Aa
Aa
A
A
A
Close
6815927 tn?1395511425

Methadone for fentanyl taper?

Hi everyone, I need some input.  As many if you know I am tapering off of high dose fentanyl patches (and eventually oxycodone) prescribed for rheumatoid arthritis and Crohn's disease over the past 20 years.  I take the medication as prescribed but I now believe I am being prescribed too much.
My psychiatrist suggested going on methadone to help the taper from fentanyl.  He said that since it has a longer half-life it is easier to taper from and that the methadone taper will create less withdrawals.

I don't know if I agree with my psychiatrist.  Everything I have read about methadone says that it is the hardest opiate to come off of.  I have also read a good deal of information about hormone suppression over time--which greatly concerns me.  My ultimate goal is to come off of these medications, and I don't know if prolonging the process by switching medications is a good idea.

I would greatly appreciate all of your thoughts.
Phoenix
22 Responses
Sort by: Helpful Oldest Newest
271792 tn?1334979657
Run...run like the wind. I would never recommend Methadone for a Fentanyl taper. Methadone is ten times harder to come off of and comes with lots of side effects. I think if you continue a slow taper with the Fentanly you will have success. What will you be doing for pain management once you come off?
Helpful - 0
Avatar universal
I agree with IBKleen.  As someone who was on methadone for 7 1/2 years I know how very hard and how LONG it takes to come off this medication. It is a nasty drug with lots of side effects and I agree that doing a slow taper off the fentanyl would be your best bet. Good luck in whatever you choose to do and please stay around and let us know how you are doing.
Helpful - 0
1855076 tn?1337115303
I second that and I'll add RUN FAST.  I have no clue why your psychiatrist would say that.  Fentanyl is a very tough drug to withdraw from but it sounds like a cake walk next to methadone.  I have no personal experience with methadone.  I definitely found tapering from Fentanyl very challenging.  Some of it was my own fault because I wanted off it so badly and I went too fast.

My first pain management team were not in favor of me coming off my medications.  They thought the pain was too bad.  I felt like I wanted to see where my real pain is at and if it was too much, I could always go back on medication though I would never go on Fentanyl again.  When they suggested methadone I didn't know much about it other than it was used in treating heroin addicts.  I told them I wanted to think about it.

After researching it and reading all the posts of people who detoxed from methadone and people in the middle of detoxing, I knew I didn't want to go through that.  The only reason I would ever go on methadone (or Fentanyl for that matter) would be if I was never going to come off it.

Think long and hard before choosing that route.  I know you have very painful conditions to deal with and dealing with withdrawal on top of your pain issues is not easy but I think you'd be jumping from the frying pan into the fire.  Ultimately everyone needs to do whatever is right for their own situation but I think most situations can be dealt with in a different manner.

Good luck making your decision, I know it's not an easy one.
Helpful - 0
6815927 tn?1395511425
IBKleen, agreed.  I feel the same way but wanted to hear other opinions.  I have not fully figured out my pain management plan but I am ordering a TENS unit and looking into neurontin for chronic pain.  I am not completely ruling out opiates but I figure I would like to know where I stand without pain meds and at the very least get off fentanyl and decrease my massive tolerance.  I am not completely ruling out opiates, but like marycarmel I am ruling out fentanyl (and methadone!). Thanks for your input!  Phoenix
Helpful - 0
6815927 tn?1395511425
Jenelle, thank you for your thoughts--I was hoping to hear from someone that had been on methadone.  I had heard that methadone was the hardest opiate to detox from and I don't know why my psychiatrist thought it would be easier.  I think it is one of those incidences where the medical community thinks they know what is best but had never experienced a practical application of their beliefs.  (My thoughts about methadone seem to be that once you are on it, no one in the medical system makes any real effort to get you off it.)  I am going to stick with the slow and steady route, coming off the fentanyl patch first by decreasing 10-20% per month then when I am done with that I will start withdrawing from the oxycodone.  It may take me a year (or longer) but I think it is my best hope.
Helpful - 0
6815927 tn?1395511425
Hi Mary, as always, thank your for your thoughts.  I very much agree with you (and the others) I just wanted to get some 3rd party input.  I think my psychiatrist was suggesting what may in theory seem like a good idea, but in reality not so much.  I did a lot of research too and it appears that not only is methadone the most difficult opiate to withdraw from due to its half life, it disrupts the hormone balance more than any other opiate (I can't take birth control pills due to depression.)
I am going to stick with the slow and steady fentanyl taper.
Thank you again - phoenix
Helpful - 0
3197167 tn?1348968606
TOTALLY concur with your plan, Phoenix~  Way to do your research!
Helpful - 0
4522800 tn?1470325834
I came off of a 12 Year Methadone ride with 2 other meds. Before this I was on the oxys/hydos..Yes the Methadone is a Beast..BUT I just had someone explain to me about the Patch. They said that the patch can be one of the hardest ones to detox off. If you take all these Meds and break them down to Semi-Synthetic to Synthetic that is where it becomes hard..I do know that the Dones and Trams are very synthetic..The more synthetic the harder it is to leave the Body. I guess there are people who have tapered from a patch but that sure does seem a bit difficult to be because you can not cut these down..I know you can go down in the micrograms. The best way in my opinion is to always taper from the drug you are one..Just like when they took my dad from his hydos and put a patch on him..Well he still had to rid the codeine out. I even was told that Morphine is a bit easier then a patch to detox from..Maybe do some home work on the Net and see what they suggest would be the next step down or just keep on tapering from what you have. This is very interesting to me becasue I was told by a rapid detox place I called that they would not do this unless I went from the Methadone to the Patch..Ha!! Well I wish you the best and if you can taper from this then keep it up..This will be much better then going from one drug to another to another..You know what I mean.
Bless
Helpful - 0
6815927 tn?1395511425
Thank you Kansas friend!
Helpful - 0
6815927 tn?1395511425
VIC, interesting.  I had not considered the synthetic vs. semisynthetic derivation factor.  I too had heard that fentanyl was exceptionally difficult due to the patch delivery system-- and I think as I progress further down the taper the lack if incremental reductions may pose a challenge.  I guess I will cross that barrier when I come to it.
I agree with you that it is generally best to detox from the medication you are currently on.  So, on I go with the fentanyl taper!
What I find is very interesting is that you were told by a rapid detox that they wouldn't treat you unless you went from methadone to the patch?!?!  What was the reasoning behind that?  I have never heard that one before!
Thank you for your thoughts - Phoenix
Helpful - 0
Avatar universal
HI  I agree with the other posters methadone is the worst of all narcotic to get off of  it took me 8 1/2 months to taper off of it and I went in and out of withdrawals threw out the taper the big thing with methadone is the energy crash that can last for months it took me a good 90 days to get over it please hear our crys DONT GO TO METHADONE!!!!!!  we will walk you threw your taper we have several members who have gotten off fentnel so your not alone hang in there and keep posting for support. Gnarly
Helpful - 0
6815927 tn?1395511425
Thank you Gnarly.  I don't know what I would do without this site.  It has been a saving grace for me in a lot if ways.  I wish i could open up more.  I will keep on the fentanyl taper, it will take me a while but I will get there.  Why do healthcare providers think they know what is right for us?  I get very frustrated them giving me advice on something they have never experienced.  Next time I am at the psychiatrists office and he asks me about going in methadone, I am going to ask him how he managed the WD's the last time he came off if it.
Helpful - 0
Avatar universal
Yay I would like to see these doctors go threw withdrawals b/4 they could write a script for it just know a taper can be tuff I dont know if the vitamine mix will help fentinal withdrawal but it cant hurt to try it it is for anny drug that takes a long time to come off of like sub or methadone it wont hurt to give it a try go to walmart and pick up a 3 in1 vitiman calcium/magnezum/zinc take 4 pills with breakfasts and 4 with dinner every day this cut down the withdrawals after several days give it a try and get back to me if it seams to help it is magical for methadone keep posting for support good luck and God bless....Gnarly
Helpful - 0
6538759 tn?1386250196
I don't know much about fentanyl, but wanted to offer you my support. I have learned through all of this that we cannot blindly trust our drs and that we have to research anything we put into our bodies. I wish i had figured that out sooner.  I really think people on this site are more knowledgeable about addiction, meds, and WD.  
Good luck to you :)
Helpful - 0
6815927 tn?1395511425
Thank you KBUSYMOM, I appreciate the support.  I agree that we cannot walk blindly into whatever our dr.'s tell us, it is a very sobering thought.  I am angry that I have allowed myself to get into this situation, and it will be hard work to get myself out of it.  I too believe that the individuals on this forum have far greater knowledge of medications that the most highly trained addictionologist out there.
Helpful - 0
6815927 tn?1395511425
Thank you gnarly for the tip about the calcium/zinc/magnesium.  I have been taking some once a night but maybe I need to up the dose.  Maybe that will stop the unbelievably annoying muscle twitches....
Helpful - 0
1855076 tn?1337115303
I just wanted to chime in about the supplememts.  When I was tapering off Fentanyl, I used a lot of things from the Thomas recipe and from tips I read from other posters.  With tapering, at least for me, you'll be in and out of mild to moderate withdrawals.  Staying hydrated is really important.  And I used Imodium it took a lot of the symptoms down a couple of notches.  (If you google Imodium for withdrawals.  I tried it not expecting it to work but I surprised and happy that it helped some.  Getting some relief sometimes means piecing together a bunch of stuff.

I've never been on methadone so I can't compare it ti Fentanyl but my guess from how I felt coming off the fentanyl is that they're neck and neck.  I'd also include suboxone as another med that'snhard to come off.

You'll get through this.  It's important to try not to evergo back to a higher dose.  It taxes your body too much.  It's better to stabilize at one drop and wait until you feel a bit better before dropping another 10 percent.

You'll get lots of supprt from here.  Keep posting.
Helpful - 0
6815927 tn?1395511425
Mary, how long did you go between fentanyl dose drops?  Did you wait until you felt better before making the next drop?  How many micrograms did you drop at a time?  You mentioned 10%.  Did you use the 12.5 ug patch for your reductions?
Helpful - 0
1855076 tn?1337115303
The first time I didn't didn't wait lomg enough and I dropped too fast as well.  The second time I only dropped approximatelymten percent and wouldmwaitmamweek or so.  If I was stable at that, I would drop again.  If I wasn't, I gave it a few more days. Ni did switch to the 12.5 mcg patch after I was done with the 25.  I had the patch that lies flat, you don't have the little resoirvoir that holds the med.  Si I just cur tiny strips and when I got to zero went to oxycodone and then tapered from that with a quick taper.  I hate that any one has to go through this.  Keep posting.  You'll get there.
Helpful - 0
6815927 tn?1395511425
Hi Mary, so you were able to go this taper a lot faster than I've been going.  I reduced 25 ug (from 200 to 175) but my dr. Has me waiting a month between reductions.  You were able to reduce about every week or so?  Did you change your patches every 48 or 72 hours?  
When I go see her on the 30th for my next reduction I may ask about picking up the pace.  I also have the Mylan brand patches that can be cut.
Helpful - 0
1855076 tn?1337115303
I changed patches every 48 hours.  At different times I would wait longer.  I didn't drop until I was feeling okay.  I did the supplements while tapering  andmfound them  helpful, especially magnesium.  My legs and sometimes arms would feel so heavy.  Are you planning on jumping from the 12..5 or switching over to a oill and tapering from that?
Helpful - 0
6815927 tn?1395511425
Hi Mary, sorry, I meant to reply earlier and forgot!  I haven't figured out what to do when I get to the 12.5--it sounds like so far away.  If I make it to 12.5 I'll probably throw a party!  Honestly, I think when I make it to the 12.5 I will probably cut the patch in half for a week or so then stop.  I can't really say jump because once I finish the fentanyl taper I am off to the oxycodone taper (which I am hoping will be a lot easier and quicker.)
I am thinking of reducing tomorrow to 150 ug (from 175).  I should wait for my dr. appt next week but I am getting frustrated with how slow this is going and I feel ok.  The one thing I have been doing is stretching out my patch changes from every 48 to 72 hrs.  (I even tried 96 one time but I won't be doing that again--I woke up that 4th morning in some pretty heavy withdrawal.). I just feel like I am not making any progress and that this should be going a lot faster.  I have definitely noticed an increase in pain but my insurance approved a TENS unit and I am hoping to get some relief when it arrives next week.
Hope you are well and I wish you a wonderful holiday -
Helpful - 0
Have an Answer?

You are reading content posted in the Addiction: Substance Abuse Community

Top Addiction Answerers
495284 tn?1333894042
City of Dominatrix, MN
Avatar universal
phoenix, AZ
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Is treating glaucoma with marijuana all hype, or can hemp actually help?
If you think marijuana has no ill effects on your health, this article from Missouri Medicine may make you think again.
Julia Aharonov, DO, reveals the quickest way to beat drug withdrawal.
Tricks to help you quit for good.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.