On Thursday last week, news headlines claiming that one in 10 Korean teenagers have tried fentanyl patches flooded media portals. I couldn't help but be astonished by these articles. However, upon closer examination, it became clear that these headlines were misleading because the survey questions were poorly devised in the first place.

Fentanyl, a potent narcotic painkiller, is typically prescribed to end-stage cancer patients or individuals with severe pain due to specific medical conditions. Fentanyl patches, specifically, are banned for individuals aged 17 and under, unless absolutely necessary.

The shocking headlines originated from the Ministry of Gender Equality and Family's "2022 Youth Media Toxic Environment Survey," which sampled 17,140 children ranging from grade 4 elementary school students to high school students. According to the ministry, the survey results showed that "10.4 percent of middle and high school students said they have used fentanyl patches." Additionally, 0.9 percent reported trying appetite suppressants known as "butterfly pills."

The ministry added that 94.9 percent of teenagers with experience using fentanyl obtained the drug through doctors' prescriptions. However, upon examining the numbers, the discrepancy between the survey's claim of 1,741 teenagers trying fentanyl and the actual number of fentanyl patches prescribed to teenagers in 2020, which was 624, raises doubts about the accuracy of the survey's findings.

Last year, the figure even went down further. According to the Ministry of Food and Drug Safety, only 482 patients under the age of 20 were prescribed fentanyl patches in 2022.

Shortly after the media reports, the gender equality and family ministry released another statement, acknowledging that the survey results required "careful interpretation." 

The confusion stemmed from the survey questionnaire itself, which included two questions about hallucinogenic substances and drugs. Respondents were asked if they had tried "Butterfly pills (Dietamin Tab.-- phentermine hydrochloride)" or "Painkiller (fentanyl patch)" in the past year. If they answered affirmatively, they were then asked how they obtained the substances, with options including those prescribed by a doctor, purchased online, obtained from a friend or senior, obtained from someone else (adult), or other.

The ministry emphasized the need for cautious interpretation, stating that the survey's mention of "painkillers" placed in the foreground might include adolescents' experiences with general painkillers. 

Those teenagers might have not known what fentanyl was but answered affirmatively anyway because most of them must have tried general painkillers.

Therefore, the survey results should have been interpreted as "one in 10 teenagers have used painkillers including fentanyl” rather than specifically referring to fentanyl use alone. These two interpretations make a world of difference.

"We included fentanyl patches in the survey to find out how to respond in policy if adolescents are informally acquiring and using narcotic painkillers," the ministry said. "We will consider the results of the next survey and make necessary improvements."

It is lamentable that the gender equality and family ministry released such a poorly-devised survey in the first place, and it is also disheartening that most major news articles did not fact-check and instead chose to sensationalize the headlines, painting a misleading picture that suggests 10 percent of Korean teenagers are getting fentanyl as casually as they would get Tylenol.

In discussions with medical professionals, it has been noted that non-cancer patients typically receive fentanyl prescriptions by informing orthopedic surgeons or pain medicine specialists about severe backaches. Still, Lee Tae-yeon, president of the Korean Association of Orthopedic Surgeons, stated that, to his knowledge, no doctor would prescribe fentanyl "at the request of a patient." It is extremely difficult for a healthy teenager to get a doctor’s prescription for fentanyl.

Given this situation, it is crucial for both the government and the media to exercise extra caution when devising or reporting surveys related to narcotic painkillers. It is high time for a more conscientious approach to surveys and reporting on this sensitive subject.

Kim Yoon-mi is managing editor of Korea Biomedical Review. She can be reached via Twitter @YoonmiKim or e-mail at yoonmi@docdocdoc.co.kr.  -- Ed.