fentanyl 50mcg transdermal patch

[luckydog65]

PLEASE HELP!! I've been taking this patch since September 1, 2010 and taking dilaudid for breakthrough pain.  I have a pancreatic pseudocyst 16cm that has now attached itself to my stomach as well.  The Gallbladder is bad and the surgeon will remove it and the cyst and will build a drain for the pancreas using my intestine.  Surgery is not till January 27.  This issue is two fold:  first, I have medicaid and there are only two participating pain management doctors in all of my regional area.  The first doctor only injects calcium into a bad back, and the second will not take me because the insurance is actually inadequate for the treatment needed.  The  second part of the problem is that I have become tolerant to the pain medication. My current physician will no longer prescribe these meds because he wants me to go to pain management, eventually sending my to a physician friend of his because the pain management situation did not work out for me.  meanwhile, through building a tolerance to these pain meds, i have started to smoke marijuana to help ease the pain.  The  physician friend did a drug test on my first visit and now will not prescribe any narcotics at all because I obviously failed for marijuana .  

I only have 5 patches left and, at the very best, they may last till the 18th or 19th.  He gave me Ultram for pain and told me I should move to California.

I am very very afraid of the withdrawl I will no doubt experience as well as the severe pain I will be in without the fentanyl.  I am really in quite a pickle now.  Any suggestions will be greatly appreciated,

[Tuckamore]

Hello Luckydog,

Welcome to MedHelp's Pain Management Forum. I am so sorry to hear about the issues you are now facing. Unfortunately when you use a drug that has not been legally prescribed for you the PMP can and often will dismiss you.

There is a patient abandonment law but that varies a bit from state to state. However by the time you engage legal counsel and attempt to enforce it your current problem will be long gone. PM Clinics count on that fact. I just signed a PM contract that does not ensure I have 30 days of medication should they dismiss me. I asked about it and was informed they do not have to assist me if I violate their rules....so what are you going to do?

I wish I had a great solution for you. I am sorry I don't. Please don't think I am very harsh or judging you but because you took an illegal substance the physician has the right to dismiss you. He/she has to follow the strict guidelines set forth by the DEA.....or he could be in danger of losing his practice and possibly his licenses.  

Other then contacting your current PCP and asking for help I don't have any good suggestions. I sincerely hope you will be able to find a tolerable solution. If your withdrawal gets become extreme then don't hesitate to go to ER. They may offer you some short term assistance.

I wish you the very best and hope that this will be an easier process than you anticipate. Hopefully your pain will be greatly reduced when you have surgery. Please keep in touch and let us know how you are doing. We'll look forward to hearing from you.

Best of Luck,
~Tuck

[namnam46]

Hi luckydog,

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.

Melissa is SOOOO correct about the need to taper SLOWLY - 12 mcg's a month!!  Unfortunately for her, her Doctor was TERRIBLE and messed her up with TOTALLY unreasonable amounts as well as TOOOOO fast!!  

Unfrotunately though it's NOT illegal for a Doctor to cut you off of the Fentanyl patches WITHOUT tapering you.  Don't get me wrong - it SHOULD BE illegal - BUT it isn't. :{

I'm VERY sorry for what you are facing - the ONLY thing that I can think of is to contact your surgeon and let him KNOW what has happened - EVERYTHING that happened and see if he will give you enough to get you through UNTIL your surgery and then MAYBE help you taper OR find you a Doctor to help you taper after you surgery.  

IF you are able to get into another PM Doctor - you MUST follow the rules and NOT take ANYTHING that isn't prescribed WHETHER it is LEGAL or ILLEGAL!!!  I would HATE for this to happen to you again as you DESERVE to have help with your pain.

Again, I'm SO sorry that you are faced with this and I HOPE that you can get SOME sort of help from you Surgeon OR MAYBE he can send you to someone that CAN help you NOW!!!

PLEASE keep us updated on what you are able to do...........Sherry

[Melissa_1982]

Legally your doctor CAN NOT expect you to go from 50mcg of fentanyl to nothing.  He needs to taper you down SLOWLY.  Sadly I'm not surprised though.  I too am on Fentanyl & have suffered through doctor screw ups.  My dose is double yours though with nothing for break through pain. The withdrawals from Fentanyl suck royally & it can be dangerous.  My best solution to you is to get a 2nd opinion from another doctor or to try & quickly find a new doctor.  

Please keep us updated & feel free to inbox/add me if you'd like to talk more about the withdrawals or anything else

Melissa