Six months or so ago my prescription for the fentanyl patch was reduced by my pain management doc from 100mcg to 75mcg. I have been on this dosage for 7-8 years or so and overall I've used them for about ten years.I really couldn't get a clear understanding as to the reason for the change but it seemed to be related to my emotional state. At that time I was having a great deal of mental/emotional difficulty adjusting to the sudden and unexpected loss of my only sister. (I also have other trauma and grief issues but they are, for the most part, manageable.) I ultimately ended up in the hospital for the first time in my life for mental health treatment.
I have been on the patch for chronic pain from multiple auto accidents, the first one being when I was hit by a car when I was five years old. I have multiple herniated and bulging discs, degenerative disc disease and basically my spine is just an overall mess from top to bottome. I have some other physical issues as well and was thrilled when I discovered the patch as opposed to narcotic pills.
For me, I consider the ability of using the patch as a QUALITY OF LIFE ISSUE since I find the constant release of pain medication is much preferable to the "roller coaster" effect of taking narcotics in pill form. With pills I wasn't actually getting pain relief, I was just "stupid" and "out of it" for a few hours, the medicine would wear off, the pain began to ramp up again and I was watching the clock for when I could take the next pill. Not to mention that the dosage kept having to be adjusted higher and higher as my body adjusted to the amount I was taking.
I haven't been doing as well with the lower dosage and after getting my emotional house in order I was ready to be more active but found I was pushing the outer boundaries of what the 75mcg patch could handle. I've recently asked to be taken back up to what was my "normal" dosage of the 100mcg but now I'm being told by the nurse practitioner that my current dosage of 75mcg is soon to be FURTHER reduced and that 50mcg is the highest dose that will soon be available to non-cancer patients!
When I questioned her if she thought (as I do) that it was in some part related to the overdoses by people using the fentanyl illegally she indicated she agreed with me and sympathized with my situation. I appreciated her honesty and understanding but unfortunately sympathy doesn't do much to address chronic pain. I also got the impression that even if my doc sympathizes and/or agrees with me it will be out of his hands.
I live in Florida so I'm not sure it has to do with state law, federal law, the FDA, the manufacturer, lawsuits, etc. but I'm wondering if anyone else has been hearing rumblings of this sort. I got the impression from the nurse practitioner that the reduction could happen as early as my next appointment (April 2016).
Just as an FYI: My breakthrough medicines are Tramadol and Baclofen and I RARELY take the full dosage I'm given. I have gone 2-3 months without even needing to refill them because I make an effort to take the least amount necessary for the maximum benefit.
I guess the bottom line is that I feel as though I'm being punished for the illegal actions of others and that no matter that I'm cautious with taking my medication as prescribed and honest with my health care team I will end up on the losing end on this one. I've faced what I believe to be a lot of misunderstanding among other healthcare practitioners as well and it just seems that instead of efforts to better educate the medical community and others involved in the situation it's easier to just ignore the needs of non-cancer chronic pain patients. It truly IS a quality of life situation for me. If my dosage is further reduced or if I'm put back on pills again it will be a painful and pointless step backwards and as best I can see it that will happen through no fault of my own.
I'm truly open to any advice, information, etc. I'm not just looking for sympathy or someone to agree with me. I just want to understand why my very real pain is of lesser importance than the misguided yet truly tragic outcomes by the people who misuse this medication.