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Fentanyl Withdraws Anyone?
I feel relatively young to been using the lowest grade Fetanyl patch for 3 years, but it has improved my quality of life to an extent that I thought was not possible. Therefore, I’m grateful it exists. My doctor could not have described it better when he said, “You’re going to want to take a pill b/c that’s what you’ve been doing for so long, but then, you’ll realize that you actually don’t need it.” Despite any stigma associated with it, I attribute this patch to enabling me to pursue professional endeavors that have I thought were unattainable with my pervasive pain.
However, I have to reluctantly take it off for a while to prepare for an imminent drug test; there’s no other way around it. This is tough. I don’t think the patch prohibits my performance. Ironically, it enables me to be more productive @ work. I called my doctor and the nurse just said that it would take 7-10 days to exit my system. Her explanation of withdrawal symptoms was not exactly explicit.
There have been hectic times that I’ve forgotten to change the patch after day 3, and that crawling skin feeling in which I struggle to sleep and sit still sets in; my pain is noticeably worse as well. I suppose I’m asking anyone who has had any personal experience with this to share it with me. I’m on day 5, and have burning muscle aches, loss of appetite, the pain is bad, and I generally feel crappy/anxious. Please provide any insight or tips you may have! Thanks.
However, I have to reluctantly take it off for a while to prepare for an imminent drug test; there’s no other way around it. This is tough. I don’t think the patch prohibits my performance. Ironically, it enables me to be more productive @ work. I called my doctor and the nurse just said that it would take 7-10 days to exit my system. Her explanation of withdrawal symptoms was not exactly explicit.
There have been hectic times that I’ve forgotten to change the patch after day 3, and that crawling skin feeling in which I struggle to sleep and sit still sets in; my pain is noticeably worse as well. I suppose I’m asking anyone who has had any personal experience with this to share it with me. I’m on day 5, and have burning muscle aches, loss of appetite, the pain is bad, and I generally feel crappy/anxious. Please provide any insight or tips you may have! Thanks.
We've got 12, 25, 50, 75 and 100. I can deal with the withdrawal if I have the opportunity, but it's irrelevant at the moment, because I need them just to be able to function. Otherwise I'd be an invalid in constant debilitating pain. I've made a payment to ask the question on another of the forum's. No response yet.
I've had local anasthetic/cortical steroid injections in
L5/S1 Epidural
T12/L1 Epidural x 2
T12/L1 R facet joint
T12/L1 R periradicular nerve
L1/L2 R periradicular nerve x 2
L2/L3 R periradicular nerve
L3/L4 R periradicular nerve
L1/L2 R periradicular nerve local only
L2/L3 R periradicular nerve local only
L1/L2 R facet joint
L2/L3 R facel joint
The first L1/L2 right periradicular nerve worked - for 2 days, before the pain came back. L1/L2 disc is tender to the touch, and the more tender it is, the greater the referred pain to the right lumbar area extending laterally and around to the abdomen. I wake up in the morning with no pain, and can swim a kilometer with little or no ill effect. But stand in the one spot for 3 minutes, or walk 50 metres, and I'm in agony. We KNOW that the L1/L2 disc is the source of the problem but nothing shows on either CT or MRI. In fact the very well respected neurosurgeon I saw (ex-pat American living and practising in Australia) went as far to say as my spine looks very healthy. In a couple of weeks, I've got an appointment with a rehab specialist. He's basically my last hope, before I'm resigned to spending the rest of my life on ever increasing doses of pain medication just to get through my daily life. I'm 45, and have two children aged 3 and 1.
I've had local anasthetic/cortical steroid injections in
L5/S1 Epidural
T12/L1 Epidural x 2
T12/L1 R facet joint
T12/L1 R periradicular nerve
L1/L2 R periradicular nerve x 2
L2/L3 R periradicular nerve
L3/L4 R periradicular nerve
L1/L2 R periradicular nerve local only
L2/L3 R periradicular nerve local only
L1/L2 R facet joint
L2/L3 R facel joint
The first L1/L2 right periradicular nerve worked - for 2 days, before the pain came back. L1/L2 disc is tender to the touch, and the more tender it is, the greater the referred pain to the right lumbar area extending laterally and around to the abdomen. I wake up in the morning with no pain, and can swim a kilometer with little or no ill effect. But stand in the one spot for 3 minutes, or walk 50 metres, and I'm in agony. We KNOW that the L1/L2 disc is the source of the problem but nothing shows on either CT or MRI. In fact the very well respected neurosurgeon I saw (ex-pat American living and practising in Australia) went as far to say as my spine looks very healthy. In a couple of weeks, I've got an appointment with a rehab specialist. He's basically my last hope, before I'm resigned to spending the rest of my life on ever increasing doses of pain medication just to get through my daily life. I'm 45, and have two children aged 3 and 1.
Hi Wilso45,
First I want to welcome you to the Pain Management Forum and let you know that we are glad you found this Forum. I want to let you know that there are NO Doctors on this Forum only CP - Chronic Pain - Patients that help each other with our OWN expertise and experiences that we have developed through our OWN CP Issues.
I, too, use the Fentanyl Patches. :) After my THP {Total Hip Implant Surgery} on September 8, 2010, just 5 months ago, my Fenatnyl was upped from 62mcg's every 48 hours to 125 mcg's. I've ben coming down from the 125 back down to 87 mcg's. My Doctor has been bringing me down by 12 mcg's every month. My Doctor leaves it up to me whether or not I need to lower the dosage based on how my hip is feeling. :) I have felt NO withdrawal's at all. H told m at the beginning that I wouldn't feel th withdrawal's IF I were to lower it slowly by the 12 mcg's. So far that has worked REALLY grat for me!! I don't know what different strength's you have access to in Australia, BUT if you have access to them then MAYBE you could request that from your Doctor. :)
As I said, this has worked VERY well for me and IF you think it would work well for you, you MIGHT consider asking YOUR Doctor about this possibility {IF you think it MIGHT work well for you, too}.
The reason I said that you MIGHT need to check if it's available for you in Australia is because I have discovered in talking with other people outside of the States is that not ALL Countries offer the 12 mcg patches. :{
I wish you the VRY best and look forward to your updates. :)..........Sherry
First I want to welcome you to the Pain Management Forum and let you know that we are glad you found this Forum. I want to let you know that there are NO Doctors on this Forum only CP - Chronic Pain - Patients that help each other with our OWN expertise and experiences that we have developed through our OWN CP Issues.
I, too, use the Fentanyl Patches. :) After my THP {Total Hip Implant Surgery} on September 8, 2010, just 5 months ago, my Fenatnyl was upped from 62mcg's every 48 hours to 125 mcg's. I've ben coming down from the 125 back down to 87 mcg's. My Doctor has been bringing me down by 12 mcg's every month. My Doctor leaves it up to me whether or not I need to lower the dosage based on how my hip is feeling. :) I have felt NO withdrawal's at all. H told m at the beginning that I wouldn't feel th withdrawal's IF I were to lower it slowly by the 12 mcg's. So far that has worked REALLY grat for me!! I don't know what different strength's you have access to in Australia, BUT if you have access to them then MAYBE you could request that from your Doctor. :)
As I said, this has worked VERY well for me and IF you think it would work well for you, you MIGHT consider asking YOUR Doctor about this possibility {IF you think it MIGHT work well for you, too}.
The reason I said that you MIGHT need to check if it's available for you in Australia is because I have discovered in talking with other people outside of the States is that not ALL Countries offer the 12 mcg patches. :{
I wish you the VRY best and look forward to your updates. :)..........Sherry
The only withdrawal I've felt, which happens even when you go onto a lower dose, is tiredness and lethargy. Extreme tiredness and lethargy. It lasts about 48 hours. When I've gone off it completely, you can add some lower limb muscle stiffness to that. Unfortunately, my pain has been so debilitating that I haven't been able to stay off it. I now alternate between a 50 and 75 ug patch every 3 days. Which causes insomnia, sexual dysfunction, and general feeling of sickness. Without it, I'm in so much pain, I can't even get out of bed. Pain has ruined my life.
This is so devastating :( Just because the public doesn't know the difference between addiction and medical dependence, this poor girl is going to be tortured. Really pathetic.
I didn't know that benadryl and quinine don't go together. Thanks for the info. Good to know.
The school rules are ridiculous. I had a doctor's note for Ibuprofen for my daughter. I bought the wrong milligram. 325 instead of 500. So the nurse wouldn't give it to her. As I don't work outside the home, I'm able to go to the school and administer medications. I just do this now. It's easier. Some days my daughter will need her clonapin.(sp?), She will text me and I'll take it up to her. They can't deny me medicating my daughter with her prescribed medications.
The school rules are ridiculous. I had a doctor's note for Ibuprofen for my daughter. I bought the wrong milligram. 325 instead of 500. So the nurse wouldn't give it to her. As I don't work outside the home, I'm able to go to the school and administer medications. I just do this now. It's easier. Some days my daughter will need her clonapin.(sp?), She will text me and I'll take it up to her. They can't deny me medicating my daughter with her prescribed medications.
Just a quick FYI regarding home detox. Hyland's Restful Legs comes in two formulas. You want the one that contains quinine. Benadryl is contraindicated with quinine, so if you need a sleep aid try melatonin. Definitely spend as much time in a hot bathtub as you can. It really helps with the creepy crawlies and restless legs. Much as you probably don't want to eat, your body needs food even more during withdrawal. Banannas are a good choice for potassium and magnesium, but in general you want to eat as much of a balanced diet as you can. That's assuming you aren't vomiting. Hydration is also essential since diarrhea and vomiting are usually part of the detox process. Try fruit juices and sports drinks like Gatorade to keep your electrolytes in balance.
One of the most dangerous aspects of withdrawal is skyrocketing blood pressure. If you have any underlying hypertension, you need to keep a close eye on your bp. I'm very disappointed in your pain doctor for not helping you through this detox. Clonidine alone would help you a great deal. It's a very old alpha-blocker hypertension medication that puts a big dent into withdrawal symptoms. Using it for detox is an off-label practice, but it's well-known and has been used for that purpose for many years.
I really admire you for enduring withdrawal the way you have. Fentanyl is a particularly vicious drug for withdrawal symptoms andyou're dealing with it with an uncommon grace. My sister is a teacher and I totally understand why you feel it necessary to detox. Many districts in our area have a zero tolerance drug policy not only for the students but for the teachers. Doesn't matter if the meds are prescribed or not. If you're a teacher taking a narcotic, you're out. A student who does not leave prescribed or over-the-counter meds with the nurse will be suspended. That includes everything including aspirin, to asthma inhalers, antibiotics, you name it.
A few years ago we had a case of two middle school students who were suspended for "sharing drugs." The boys were neighborhood friends and both had asthma and used the same asthma inhaler medication. Boy #1 had a bad asthma attack during an outdoor activity, but did not have his inhaler. Boy #2, as he had done so many times in the past, whipped out his inhaler and gave it to his friend. Unfortunately, the incident was witnessed by a teacher who made a huge stink out of it and they were both sent to the principal. The police were called to investigate possible drug charges and both boys were suspended for a week.
We all understand that prescription medications should not be shared, but both boys and both sets of parents were aware of the practice and had always encouraged them to help one another out in an asthma emergency. All parties were fully aware that it was the same medication so no harm done. The school district never backed down from their zero tolerance policy, which was the beginning of some districts reeavaluating that position. Makes me sick that a girl with cramps can't even carry Midol in her purse, but has to go to the nurse to have it dispensed. Makes me even more sick that in some districts, teachers must submit to the same policy or lose their jobs.
One of the most dangerous aspects of withdrawal is skyrocketing blood pressure. If you have any underlying hypertension, you need to keep a close eye on your bp. I'm very disappointed in your pain doctor for not helping you through this detox. Clonidine alone would help you a great deal. It's a very old alpha-blocker hypertension medication that puts a big dent into withdrawal symptoms. Using it for detox is an off-label practice, but it's well-known and has been used for that purpose for many years.
I really admire you for enduring withdrawal the way you have. Fentanyl is a particularly vicious drug for withdrawal symptoms andyou're dealing with it with an uncommon grace. My sister is a teacher and I totally understand why you feel it necessary to detox. Many districts in our area have a zero tolerance drug policy not only for the students but for the teachers. Doesn't matter if the meds are prescribed or not. If you're a teacher taking a narcotic, you're out. A student who does not leave prescribed or over-the-counter meds with the nurse will be suspended. That includes everything including aspirin, to asthma inhalers, antibiotics, you name it.
A few years ago we had a case of two middle school students who were suspended for "sharing drugs." The boys were neighborhood friends and both had asthma and used the same asthma inhaler medication. Boy #1 had a bad asthma attack during an outdoor activity, but did not have his inhaler. Boy #2, as he had done so many times in the past, whipped out his inhaler and gave it to his friend. Unfortunately, the incident was witnessed by a teacher who made a huge stink out of it and they were both sent to the principal. The police were called to investigate possible drug charges and both boys were suspended for a week.
We all understand that prescription medications should not be shared, but both boys and both sets of parents were aware of the practice and had always encouraged them to help one another out in an asthma emergency. All parties were fully aware that it was the same medication so no harm done. The school district never backed down from their zero tolerance policy, which was the beginning of some districts reeavaluating that position. Makes me sick that a girl with cramps can't even carry Midol in her purse, but has to go to the nurse to have it dispensed. Makes me even more sick that in some districts, teachers must submit to the same policy or lose their jobs.
Hi there: I can only speak from my experience with job related drug testing. I was on the duragesic patch when my last employer had hired me. It was a great concern of mine that I would not get the job because of the results of the blood work. I got the job and the subject of drug use never came up. Don't know if it was because of oversight or negligence or what. No one ever contacted me after the bloods were taken.
I'm in agreement with those who suggest looking into whether you really need to come off it. You're on this medicine legitimately. It just seems wrong that you have to endure withdrawals when you're doing nothing wrong.
With whatever you end up doing, best of luck.
With whatever you end up doing, best of luck.
Hi! If you must go through these withdrawals, which I definitely don't recommend, there are certain OTC drugs that might help you. I did go off cold turkey and it wasn't fun.
I used a product called Restless Legs for the creepy crawlies. Also, if you can use phenergan, do it. If not, try Dramamine for nausea. Benadryl will help as well. Sublinqual B12 and a STRONG multi B complex vitamin will help. The energy shots that are sold made me sick. Soda crackers will help with the nausea. And keep hydrated. A drink like Gatorade or something like it. I don't know about the newer energy drinks.
If I think of anything else, I'll let you know. But as earlier posted, if these are prescribed medications, there's no reason you should come off them. So please look into that prior to subjecting yourself to the withdrawals.
Good luck sweetie. Let us know how it turns out
Sara
I used a product called Restless Legs for the creepy crawlies. Also, if you can use phenergan, do it. If not, try Dramamine for nausea. Benadryl will help as well. Sublinqual B12 and a STRONG multi B complex vitamin will help. The energy shots that are sold made me sick. Soda crackers will help with the nausea. And keep hydrated. A drink like Gatorade or something like it. I don't know about the newer energy drinks.
If I think of anything else, I'll let you know. But as earlier posted, if these are prescribed medications, there's no reason you should come off them. So please look into that prior to subjecting yourself to the withdrawals.
Good luck sweetie. Let us know how it turns out
Sara
I have no experience with withdrawals from Fentanyl, but I'm sorry you have to go through this. Again, such a sad testament that our society cannot understand chronic pain and/or pain management.
I just started the patch at the beginning of the summer. I was very reluctant (hypocrite much??? :) Finally, after a lot of research and talking with some people here, I decided to give it a shot. I'm on 75 mcg and I'm supposed to change it every 48 hours, but I do stretch it to 3 days.
It's been a huge blessing for me. I still need to take a substantial amount of oxycodone for BT pain, along with some other things, but it sure feels good to take something that helps the pain but doesn't produce any of that euphoria, cloudy feeling. I have found for me I'm getting some hot flashes. They were much worse when my BT med was morphine. We switched back to oxycodone, and even though I still get them occasionally, it's not nearly as often and they don't last as long.
One thing I've noticed is since switching to the Duragesic patch, I get quite tired and when it hits, it hits hard. I was on a generic brand initially. It was fine for the pain control, but it was gel-filled and I just couldn't get it to lay flat, stay on no matter where I put it and the residue the glue left was impossible to get off AND it transferred to my clothes, which it wouldn't come out of.
I didn't think they'd approve the Duragesic brand as it is so much more expensive but fortunately they did.
I feel bad that you, and others, have to go through this. I think Tuck's advice of checking out the SA forum is a great idea. They have lots of suggestions to take the edge off withdrawals.
I just started the patch at the beginning of the summer. I was very reluctant (hypocrite much??? :) Finally, after a lot of research and talking with some people here, I decided to give it a shot. I'm on 75 mcg and I'm supposed to change it every 48 hours, but I do stretch it to 3 days.
It's been a huge blessing for me. I still need to take a substantial amount of oxycodone for BT pain, along with some other things, but it sure feels good to take something that helps the pain but doesn't produce any of that euphoria, cloudy feeling. I have found for me I'm getting some hot flashes. They were much worse when my BT med was morphine. We switched back to oxycodone, and even though I still get them occasionally, it's not nearly as often and they don't last as long.
One thing I've noticed is since switching to the Duragesic patch, I get quite tired and when it hits, it hits hard. I was on a generic brand initially. It was fine for the pain control, but it was gel-filled and I just couldn't get it to lay flat, stay on no matter where I put it and the residue the glue left was impossible to get off AND it transferred to my clothes, which it wouldn't come out of.
I didn't think they'd approve the Duragesic brand as it is so much more expensive but fortunately they did.
I feel bad that you, and others, have to go through this. I think Tuck's advice of checking out the SA forum is a great idea. They have lots of suggestions to take the edge off withdrawals.
Great information skmedlin. Thank you. It's good to hear from someone that has experience on the other side of these testing companies.
In my experience...being both the employer and the prospective employee, the lab does notify the employer that there is something amiss in your drug test. Drug test results are expected to be available for the prospective employer in X number of days. When they initially return as positive it will take longer to confirm that you are on a legally prescribed narcotic. Your employer is aware that there is a question, at the very least because of the time factor. It's been my experience that it is impossible to hide the test results from the paying employer.
How did your company handle these time situations?
Thanks,
~Tuck
In my experience...being both the employer and the prospective employee, the lab does notify the employer that there is something amiss in your drug test. Drug test results are expected to be available for the prospective employer in X number of days. When they initially return as positive it will take longer to confirm that you are on a legally prescribed narcotic. Your employer is aware that there is a question, at the very least because of the time factor. It's been my experience that it is impossible to hide the test results from the paying employer.
How did your company handle these time situations?
Thanks,
~Tuck
When you take a drug test for an employer and you are on narcotics that are prescribed what happens is an MRO doctor calls you and gets all your rx information and calls to verify from the pharmacy. When your test is reported back to the employer it is reported as negative. Your employer would never know you are on the Fentanyl unless you tell them. (I used to work for LabCorp of America)... So I wouldn't go through those withdrawals... you don't have to. Plus most common drug screens do not test for fentanyl because it cost the employer way too much. Hope this helps.
I’m grateful for your thorough, supportive response!
Being honest with my employer would not be prudent b/c I’m endeavoring to get hired as an English teacher (despite stellar performances, many of us are still holding pink slips). After countless surgeries, I barely got through student teaching 3 years ago, and would never have been able to complete it without the patch. There’s such a stigma associated with narcotic use-especially for people who don’t understand how the patch works, and that it doesn’t make the user feel euphoric.
With the state budget cuts, just getting an interview has proven to be a major feat. Due to funding constraints, not all districts conduct drug testing, or sometimes they ask the candidate to cover the cost; a background check and fingerprints were ample for my previous employer. Since some promising leads are beginning to materialize, I want to be certain that I would pass a drug test. I like my doctor, but his nasty gatekeeper nurse said that it’s best to just legitimately flush the system.
I will definitely use the 15mg patch again when I’m employed. It’s my hope that when our state recovers from this fiscal crisis that I can establish myself within a desirable school district without have to literally (and figuratively) sweat it out every summer.
From your response, it sounds like you have experienced the quality of life that the patch can offer? Consulting the Substance Abuse Forum members is a good suggestion, and of course, I would not interpret that as an insinuation that I’m an addict. There is lots of info on the net, but sometimes it’s more helpful to read a description from someone who has actually experienced it.
Thanks again, Tuck. Yes, I’ll definitely be checking in periodically w/ the PMC.
Being honest with my employer would not be prudent b/c I’m endeavoring to get hired as an English teacher (despite stellar performances, many of us are still holding pink slips). After countless surgeries, I barely got through student teaching 3 years ago, and would never have been able to complete it without the patch. There’s such a stigma associated with narcotic use-especially for people who don’t understand how the patch works, and that it doesn’t make the user feel euphoric.
With the state budget cuts, just getting an interview has proven to be a major feat. Due to funding constraints, not all districts conduct drug testing, or sometimes they ask the candidate to cover the cost; a background check and fingerprints were ample for my previous employer. Since some promising leads are beginning to materialize, I want to be certain that I would pass a drug test. I like my doctor, but his nasty gatekeeper nurse said that it’s best to just legitimately flush the system.
I will definitely use the 15mg patch again when I’m employed. It’s my hope that when our state recovers from this fiscal crisis that I can establish myself within a desirable school district without have to literally (and figuratively) sweat it out every summer.
From your response, it sounds like you have experienced the quality of life that the patch can offer? Consulting the Substance Abuse Forum members is a good suggestion, and of course, I would not interpret that as an insinuation that I’m an addict. There is lots of info on the net, but sometimes it’s more helpful to read a description from someone who has actually experienced it.
Thanks again, Tuck. Yes, I’ll definitely be checking in periodically w/ the PMC.
Hello Ceesel,
Welcome to our Pain Management Forum. I'm glad that you took the time to post and share your concern.
You have given great testament. Not only have you have explained so well what proper chronic pain management should accomplish, you've also achieved the goals that every physician and chronic pain patient should strive to meet.
I am so sorry that now you feel you must hide your legal opiate use. Is there no way to be honest with your employer? You should not have to hide the fact that you require opiates to function. As you know this is not illegal or should there be any shame associated with it. Would this not be excused?
I have never had to detox so unfortunately I cannot give you the information you are seeking. Based on the little information I know, at day five you are probably through the worst. In the first 17 hours, there is 50% decrease in serum fentanyl concentrations. It's neither a quick or easy process.
Symptoms of Fentanyl withdrawal can include: anxiety, irritability, confusion, tremors, sweating, muscle aches, stuffy or runny nose, abdominal pain and rapid breathing
There is a lot of information on the net. Warm baths and exercise can be helpful. Treat the symptoms as they come the best you can. It's a shame your physician did not offer to help you through the w/d process. You can always chat with our Substance Abuse Forum members. They have experience and are always willing to help. I am not suggesting that you have an substance abuse problem by any means. I just think that they can help answer your questions. If you have difficultly locating the SA forum please let me know.
I hope you will soon be through this process. May I ask what your plans are once the drug testing is complete? I certainly hope you do not have to go through this on a routine basis. I wish you the very best and hope you will keep in touch with us.
Take Care,
~Tuck
Welcome to our Pain Management Forum. I'm glad that you took the time to post and share your concern.
You have given great testament. Not only have you have explained so well what proper chronic pain management should accomplish, you've also achieved the goals that every physician and chronic pain patient should strive to meet.
I am so sorry that now you feel you must hide your legal opiate use. Is there no way to be honest with your employer? You should not have to hide the fact that you require opiates to function. As you know this is not illegal or should there be any shame associated with it. Would this not be excused?
I have never had to detox so unfortunately I cannot give you the information you are seeking. Based on the little information I know, at day five you are probably through the worst. In the first 17 hours, there is 50% decrease in serum fentanyl concentrations. It's neither a quick or easy process.
Symptoms of Fentanyl withdrawal can include: anxiety, irritability, confusion, tremors, sweating, muscle aches, stuffy or runny nose, abdominal pain and rapid breathing
There is a lot of information on the net. Warm baths and exercise can be helpful. Treat the symptoms as they come the best you can. It's a shame your physician did not offer to help you through the w/d process. You can always chat with our Substance Abuse Forum members. They have experience and are always willing to help. I am not suggesting that you have an substance abuse problem by any means. I just think that they can help answer your questions. If you have difficultly locating the SA forum please let me know.
I hope you will soon be through this process. May I ask what your plans are once the drug testing is complete? I certainly hope you do not have to go through this on a routine basis. I wish you the very best and hope you will keep in touch with us.
Take Care,
~Tuck
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