Hi, I am concerned. I have always believed you must take some kind of breakthrough medicine with the Fentanyl Patch. I currently Take Fentanyl 100mcg patch every 2-3 days ( depending on if patch actually stays on my arm even with a Tegaderm film). Also, for over a yr. I've taken 4 Norco, and 2 , 4mg dilaudid pills per 24 hrs. It's a lot I know... so, I sought help. l got a new PMD. He insists on no Narcotics for pain eventually..seeking other methods for chronic pain in hips, spine , legs. I am being told I can take Fentanyl any mc amount, without extra pills eventually after ween down process. He said , work w/your current medication, but slowly leave out 1 pill, 2 etc, until you get to 0 pills, and 50 mcg of Fentanyl, I will help you then. You will have much less pain. I thought w/ Fentanyl, you were suppose to me taking breakthrough meds , such as Norco, etc. at least maybe twice daily at minimum to take safely, Fentanyl patches?? I was I guess misinformed? Can someone please reassure me , he knows his meds? I want to follow his directions, but am afraid to take 0 pills and only be on Fentanyl patches!! Thank you so much for feedback and information regarding this.