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Avatar universal

Chronic pain from Hydrocodone to Duragesic patch

Due to chronic pain I was put on Hydrocodone (Loritab 750)  I  was prescribed 2 a day 500mg to start then 2 a day 750 up to 3 a day all in a 2 year period.  Just recently because of my drs concern for the tylenol affect to my liver I now use the Duragesic Patch 50 mg which has been such a relief...I am able to do almost anything without worrying about the pain I will feel tomorrow.  The dr was happy to give me the patch and I am happy to have it.  What is this doing to me physically...he even remarked that my dosage would be upped as my tolerance needed it. I expect to be on medically supervised narcotic pain relievers for the rest of my life.  Having no side affects now and  several people have commented 'if you are in chronic pain the medication goes to the pain and not to form an addiction' this doesn't sound possible to me...appreciate your opinion on this.  Thank you
70 Responses
Avatar universal
I'm very glad to hear that you've found something that will help give you good pain relief. That is very important to one's quality of life.

When people say that if you take pain meds for chronic pain you won't get addicted, that is a misleading statement.

If by "addicted" you mean most chronic pain patients don't abuse the medication, that tends to be true.

But anyone who takes narcotics round the clock long term will develop physical dependance on the medication.  This means that if you suddenly stop the medication, a syndrome of withdrawal symptoms will occur.  That is just what physically happens, regardless of the reasons or motivation for taking the medication.

Physical dependance is not the same thing as mental addiction though.  Some folks are able to take narcotics for pain, appropriately and as prescribed, without ever abusing them.

hope that helps answer your question!

Avatar universal
Thanks WW ~ I take it all under doctors orders and do just like they say...my mixing drugs to get a buzz days are over.  Thanks for your response. I appreciate it...Hippiealways
I found this forum by chance but since I've been a fentanyl patch user going on about 15 years, I feel I'm an expert now. I started at 50 mcg/hr every 48 hr and after a severe auto accident and no Dr.'s wanting to do the needed surgeries to eliminate the excess pain, they keep doing facet joint ablations to kill the nerves sending the pain signals to the brain. I'm unsure where I would be without the fentanyl patch. Time mixed with deteriorization of other joints has me now using 4 - 100 MCG/h patches every 48 hr. Thank God I live in Canada and I have everything paid for but I'd much rather be working! It feels like they all play this big game at our sufferings expense, don't fix anything until is at the stage where permanent nerve damage can happen, then operate. Now comes the chance of permanent nerve damage if the surgeon shakes. I'm trying to get sent out of country for surgery, who knows.
Avatar universal
Good name.I too have chronic pain going on 30 of my 44 years. Early on the docs wouldn't give opiates for pain except for broken bones and surgery. But the pendulum has swung back. I have some questions for you. Did you abuse a lot of opiates before you got medical care? I ask because I did. I was finally put on Vicodin, which got rid of 20 minutes of pain per dose. Then I was switched to MSContin and then to Methadone. I have hit points of tolerance and have taken an extra pill only to get myself in trouble. I don't anymore for I finally learned my lesson. Tell me about the patch, would you. Where is it in the realm of strength? Have you had an increase? Sometimes I think the control should be taken out of my hands. I told my doc that she had to take control of my corticosteroids. I was worse with them than opiates and they don't give you a buzz, they will just kill you.
Avatar universal
Hi, I too would like to know about this patch you use for pain.  I take more than my perscribed dose and then run out of pills.  I would like to put this in somebody else's hands.  How does the patch work, is it a narcotic, etc.  Thanks!
The fentanyl patch is so badly abused now that they are thinking of making you return the old used patches before renewing your script. It's so very sad that each new and great pain med created gets turned into something that people only take to get high. Personally I don't know what a high feels like. I'm one that has to feel I'm in control of my body at all times and even when I'm in desperate pain, if I start to feel strange because I used an extra piece to get through it, I have to get it of asap. Yes we can all get physically addicted to any drug we take for long periods of time, this I don't care about as long as I can live a somewhat normal life, in as little pain as possible. I can and will answer anyone's questions about the fentanyl patch if asked.
Avatar universal
patch info:

duragesic (fentanyl transdermal system) as far as i know they come in 3 strengths- 2.5, 5.0, and 10.0 fentanyl-
delivery is described on the box as "in vivo delivery of 25 ug/h fentanyl for 72  hours"- this is obviously a chemistry term but i am not sure what it means scientifically-
what i do know is from my own experience- i was placed on the patch for 3-4 months (i still have the old box that i was copying info from) the patch was taken away from me coz of an errant random urine test in which the doc found something else that wasnt supposed to be there- anyway- the fentanyl is supposed to be a real strong narcotic- you wear the patch for 72 hours or 3 days- the boxes come in packages of 5 patches each- and they are expensive- even with pretty good insurance- i paid approx 30 bucks - according to the doc they are very effective pain relievers, but i noticed that i still had a lot of breakthrough pain when i used them- you do not get high off of them used as directed- but there are ways to get high off of them- the doc also told me he uses them to wean his patients off of narcotics-  the idea being that at the lowest dosage- (2.5) allows an addict to detox down from a much higher dosage of some other narcotic and ultimately reduces withdrawals- it definitely has the advantage of a constant flow of pain meds- and since you do not get high when used as directed- their abuse potential is somewhat less-
hope this info helps
The patch in Canada comes in 12.5, 25, 50, 75 and 100 micrograms per hour release rate. Now a 100 MCG patch has 16.5 mg of fentanyl on it and after the supposed 72 hr span only half is used except the patch made by Milan. The two best for use in regards to staying on are the Milan and Teva brands. Strangely enough though the Milan brand only starts off with half the amount of fentanyl on it and has the best adhesive properties of all brands and the worst to try and abuse.
Avatar universal
Thank you for th patch info.   I am going to ask my doc for me to try it.  It sounds like something that may take care of my pain, but, not get me high.  For everyone out there who is wondering , thinking, what is my New Year going to be like.  Choose one goal at a time and work on it.  Let the other  be there, but, the hardest one is the one you should work on.  Don't expect miracles, only true happiness of oneself.  I love all of you.
Love Butterbeans
Avatar universal
This is some info on the Duragelsic patch: first it is a class 2 narcotic(which is the strongest legal narcotic there is) it is highly expensive I am on the 75 mg. patch and it is 370.00 per. month(that is 10 patches) They are highly effective in controlling withdrawl symptoms and controlling chronic pain.Quitting taking pain killers is the hardest thing I have ever attempted, this is my second shot at it and I have to make it this time. As for the expensive part if you weigh out what you would spend on drugs on the street to me the money is well worth it . I am spending alot for the patches but, I still am not spending as much as I was on pills. If you have any other questions on these patches please feel free to ask if I can help and answer I will ... T. Bear
Avatar universal
I am trying to get through oxycontin withdrawls by wearing a patch.  I am learning from others how addictive fentinyl is and now I don' know if I'm doing the right thing.  I wore the 50mg. for over 72 hours and now I am feeling some withdrawl symptoms. I think the further away I get from the oxycontin the better my chances but maybe I'm fooling myself.  Thinking about going to a lower dosage and then being done.  OC withdrawls are so hard I was hoping I could taper down with the patch.  Any thoughts or insights will be appreciated.  love, Telby
Avatar universal
Telby, These patches are highly addictive as I stated earlier they are a class 2 Narcotic.I was told by my doctor that it would probably take me a year to come off of lorcet 10/650 then he would begin to lower the dose of duralgesic until I was off of it also. I will try to find out more information for you if you wish... Good luck in this fight that has been set before you
Avatar universal
greetings to all pain warriors!needless to say i,ve seen it all like many of you.i've been every where from sissy hydrocodone to the 4 mg dilauded/hydromorphone taking up to 15 pills a day.what i can tell you is this if your pain doc is willing to give the duragesic patches a try, go for it.if you are also taking some sort of other opiates in pill form,stop taking them now!.

if you are opiate tolerant, and have been on these nasty meds for 6or more months, you will probably be given the 50ug/h fentanyl patch/duragesic.you will be very happy to see that you will no longer reqiure the pills anymore, you will probably not sleep all day/nite, you will! be able to attempt to live your life again.a little trick i use to help with the sudden breakthrough pain, and when being on the patch and no opiate pills, is to take something like aleve/naproxyn.the reason this will work is simple, you already have the narcotic in your system working on your perception of pain and threshold to the same, now by taking the naproxyn/aleve or something with the same type of result, acetaminaphen, ibruprophen, ect this will give you a true pain reliever along with the narcotic.ask your doc i'm sure if he/she has half a brain, the will jump at switching you from pills to patches.from my past, i think anything over the 50 ug/h patch is to much and you may see some negative side effects you most likely will not see by staying with the  25 or 50 ug/h patch.

anyway, have the courage to fight and make that change on your own. you WILL NOT! get to where you want want to be in life as the same is true for these getting off or down to a functioning level on these wicked meds.

so long, and watch that rocky road! if  you have any questions ask, unfortunately i did have a doctor with half a brain!
Avatar universal
First, I'm a novice at the internet.  Please be patient. I am looking for assistance given my very limited research ability.

My story is simple.  I was in a motor vehicle accident while on military duty.  I now suffer from chronic pain and no long meet the universal terms of service required of a soldier.  I have been medically released and am trying to adjust into civilian life.  Seeking medical assistance is now an urgent requirement.

I had been prescibed Tylenol 3's,and their effectiveness was OK provided I took about 10/day.  I was then prescribed the Fentanol (smallest) dose patch.  It worked but my spouse said it me even more unpleasant than I already was.  Comments by the Dr appeared to indicate that I was addicted to the 'heavy artillery' narcotic so I 'turned' them in.

I was then prescribed codeine phosphate but I don't think it works worth ****, excuse me.

Can someone plse give me some thoughts on how a person should consider in moving towards a solution for the pain relief?  Is there a progression that should be a reasonable procedure?
Thanks for anyone who replies.  Currently I feel as successful as a ***** in a church.
Avatar universal
confused canuck:
welcome to the forum. for someone new to the web (internet) you
have managed to land in a place that may have exactly what you

first of all a suggestion. try posting as close to the beginning
(top) as you can. don't worry about going in under a unrelated
question, as this is done on a frequent basis.

i've used drugs since i was 14 years old. i'm going to be 51 this
year. in the late 70's i took what turned out to be a 17 year
break. several years back  i started having trouble with an old
neck injury. 2 surgerys later the doctor told me nothing more
could be done and refered me to a pain clinic for the intractable
pain i expierence. 20 years ago i would have been overcome with
joy. every month i come from the pain clinic with a huge Rx of
oxycontin. i'm not quite as happy today as i would have been 20
years ago. the important thing here is i may never have the life
i used to have, but i still can have a life of some sort.

perhaps you should look into a pain clinic. i don't want to sound
like i advocate the use of drugs, but i know how bad things can
get for someone in constant pain.

this forum is full of many people who have expierenced a lot of
the same things as you are going thru. i look forward to seeing
you post again, as i am sure everyone else is.

Avatar universal
Hi, I am new to the forum. So here goes. I was diagnosed with Parsonage Turner Syndrome in October. I was in the ER with severe pain, and the doc gave me a mega dose of Morphine IV. Anyway, then I went on Vicodin 7.5, didn't touch the pain, then I was prescribed Fentynl Patches, first at the lowest dose of 2.5, all the way up to 7.5, I am now weaning off to the 2.5 again, but am having HORRIFIC withdrawl symptoms, like shivering, and anxiety. The doc gave me Xanax o.25mg. not helping ,any suggestions?? I had 7.5 vicodin left over, but am afraid to take that, any suggestions for the withdrawal symptoms?? PLEASE HELP!! THANKS, DEB
Avatar universal
I am writing for my husband who is addicted to Norco< I don't believe he gets high from it although he admits that he gets a better feeling sometimes when they take affect. He is taking 12 to 14 a day, before(3yrs ago) our doctor had him taking Ultram which at the time was described as the non narcotic non addictive great pain killer. Obviosly we found out this was not the case. His pain is the result of breaking most the bones in his body 27 years ago. I guess seeing him start withdrawl today made me look to see what I could learn.......not on the internet much but after reading what some of you have written I realize how many others are on the high doses and living with chronic pain helped me understand. By the way he also tried oxycontin and found that at the recommended dosage (2 per day) they were not as effective, with more side effects.
Avatar universal
The vicodin might be used to slowly lower your tolerance so the withdrawal won' be so severe.  If you look furhther up the board you will find much dialogue about opiate withdrawal including the address to another board which has a "detox receipe by Thomas" which is very helpful.  Opiate withdrawal is very scary if you haven't been through it before but it is not life threatening (unless there is another health condition) although it is very unpleasant both emotionally and physically.  I encourage you to read the other postings and know that you are not alone and that there is hope of getting out from under this addiction.  Best of luck, Telby
Avatar universal
I was on Vicodin ES, Soma and the patch... the hard part was to get off the patch! I got rid of it one month ago and I am doing fine without it. I am still dealing with a lot of pain (headaches, cramping, back etc) but I beleive that the patch is very addictive and does not take care of the pain that much. At least, it did not work for me. I was on it for about 8 months and I really got tired of putting it on and off every 3 days. I have to tell you that the symptoms when you get off are very strong. Sweating, not sleeping, shaking, hot flashs and cold sweats. If it helps you, that's good but keep in mind that the day you decide to take it off, it will be another battle. I am currently dealing with getting off the pills and it is hard mentally. I keep reading all the comments and it helps. LEt me know if I can assist anyone. Take care.
Avatar universal
Hi, on those transdermal patches. I first saw them at VA OutPatient clinic. The vets could not believe what we were giving them and actualy got mad thnnking we were giving them some type of placebo. The effects though were great. We had substancial pain relief without worrying about patient capability for injections or counting out and keeping track of a bunch of MSIR tabs.
Avatar universal
Hi, on those transdermal patches. I first saw them at VA OutPatient clinic. The vets could not believe what we were giving them and actualy got mad thnnking we were giving them some type of placebo. The effects though were great. We had substancial pain relief without worrying about patient capability for injections or counting out and keeping track of a bunch of MSIR tabs.
Avatar universal
I was checking the doses of the fentanyl patch for my wife who will be going to the Dr. today and I wanted to get the dose correct.  I work in a pain clinic doing research on new types of pain medication and things like oxycontin that will no longer be able to be abused (they will be putting another drug with the oxycontin that if it is crushed for snorting or whatever, it will inactivate the oxycontin.
My wife has a drug problem, but also has MS and needs something for pain.  I feel like some of you that it will be less likely for her to abuse the patch.  The patch works by slowly allowing a small amount of drug to enter your skin and your body.  It is less likely to be abused because of the way it works, but of course anything can be abused if a person works at it.  By the way fentanyl is considered much more addictive than morphine.
Another form of fentanyl on that market that works through a unique delivery system is a drug called Actiq.  This is fentanyl in a lollipop, but I have heard these are extremely costly.
Lastly, those that talked about wanted to withdraw from narcotics, there is a relatively new medication that helps facilitate this and is not the same as just slowly tapering off of the medication you are on.  The drug is called "SUBOXONE" and I understand it is a lifesaver for many addicts in helping them get throught the withdrawal process.  Look it up on the internet and it will tell you all about it and you can go to your Dr. with this information.
Anyway, I will let you know how my wife does on the patch.  I am hopeful and I am also sick of seeing her gorked out all the time by taking too much of the liquid morphine she was on.

Best Regards, Bigare
Avatar universal
Hi - I had lower back surgery in feb of 05, fusion L4 and L5 and it's been a long road.  I have had continous chronic pain. I have had numerous injections and my dr has had me on percocet 10/325's up until about a month ago.  Now I'm on Duragesic pain patchs, 25's and they seem to help more than anything I've ever been on. I guess one day they won't work though, like anything else, you get addicted to it.  BUT I can tell you that this has enabled me to live a normal life, I've had no side affects and I hope that continues.
260430 tn?1268805504
Be careful with the patches.  I have chronic lower back pain and have been treated by pain management doctors for 10 + years.  I was on 3 of the 100s of Duragesic for over 2 years.  It didn't relieve all the pain, but when I was tapering off I found out how much in control of my brain it had been.  Try anything else first.  It was really nice to get my head back.  The nausea was very bad and I lost 40 pounds.  
Avatar universal
I have fibromyalgia and have been on pain meds for 4 or 5 years.  I had endometriosis first and had a hysterectomy in January of this year to relieve that pain.  The fibromyalgia is awful.  My husband will hug me and I cry out from the pain or just putting on a shirt will cause pain.  Some days, I have trouble walking from the pain and other days, I just have trouble getting out of bed.

I was first on Vicodin 5/500, but ended up taking 3 to 4 tablets of that for any kind of relief.  My doctor then switched me to Vicodin ES, but again, I have to take 2 to 3 tablets to get any relief at all from the pain.  I am not looking for a high or anything like that, but I feel like the pharmacist thinks I am a drug addict because I need refills so quickly on my medication, but the Vicodin just doesn't work.  I think it is perhaps because I have developed a tolerance to it.  My doctor has talked about putting me on the Duragesic patch, but she wants to save that as a last resort because of the high capacity for addiction.  

I don't want any mental addiction, but I do want to be able to get out of bed in the morning and take care of my kids and go to work.  I have lost one job from pain and I don't want to lose another.  I am a nursing student and getting ready to apply for clinicals and I am scared that without having this pain under control, I am not going to get through the program.  Is there something other than Vicodin, but without going to the patch, that might relieve this pain?

Avatar universal
I should also add in that I am currently seeing a chiropractor, scheduling physical therapy and exercising and working on a weight loss program with my doctor to get the symptoms under control, so I am trying therapies other than just pain medication, but I have gone without the pain medication before and I just have no kind of life at all.  The pain is almost overwhelming and I usually end up in the emergency department.  

I just wanted to add that little bit.
182493 tn?1348056515
this is the addiction forum.. since you are wanna to know info about pain meds I would ask you to go to the fibromyalgia forum.. we are not the ones to tell you what meds to go on for pain.. we have abused all of them so i doubt we would be good for this question.
Thanks and good luck
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