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Replacing Fentanyl with Vicodin?
How to start the story? They are all the same, aren't they? Different but the same.
I am so sick, my main problems are ankylosing spondolytis and palindromic arthritis and lupus. It all started with crohn's and I guess your gut can mess you up and it did spawning all these other auto immune diseases. (I also have Raynaud's and Hashimoto's and probably more I can't remember.)
I was put on the patch because due to my Crohn's, I cannot take sustained release pills and I wasn't able to sleep longer than 4-5 hours. I had to have my children sleep with me at times to shove pills in my mouth because the pain was so bad I could not even open my hands to pick up a pill I had laid out, so yes, the patch was a Godsend.
I have never gotten a buzz from pills. The only pills I "feel" are valium and flexiril. I can suck down oxycotton, dialaudid, vicodin and never ever notice it. Granted, if I take enough I do go to sleep eventually. I don't "feel" the fentanyl patch so I am not really motivated to stay on it other than it is convenient.
I started the patch back in September and it has served its purpose. But I have moved states away from the original prescribing doctor. Where I am now the general feeling is drugs for chronic pain is the sign of a drug seeker and I can't find a doctor's office that will manage a patient on medication for chronic pain. Everyone is sent to a pain clinic. I have heard such horror stories about pain clinics I am afraid to go.
I want to stop the fentanyl patch only because I don't want to deal with being treated like a subhuman. I fly back to see my rheumatologist every 3 mos and I am thinking I can go back to vicodin pain management again, and of course I am hoping the pain will get better. Not really sure how that is going to happen though?
I have left my patch off for a couple hours here and there, never much longer. I do kinda feel "crummy" but nothing like a withdrawal. Here's what I am wondering, can I just kick this patch and use vicodin to replace the fentanyl? I can't seem to find that answer. Does the vicodin replace fentanyl for withdrawal purposes? I also have oxycodone, too. It is just vicodin works better on my pain than oxy-anything.
Currently I am on 50 mcg every 2 days. The patch I have on right now is half attached and on its third day. I am using the ones that are solid, without the gel pocket. Really, really I want to just pull this stupid thing off and see how I feel. The talking heads all have horror stories about that.
In the past, I have come out of a flare where I've been taking 2qty 7.5mg vicodin every 5 hours for weeks on end to taking just 2-3 a day total then 2-3 a week without a withdrawal.
I am tapering off prednisone right now so the doctors don't want to address going off the patch at the same time but in the same breath they don't want to address me continuing it either. All of the conversations have involved very long tapers of slowly decreasing doses of the patch and that just doesn't sound like something that would be fun to deal with.
If I just go cold turkey, can I cover any really bad heebie jeebies with vicodin?
I don't really understand the residual effects of the patch. When I've been patchless for 2 hours, shouldn't I have been going through withdrawals or do they take a while to come on? I got that kind of all over yuck feeling, I am guessing that was withdrawals starting?
If I've never had withdrawals before, when all of the doctors have said I would, will I get them with fentanyl? I am also one of the very few that can drink alcohol on flagyl (in the same class as antibuse).
If it starts to get bad, and I slap a patch back on, how long would it take to stop withdrawals if I was having them?
Frankly, I am feeling really abandoned by the medical community, I know, I was the one that moved. I forgot how really incredibly lousy medical care was in Alaska. Urgh!
I was so grateful to find this forum. It seems people are honest and supportive here.
Thanks for listening.
Urgh! Re-reading this in the morning!
All I want to know, is the drug in vicodin or oxycodone (preferably vicoding) close enough to substitute for fentanyl so I can stop the fentanyl on my own?
Sorry the other post is so long winded, I was hoping to edit it to remove the rambling. I guess there is not an edit feature.
Ali...I weaned off 100 mcg of Fent along with dilaudid, then stepping down to oxy ir and lastly norco.
I can't give you a direct answer to your question as I'm not a doctor, but I can tell you about my experience.
Once I weaned down to 50 mcg, I tried jumping off the Fent using oxy (about 120mg/day). I thought I was going to lose my mind. It didn't work.
I went back on the patch and extended the amount of time each week from 72 hrs. to 96 hrs. I stayed on the 50 patch for about 3 weeks until I felt stable then went down to 37.5 mcg while taking progressively lesser amounts of oxy. I continued the weaning process by reducing 12.5 mcg at a time and changing patches every 96 hours.
When I was down to the 12.5 mcg patch, I was taking (6-8) 10/325 norco per day. Then after a few weeks I was just taking norco. This went on for another 6 weeks of me weaning off of norco and being totally drug free.
I wouldn't recommend what I did. It was really painful. But for me just taking oxy (which is stronger than norco) and jumping off at 50 mcg was IMPOSSIBLE.
Fentanyl is a terribly hard detox. FYI, If I had to do it all over again, I'd use suboxone and ask member Robert 325 for his help as he's gotten 1000s of folks off of drugs comfortably.
Best of luck,
Thank you! You somehow completely understood what I was trying to figure out and couldn't say.
Sigh, looks like it will be a bit then. I am day 4 with a patch held on by medical tape. I will stretch it out as long as I can.
I am doing this because I don't want to be dependent on them, I have never been dependent before. It isn't that I'm out, I have 9 left and a script in my hand for 15 more. I am just terrified of a time when I might be out and no where to turn for more.
Oh well. Thanks for the info, Kelly. I will read up on this suboxone so I am ready.
Ali...Here's a link to Roberts 325 suboxone therapy (see below).
I'm having hip surgery for the third time in 2 years next week and if I need to detox again, I won't hesitate to use subs with Roberts help.
Keep posting and let me know how it's going. This place is so helpful.
The Mad Man
I have been on the Fentanyl patch since before November. I have had 4 back surgeries and recommended for the patch. My insurance would not cover the patch but I went to my veteran doctor who put me on 50mcg duragesic patch. By January I asked to lower my dosage and he brought me down to 25mcg. The VA does not carry anything lower and I cannot afford the 12.5 dosage over the counter at $90.00 for 5 patches. My VA doctor recommended that I extend the days I wear the patch which I have done. I can go 4 days on the same patch but feel the withdrawal on the 5th day. My VA doctor has recommended Valium to take on the end of the 4th day but I am not sure I want to substitute one drug for another. I will be asking my pain management doctor what he recommends but I am not sure those results will be any better since he did not prescribe this patch.
How about some advise here. The withdrawal is too rough for me to go cold turkey, I have tried.
I hear the back pain will continue but why is that? I have a lot of unanswered questions here and would like some help or direction PLEASE. I only take the Norco once a day as needed and that is the only other pain medication I take.
I look forward to some solid good serious advise. My VA doctor is willing to keep me on the patch for life is needed but do I really need this medication? My pain levels are down but the patch does help.
Thanks again, Kelly. I am day 5 now I guess? Not taken any vicodin or anything at all today. No symptoms to speak of.
I am wondering if I won't get any at all? I have never, ever experienced a buzz or a high off of pain meds and even after not being on them for a long time it still takes a lot to touch my pain. Those that don't know me always say I have a built up tolerance. They don't know.
Twilight sedation does not work on me either though. I have screamed through more than one colonoscopy and can tell you personally what drowning feels like after a bronchoscopy fully alert.
I am waiting though. Not feeling like I am out of the woods yet. Especially after what Mad Man says. If it hits I am gonna stick that patch on and request suboxone and follow Robert.
Fortunately I am not in a flare right now so I don't have an issue with pain. Gotta run, late for work.
Did I ask a Stupid question here?
I thought I was asking for some serious help but it seems none available. I am not here to get opinion, just some help about getting off the fentanyl patch. Does anyone have some serious help to offer?
Madman, read my post above to Ali on how I weaned off Fent, Dilaudid, Percocet etc.
Originally Posted by The Mad Man
It was terribly hard and not something I'd do again. If I have to detox again I'd use suboxone.
Well, Monday night I started panicking, elevated heart rate, etc so I stuck a 1/2 patch back on and was better within 5 minutes... clearly all mental! Sigh! So I pulled that 1/2 patch off this morning because I want to be done with it and try cold turkey again since I realize that last one I was just psyching myself out.
I'll see. I'll push through and not give up so fast this time. On a side note my crohn's is going crazy but not the joint stuff so the pain isn't that bad and the fatigue from the crohn's should make me sleep through any bad stuff I would hope.
MadMan - you might try starting a new thread?
Ali...you sound just like me I spent my fair share of time playing take off the patch and tough it out.
If I were you I'd move over to the "NEED TO TALK" section and ask for Roberts opinion. There's also several others who've detoxed off Fent. These folks are really great. (for some reason this section gets little traffic)
If you need help on setting up a new thread, let me now and we"ll get it done ASAP.
FYI, I'm having hip surgery next week, so come Thursday I'll be gone for a while.
Hey Ali -
I'm no expert, just an old junkie! My only experience with Fentanyl patches was chewing them to get wrecked (like an idiot). I would say your going to feel some discomfort. Fentanyl is a lot stronger then Vicodin. If your patches don't have gel in them can you try cutting them in half and then in quarters, and using them for an extra day? Once you get to a 1/4 of a patch then maybe switch to Vicodin spaced evenly throughout the day, same time daily, same dose to keep your receptors covered and keep your pain under control.
From what your saying I gather you don't need those patches, you've become mentally and physically dependant on them which we all do, even the strongest of us. If Vicodin handles your pain then you should switch to that in my opinion. It would be easier for you to aquire even through a pain clinic. If you don't get high from opiods it most likely means you have a tolerance of some type. My Uncle died from cancer and before his treatment he had never taken pain medicine in his life. After a minor surgery and 8 or 10 Vicodin they had to break down and give him IV Morphine as he was writhing in pain and not feeling any releif. They surmised it was because he was an alcoholic for whatever reason. I make no judgements about you.
I feel for you as far as being treated like a "piece of". It's funny isn't it how they are the ones that made you this way and now they don't want to deal with you? Most Doctors are totally clueless about addiction and opiod dependance. If you complain, question or make any requests your demonstrating drug seeking behavior. My Mother and I had a great laugh when we first arrived at my current treatment center for Suboxone therapy. Guess what the front of the building is? A PAIN MANAGEMENT CENTER. Around back is the Suboxone clinic. Same Doctor owns both practices. Tell me he's not making a killing? "Get em hooked in the front and then send them out the back"!
What your going through is pretty typical and standard. Pain medication is becoming more and more frowned upon by the Medical Community but seemingly there's no happy medium. You either have Doctor's pumping people full of horse doses of narcotics or refusing to give people with broken bones Tylenol with Codeine...unfortunately when those Doctor's lose their licenses to RX Narcotics, or they get a little spanking from the Board of Medicine, nobody wants to deal with you while your in limbo looking for a place to get your meds; and technically they really don't have to either. It really stinks.
One thing, I wouldn't be too afraid of the pain management clinics. I can tell you I went to one and they were dead set on trying everything but narcotics first because they cared more then to shove me full of them. I can't be anything but thankful for that. I wish my GP would have said NO. Most of them are highly trained in pain management and know a lot of different things to try. I am also sure if you went and showed your medical records none of them would refuse to give you atleast tapering doses to get you off those meds and work with you. I don't think they'd refuse to give you help there. But they would want to try alternate routes and really, there's nothing bad about that. However, I understand there are "pill mills" or other pain clinics that are just legal drug dealers so I'm not sure which one your referring to when you say "they're horrible". It could be horrible to you either way. Scared of them not wanting to give you the meds or scared of them keeping you on them. I honestly think your best bet is to be in a pain clinic. Sounds like your physicians don't want to deal with you, and you deserve more than that.
Thank you for your comments, Queen. They are the even patches but I have no interest in doing a slow taper quite yet. I have boxes of patches left so I am not in a position of needing more.
I think that is hysterical about the pain mgmt/sub clinic! I kind of liken that to all of the Naturopath docs that say prescriptions (not pain meds) are terrible yet load you up with 10-12 natural concoctions, which, by the way, you can pick up in our 'apothecary' in the lobby. Nevermind the fact they're making a 400% mark up and strychnine is natural if you really want to get down to it.
My pain is not consistent as I have autoimmune diseases. I never know one day to the next if I am going to be able to walk. One of my diseases is really pretty cool, it is palindromic arthritis, not sure if I mentioned it before? It is a type of rheumatoid arthritis but it is migratory, it pops up unexpectedly and immediately; the affected joint(s) are within hours red and swollen and gnarled. It only lasts 3-5 days and goes away completely like it never happened. So while I am not in considerable pain now, that doesn't mean I won't be tomorrow.
At this point I am 3 days off the patch. Just waiting. Not sure what to expect. After that last try and feeling remarkably better after 5 minutes I am not falling for that again! I just don't know how next time I will be able to tell real from imagined? I definitely feel the urge to just stick a patch on so I don't go through the anxiety anymore. I dunno. I'm going to see what becomes of this. It was only 50mcg/2 days.
Good luck with your surgery! You are so brave! I think I would be looking for a hole to hide in right about now if I were you!
I'm gonna miss you! I'll be very busy the end of this next week with my job. We have a big project starting Wednesday, partly why I want to get this withdrawal stuff over by then because I am going to need to pull some really long hours (for me). Fortunately I work from home so I don't have to worry about what I look like, for me casual Friday means... well... we won't go there!
When do you suppose you'll be back with the world again? I have no idea about that. I just know when the arthritis hits my hip I plain old am not walking at all. Fortunately I only had that one time, cried so hard snot ran out my nose and hit the floor! I know, ew! And that was on the patch loading up on vicodin and drinking codeine. I am a baby when it comes to pain!
I dunno about the other spot. If Tuesday comes and I am rough I will post over there. I know it sounds stupid, but just knowing you're there to touch bases with makes it all okay. I am trying to not think about what's next too much right now though since last try that psyched me out so bad! I gotta get a plan straight in my head as far as how long before I decide it is a real symptom or not? Remember I've never experienced withdrawal and pain meds have never given me a buzz. Now valium, I LIKE valium, I have one, lonely 10 mg that I might take half of if I get too crazy.
So that's my story. I am going to miss you, Kelly. I hope the surgery goes well and you are not in pain. Pain is awful.
Thank you for taking notice of my post.
Ali you are such a sweetie. I'll be around until Thursday for you. Then I don't know how long I'll be in hospital. But if I'm not feeling like death, I'll have my iPhone on me so I can check your thread.
Anyway, whatever I can do, I'm here.
Thank you Kelly! I was reading Russ' thread. If this doesn't work I will get the subs and find Robert. I have to go to a special doc, huh? God I hate the thought of being labeled an addict. What will this do to me down the road? Will they treat me differently because of it? They're pretty about people on pain meds up here, but there is so much recreational abuse in this state. I dunno. Suck it up! I've learned that lesson lately at work.
Here we go.
Last edited by ddcmod; 03-05-2012 at 03:57 PM.
That's great that you checked out Russ's thread. He was reluctant to go the sub route too but finally relented.
BTW, my PM Doctor offered me subs coming off Fent and he assured me it's not just for addicts. And I wasn't an addict. So don't worry about the stigma.
Woohoo! Still doing good regarding the patch. My crohn's really, really sucks but maybe that is stopping the patch? Buh!
I had replied to your last post, Kelly, I don't know where that went.
Went to PT today, after a dead battery, so I was too late for my pool time and doing PT on the hard is clearly a whole lot harder. So I am absolutely exhausted here at 7:45.
Thinking of you and your surgery prep. While we all have our issues with the pain meds, most of us it seems are still dealing with the issues they gave us the meds for in the first place. Sure would be nice if there was some magic way to not be in pain. I am going to try Qigong and see if I can find someone that does acupuncture close to me.
Originally Posted by Ali_R
Ali...great news about the patch! I felt so much better when I finally got off Fent. (took me 3 months, then a couple of more months to wean off the pills).
I just spoke to my PM doctor who is part of the Hospital for Special Surgery and who will be in charge of ordering my pain meds. I told him NO dilaudid, no morphine, no Fent, just Percocet 5s or 10s, or some vicodin. He said that it's going to make it really hard on me pain wise. I told him withdrawls are twice as painful as surgical pain since it took months of being sick getting off all the narcotics last time.
Sometimes I wonder if doctors really understand how addicting these meds are.
Anyway, you're doing great. And remember to follow Russ's thread. Even introduce yourself if you're comfortable with that?
Yeah, you are much braver than me! I wonder about hypnosis and pain?
I might head over and introduce myself. We're launching a new product today and I am going to be upside down at least through the end of the weekend.
While I am not suffering yet, knock on wood, there is certainly stuff going on. Glad I read up. I have been sneezing lots. That's a very funny side effect.
If you check in here this morning, know that I am thinking positive thoughts for you. I hope they take good care of you and your pain isn't too great. You are very brave. Do what you need to do to get through.
Looking forward to hearing from you when you're back at 'em!
Ali...packing for the hospital. No matter how brave I talk, I'm scared silly right now.
I'll check in with you hopefully by the beginning of the week. Don't forget Russ's thread. And Robert_325 (he is a life saver). They are all great people that have tons of experience with detoxing.
You should be home now? I've been thinking of you. Tell me how it went? I hope you're on the good side of pain now.
Me, not so much. I did okay with replacing the fentanyl with vicodin because I think maybe I wasn't taking so much to start with? (50mcg/48 hrs) and maybe my personal tolerance?
The pain hit me, I had a lupus flare Friday afternoon and just now I am able to sit up enough to type. It was to the point I had to be carried to the toilet and back, I couldn't even reach behind me to flush on my own. My husband wanted to call the ambulance but all I could do was sit there and think why? What are they going to do? This is the hell that is my world, just an unpredictable part of it. I need to re-address the pain meds. I guess I need to go in. I put a patch on Sunday because nothing I had could touch the pain. The patch didn't so much either.
Enough about me! How are you? I am looking forward to hearing some good news.
Hi Ali...I'm in the worst pain ever. In addition to mechanical revisions done to my hip, I had a 7" tear of my deep fascia (sp?). In short, I was sliced and diced. Quite upset with what I'm facing. BTW, I did the entire surgery without any dilaudid, or Fent. But I am ingesting a HUGE amount of percocet.
As for your pain, I empathize completely. Please see your doctor ASAP. Remember being your own advocate is so important.
Taking my seventh drug induced nap