I was just diagnosed. In office, dr said he would get the approval for the Xyrem for me-best drug for my situation. Then he called back saying I couldn't get it due to the opioid pain med (fentanyl). Is this a hard and fast rule? Or is it a case by case type of thing- based more on how a patient metabolizes meds and/or actually reacts to meds? Because I do not want to suffer anymore! I have lost my entire life for 6 yrs now, due to narcolepsy(cause unknown til now), and a hip tumor and possible auto-immune cancer. I would really like to regain as much of my life back as I possibly can... My lung function isn't compromised, my heart is healthy,and beyond the obvious narcolepsy-I am NOT otherwise sedated or "dopey". I have been on the pain med for 6 yrs and at this point my vitals are no different on them than before I started (reluctantly) taking them. Can anyone offer any insight?