esophagus, Duterte said he also suffers from “Buerger’s disease” due to previous heavy smoking.

The Mayo Clinic says:

“Buerger’s disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger’s disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). … Quitting all forms of tobacco is the only way to stop Buerger’s disease.”

Duterte has fallen ill at least five times this year

Despite Duterte’s revelations of his various illnesses, the public really does not know the true state of the president’s health.

I counted five times this year that Duterte was too ill to attend functions.

The first time was on February 11, 2016 just as he was about to speak before a medical association. He blamed his dizziness and severe headache on bronchitis.

Duterte said his headache was so severe “I wanted to puke”.

The second episode was on August 26, 2016 when he skipped going to a policeman’s wake due to a severe headache.

He said the next day,

“I was supposed (to go) yesterday, but I had this spinal thing going crazy again.

I had a migraine… I vomited in the morning so I said I could not make it.

I had this terrible headache and this is because of something misaligned in my spine (which I got) when I met an accident when I was already 67 years old in a motorcycle spill.”

You can read about it in Philippine Star.

The third episode took place on September 8, 2016 while President Duterte was attending an ASEAN summit in Vientiane.

According to the Philippine Daily Inquirer,

“The President had a bad headache. We advised him to take a rest because he will be flying immediately to Indonesia after the Asean summit,” said a Malacañang official, who agreed to talk on condition of anonymity.” When asked if the President had migraine, the official replied: “It’s a bad headache. I don’t want to speculate if it was migraine or what.”

The fourth episode was on November 11, 2016 when Duterte was unable to join Kris Aquino who was hosting a summit of small businesses in Davao City that day. The official reason given was that the President had a migraine. Hours later, though, he was seen gracing another function.

The fifth episode took place on November 20, 2016 in Peru. All we know is that the President was too ill to pose for the APEC leaders’ photo shoot and attend the gala dinner. He did meet earlier with Chinese president Xi Jinping and Russian president Vladimir Putin.

Later, Duterte blamed it all on jet lag. That’s entirely possible, especially for a 71-year-old man.

Still, you can see from the list below, drowsiness is one of the side effects of Fentanyl.

The drug Fentanyl has a number of side effects. The Mayo Clinic listed them:

More common

Decrease in the amount of urine or in the frequency of urination

hallucinations (seeing, hearing, or feeling things that are not there)

Less common

Chest pain

difficulty with speaking

fainting

mood or mental changes

Problems with walking

redness, swelling, itching, or bumps on the skin at the place of application

spitting blood

Incidence not known

Bloating or swelling of the face, hands, lower legs, or feet

fast or pounding heartbeat or pulse

rapid weight gain

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Cold, clammy skin

convulsions (seizures)

drowsiness that is so severe you are not able to answer when spoken to or, if asleep, cannot be awakened

pinpoint (small) pupils in the eyes

slow heartbeat

very slow (fewer than 8 breaths a minute) or troubled breathing

The Philippine Dangerous Drugs Board defines “drug dependence”as “the state when an individual is dependent upon the drug for normal physiological functioning.”

The question is, how dependent is President Duterte on Fentanyl? Can he function without it or does he always need it?