The question of President Duterte’s use of powerful opiate painkillers has arisen again, after he said fentanyl made him feel “on cloud nine”.
The remark was made as the president addressed a crowd in Davao City this week, and has renewed calls for the leader to release his health records.
Critics have seized on the admission, highlighting the apparent hypocrisy of using such a drug in the midst of his bloody campaign against illegal narcotics.
In his Davao address, Mr Duterte — at 71 the oldest ever president of the Philippines — said he was prescribed fentanyl due to a severe spinal injury suffered in a motorcycle accident when he was 68.
“I am perpetually in pain,” he told the crowd, in a video broadcast by Filipino television network ABS-CBN.
“The doctor stopped prescribing fentanyl because he got mad. I’m supposed to cut it into four pieces,” he said, suggesting he used the pain-killing patches well beyond the prescribed dosage.
“More than just the disappearance of pain, you feel that you are on cloud nine,” he said. “Everything is okay with the world, nothing to worry about”.
It was in December that he first revealed he used the drug and had been “abusing” it by exceeding his dosage.
However, the president strongly denied he was an addict.
At a news conference in Singapore last year, a BBC reporter confronted the president on how he could justify his anti-narcotics war when he himself was “highly dependent on drugs”.
“I’m not an addict,” he replied. “Only when it is prescribed. Addiction is only with regularity, my friend.
“When you take it and there’s a monkey on your back, that’s addiction. You know what? I’ll give you an idea, nicotine is an addictive element. It’s more than … worse than the medications you take for your headache.
“You must know that I have a headache, because I had a bad spill and my — and may I show it to you? This is the cause. So, I have intermittent … but I take the drug, for my migraine.”
He then went on to say that taking fentanyl was better than smoking. “Smoking? That’s far worse. You ask any … it’s far worse than … nicotine is an addictive form and it has — but since it was there a century, two centuries ago, nobody can stop it.”
Mr Duterte has often been urged to undergo a medical examination and disclose the results to silence questions over his drug use and general health.
Carlos Zarate, an ally of the president in congress, said: “To end this speculation, it would be better if his physician explains how the president manages the pain that he suffers.”
His critics, meanwhile, have been more outspoken. Senator Leila de Lima said: “It is not just the illness itself that we should be worried about, but also the impact or side effects that the medications he is taking may have, especially on his lucidity and ability to make decisions with a clear mind.”
In the past, Sen. De Lima has also said that the president’s drug use had driven him to “madness”.
“Duterte should stop taking Fentanyl because obviously it has already driven him to madness and to fits of paranoia where everyone he sees is either a drug addict or a drug lord,” she said.
“Mr President, stop abusing drugs so for even one single second you can experience a lucid interval and discover how crazy this drug war witch-hunting has become.
“At least I, whom he recklessly and wrongly accuses as a narco-politician, haven’t taken a single addictive drug in my life, while he who runs amok and froths in the mouth like a rabid animal has the temerity to make up a list, when he should be on the top of that list.”
In the past, president Duterte has backtracked on his admission of taking fentanyl. During another speech in Davao, he commented on his previous statement about the drug: “Fools,” he said. “I just made up that story and you believed it.”
There are also ongoing concerns about the 71-year-old president’s physical health and he has repeatedly been forced to deny rumours he is suffering from cancer. Last month, it was speculated that he had made a secret visit to a hospital in China.
The leader has previously admitted to suffering from migraines, spinal problems and Buerger’s disease, a cardiovascular illness typically found among smokers.