How to remove the fentanyl from a fentanyl transdermal patch?

Answer 1

Ending Duragesic dependence is not easy, nor can it be done in a short time. Of course it totally depends on the patient's current dosage and how long they've been using it as to how long it will take to get off it it. I can tell you that after 10 years of Duragesic use (2 100mcg patches, plus 120 Percocet 10/325's per month) it took a total of 8 months to lower my dependence enough to where I could switch to Percocet and lower those amounts as well.

Keep in mind that it comes with a cost - you'll find out how much real pain you're in once your levels are low enough, and in the end it might be easier to keep using it. It'll take time, as there's a point where the withdrawal pain is strong enough you can't get a good read on your actual pain. You'll know when it's gone and your real pain is letting you know it's still there.

Even though I've not used one since August '09, my pain is still strong enough that I consider starting to use them again every day. But for me, I resigned myself to the fact years ago that I'd be an opiate patient the rest of my life. I've experienced extremely high levels of pain without the benefit of opiates in the past (hospital & doctor screwups - read my bio if you're curious) and as such my mental tolerance for pain is extremely high. But regardless of how mentally focused you are, you can't keep it up all the time - all of us who are chronic pain patients need some type of pain relief, and that's just reality. If you're at the point where your pain is low enough you can discontinue Duragesic, that's great. But be prepared for the possibility that you might not like what you find once your opiate levels are lowered to the point where your brain is really feeling your pain. Regardless, it's good to do it to better assess your actual pain level, which you can't really do while using Fentanyl.

Depending on your current dose, there's a couple of ways you can do it. You can get lower patch doses and drop your dependence that way, using your breakthrough meds to cover the withdrawals from the difference in dosage. Over the many years I've used Duragesic, I've had to increase my dosages several times from 100 to 200mcg's and then back again - I never did it by using smaller patch doses as it's easier to do it another way. But everyone's different.

First off, you need to stretch your patches to where you're getting the absolute most out of them - change them only when the current one has expired and you're already dealing with withdrawals. Use smaller doses of your breakthrough meds to help ease the pains. Eventually you'll get used to incremental lowering, and be ready to head into your first major withdrawal period. For me, it was about 5 days of major withdrawals - I used Percocet instead of Duragesic until the withdrawals were such that I had to apply a patch. After another month, I was at a point where I was able to do it again, and successfully switched back to Percocet after 3 weeks of withdrawals that weren't nearly as bad as the first period.

To say it's not easy is an understatement, but it's not impossible either. Aside from setting aside time to deal with it, the things I always recommend are:

1. Be completely prepared mentally - eventually you'll get to the point where you'll know you're ready to deal with the discomfort that's to come. Anyone who uses Fentanyl deals with withdrawals regularly - it's no different, just longer.

2. Have lots of water and Gatorade available - Staying well hydrated is essential, as you'll be sweating buckets. You can literally smell and taste the Fentanyl sweating out of your pores. Keeping your electrolytes up is essential as well.

3. Stay warm - You'll be sweating but freezing as well. The best way to describe it is like having the flu, but without the fever. I did it in the middle of Summer, and I was freezing every day.

4. Have a family member around - Trust me when I say you're not going to feel like doing much of anything besides getting up, going to the bathroom, and going back to bed for more misery. That includes making something to eat.

5. Stay sedated - Virtually every instance where I've needed to lower my dosage levels and had to deal with withdrawals for extended periods, I've asked my doctor for something or used one of my other meds to help keep me sedated. When you're sedated, the discomfort is much easier to deal with.

6. Anti-anxiety / Anti-nausea meds - Anti-anxiety meds will help with the withdrawal pain; Anti-nausea meds help when you're near the end.

7. Movies, Music, Games - Anything to distract your mind from the discomfort. Personally I use David Gilmour (Remember That Night BD Live), though gaming helps a lot as well. I also got a lot of WikiAnswers Supervisor work done on this and my other categories during that period. It doesn't really matter what it is, as long as it's a mental distraction strong enough to focus your attention away from the discomfort.

8. Breakthrough Meds - Don't even think about this unless you've got a good supply of Percocet or other meds that you can use to help lower your dependence. My normal supply/dose is 120-150 Percocet 10/325's per month. I started with 10's, then cut them in halves and quarters, taking them together to make 7.5 and then 5mg's.

9. OTC Meds - 2 OTC meds I've used for years are Bayer Back & Body Aspirin and Tylenol Extra Strength Rapid Release Gel-Tabs. Both work fast and really ease pain, enough that I've used them when I don't feel the need for a Percocet. They'll help take up the slack for the pain that your BT med can't cover so you don't have to take as much of it.

10. Doctor - Make sure your doctor knows what you're doing - most will support your efforts. But don't get discouraged if you find that your pain is still great enough you need to continue using it. Remember Duragesic use for all of us is a quality-of-life decision. Using it sucks, since none of us like being a slave to Schedule 2 opiate regulations. But being in constant agony 24/7 isn't a picnic either.

If you've got any specific questions, feel free to contact me through my WA Supervisor email address on my bio page.

Answer 2

You should speak to your doctor about withdrawing from morphine consumption. As with all drugs, withdrawing causes side effects that need to be managed under medical supervision as otherwise they can be very dangerous or even deadly if they are not managed correctly by fully qualified medical personnel.

Answer 3

Removing it is pretty easy - just peel it off like tape. Getting it to stick on for 2-3 days is usually the hard part for most people.

Once it's removed, it should be properly disposed of. The drug literature recommends folding over the adhesive part onto itself and then flushing, though I don't recommend that if you've got a septic system. As long as it's folded and put into a trash container where kids or pets can't get to it, it's okay. Remember that the patch can be cut, and there's always a little bit of gel left (though not enough fentanyl to really affect a patient). But it can be enough to make someone who isn't opiate tolerant either really sick, or worse.