[Tapering]

I have been attempting to gather information but have been unable to arrive at reasonable conclusions given the information I have found.

Four and one half weeks ago I went from 87.5 mcg /48 of fentanyl transdermal to four 10/350 morco per day.

Now as of today, I have tapered that further to 15 mg of hydrocodone per day. Can I discontinue use without severe withdrawal effects at this time. Please not that I did not abuse and took all prescriptions as directred for close to 3 years.

I can't imagine that discontinuing the 15 mg will be anything like the drop from the fentanyl to the norco.

If you can advise, please do. Should I taper further.

Thanks.

[Robert_325]

Originally Posted by Tapering

I have been attempting to gather information but have been unable to arrive at reasonable conclusions given the information I have found.

Four and one half weeks ago I went from 87.5 mcg /48 of fentanyl transdermal to four 10/350 morco per day.

Now as of today, I have tapered that further to 15 mg of hydrocodone per day. Can I discontinue use without severe withdrawal effects at this time. Please not that I did not abuse and took all prescriptions as directred for close to 3 years.

I can't imagine that discontinuing the 15 mg will be anything like the drop from the fentanyl to the norco.

If you can advise, please do. Should I taper further.

Thanks.

Stopping the Norco will not be as bad as the drop in Fentynal. Fentynal is a bad detox ... very painful. I am sure you can handle stopping the Norco, but I would still expect some W/D symptoms even if you have it down to a pretty low dose. You have been using opiates for three years even if it was a smaller dose recently.

I would go ahead and do it if you are not requiring the Norcos any longer. Just realize you will have some uncomfortable days. Face it and deal with it. If you can't handle the total detox then sure ... you can taper. I was never successful doing a taper. It had to be all or nothing for me. I would make it a few days then totally blow it. So if you are going to do it, make your mind up that you can handle whatever happens and just tough it out. People are always here to give you support and make suggestions. Let us know what you are doing and stay in touch. Good luck and God bless.

[Tapering]

Originally Posted by Robert_325

Stopping the Norco will not be as bad as the drop in Fentynal. Fentynal is a bad detox ... very painful. I am sure you can handle stopping the Norco, but I would still expect some W/D symptoms even if you have it down to a pretty low dose. You have been using opiates for three years even if it was a smaller dose recently.

I would go ahead and do it if you are not requiring the Norcos any longer. Just realize you will have some uncomfortable days. Face it and deal with it. If you can't handle the total detox then sure ... you can taper. I was never successful doing a taper. It had to be all or nothing for me. I would make it a few days then totally blow it. So if you are going to do it, make your mind up that you can handle whatever happens and just tough it out. People are always here to give you support and make suggestions. Let us know what you are doing and stay in touch. Good luck and God bless.

Thank you very much for your information. Whether I need the norco or not is exactly what I am trying to determine. I want to make sure since it has been 3 years since opiod therapy began that I am not experiencing hyperalgesia. I do not think I am, but nonetheless, I want to discontinue medications completely to make that determination on a personal front. I have managed to taper myself during this month after switching from the fentanyl to the norco. As stated, I started the norco at 40mg a day and have actually ended up today at 13.25mg. (Just took my last dose for the day prior to bedtime).

I do not have any issues with self disciplining the tapering; I am simply anxious to end the medications. However, the switch from fentanyl to norco was traumatic enough to encourage me not to quit too soon. I was told by my physician that I would feel like I had a bad flu, and nothing could have been farther from the truth! I have had the opportunity to experience the flu in recent years, and I can't think of any comparable symptoms. Body aches are not the same as flu-like body aches. Stomach disturbances are much worse. I had particular issues with leg and arm twitches as well as extreme anxiousness. Not to mention that you can sleep when you have the flu. Sleeping during this process is an absolute effort in futility. Glad to have that portion of this experience behind me.

I am experiencing pain as I remember prior to beginning medication and physical therapy, however, this cleansing so to speak will certainly have its advantages whether or not I have to remain on opioid therapy in the future. My body is certainly more opioid naive than it was a month ago, and perhaps we can once again begin at very low dosages to control pain if indeed I do not have hyperalgesia (which at this point I am convinced I do not), but I am still taking a small amount of opioids so I will hold that determination for when I have been opioid free for a period of time.

As to the nastiness of fentanyl withdrawals in particular...I don't know if they are any worse than what anyone would experience on any such strong medication, but I can attest that my body certainly reacting to this dependence in a markedly nasty way. If I choose to continue opioid therapy, I will certainly NOT choose the patch as a means of administration. For one thing, there is no control to take LESS on the days when the pain may not be as bad as the day before. I do not like not having that option.

Again, thank you for your response and blessing as well.

[Robert_325]

Hyperalgesia is definitely something that lots of people who use most any narcotic pain meds for an extended period end up dealing with. I guess I should say that lots of opiate dependent people end up having their minds play tricks on them into thinking their pain is worse than it really is. Whether we want to call that hyperalgesia in every instance is debatable. I do totally agree that it is almost impossible to accurately determine what our true pain level is following an extended time on opiates unless at some point we do actually "purge" as you say the opiates from our systems and see where we really stand. At this point we can make a better determination of whether or not we need to continue on with opiate therapy and if so at what dose can we maintain on. I also agree that W/D symptoms of detox are much more serious than "flu" symptoms. LOL That is a common comparison made by people who have most likely never experienced detox. I don't recall bouncing off the bed from RLS and shaking, sweating, diahrrea, and all the other elements of detox being present when I had the flu. I think you have the right attitude to do this. You are prepared mentally and the rest will fall into place for you. Stay in touch and let us know if we can help you. Good luck and God bless.

[scarednow]

I too was on the Duragesic patch and it was hell getting off of, I was at 100 mcg every 2 days with 20 mg oxycontin and 5/500 vicodin for breakthrough pain. As of May 15th I started tapering after 2 years of treatment and am now down to 10 mg oxycontin twice daily until surgery on Wednesday for my back. After that I will continue to go down till I am off these evil things, the doctors never told you it would be hard to get off of them when you are done, they handed this stuff out to me until I said enough. Anyone who's Dr reccomends the patch.....dont, keep on something you can control. Its not worth it in the end. I still have to find my end.

[Tapering]

Originally Posted by scarednow

I too was on the Duragesic patch and it was hell getting off of, I was at 100 mcg every 2 days with 20 mg oxycontin and 5/500 vicodin for breakthrough pain. As of May 15th I started tapering after 2 years of treatment and am now down to 10 mg oxycontin twice daily until surgery on Wednesday for my back. After that I will continue to go down till I am off these evil things, the doctors never told you it would be hard to get off of them when you are done, they handed this stuff out to me until I said enough. Anyone who's Dr reccomends the patch.....dont, keep on something you can control. Its not worth it in the end. I still have to find my end.

I understand the lack of control with the patch. You are left with no control to take less if pain is at a minimum. But, I wonder if it is the driving force for the dispensement; you are unlikely to take more than prescribed perhaps?

I wish I could be of more help to you, but I have no experience with Oxycontin. I can tell you I am roughly 4-1/2 weeks into the process of tapering down and am now down (yesterday & today) to 10 mg of hydrocodone. It is my opinion, however, that this a relatively fast taper down. (87.5 mcg of fentanyl to 10 mgs of hydrocodone in 33 days). I anticipate cutting again tomorrow to 8.25 mgs.

I have instituted this taper myself. When I return to the doctor next week, I intend to speak with them regarding the end phase of the taper since I am somewhat lacking on how exactly to end with any withdrawal. The drop from the fentanyl to norco was difficult and traumatic enough to have me operating somewhat fearfully.

The general consensus from the information I am gathering seems to be that those discontinuing fentanyl find it quite intense and "dirty." I have nothing to compare it to, but can tell you after the passage of approximately 4 weeks, things started to improve and the taper from the hydrocodone became much easier (or what can at least be termed easier in comparison to the fentanyl withdrawal symptoms).

I like you had no true picture or reference of what discontinuing the medication would be like but found it very, very intense. What has even more comedic value is that the pharmacist said that fentanyl withdrawal is easier than other opiates. I find that hard to believe after reading the testimonias of those who have experienced it. I can not validate that determination. Again, I have nothing else to compare it to.

I am hoping to be completely finished with my taper in no less than 2 weeks.

Good luck.