posted 08-27-2003 03:36 AM            

I have been using Duragesic 50 mcg (1 patch every 72 hours) for severe chronic pain since September 14, 2002.

I would like to know what your experiences are with Duragesic withdrawal. What are the withdrawal symptoms?
How long do they last? How intense are these symptoms?

Do you think it is dangerous to stop using Duragesic "cold turkey", that is, without weaning off?

posted 08-28-2003 12:51 AM            

I have severe chronic pain caused by Reflex Sympathetic
Dystrophy (RSD). Because there is no cure for RSD, my severe chronic pain will always be there as long as RSD
is there.

My Primary Care Doctor has prescribed Duragesic for me to control the pain. No medication, except Oxycontin, works as well as Duragesic.

posted 08-28-2003 02:53 PM            

The right way to do it is to reduce patch size. There is a trick to reduce the size of each step. 25mics at a time is a big step. If you only remove half the backing of each patch that touches the skin and apply it and tape it down you have effectively created a patch half the strength since the amount absorbed is based on the amount of patch exposed to the skin. Dropping in 12.5 increments would be much easier than 25mic increments.

If your on 50 you could use one 25 totally normal and one 25 half exposed to your skin, creating a 37.5 dose, then go to just a 25 then go to half a 25 to nothing. Although Fentanyl is unique and hits the Kappa receptor along with the MU, Demerol can be used short term since it's in the same family.

Using a different med that doesn't bind to the Kappa wouldn't be much help. Hydro,Oxy,Morph,Hydromorph are all strong MU binders but don't hit the Kappa. Demerol does but should only be used short term. I would definitely talk to your PM doc about DCing your meds. If you have blood pressure problems or seizure disorder or any other health problems rapid withdrawal could become very dangerous.

posted 08-28-2003 04:36 PM            

Thanks for the information and advice.

I do have a seizure disorder among many other health problems, so withdrawal could be dangerous for me. Do you think it could be fatal?

How do clonidine and benzos make the process easier?

posted 08-28-2003 07:08 PM            

The American Society of Addiction Medicine's website has an excellent explanation of what you might expect.

posted 08-29-2003 12:06 PM            

People don't normally die from withdrawal, it's from complications that arise, like uncontrolled BP when the patient already has BP or heart problems. Dehydration that causes stress on kidneys and other organs can cause imbalance of electrolytes which could induce a seizure in seizure prone patients.

posted 08-29-2003 08:03 PM            

If you apply only 1/2 of the patch to your skin.., you are NOT cutting the dosage at all. The full contents of the patch will still be used 100%. The fentanyl is drawn to where the heat is, therefore whatever part you have attached to your skin, the contents of the patch will still be absorbed to that portion of your skin.

This is what my doc had told me when I had asked him the same question about a year ago.

posted 08-30-2003 03:55 AM            

Shore and PoloBailey, thanks for the information.

I now understand how clonidine, benzos, and anti-nausea medications can help with withdrawal from narcotic painkillers. I also understand how withdrawal can be dangerous for some people.

posted 08-31-2003 12:56 AM            

Duragesic has never made me tired but it gives me severe nausea and sometimes severe vomiting.

The withdrawal symptoms seem awful and frightening. How did you get the doctors to accept that you check in the hospital?

True, Duragesic is a great pain med. I guess the withdrawal symptoms are so bad because fentanyl is so strong.

posted 09-02-2003 03:33 AM            

I guess everyone who has been using Duragesic for a while gets physically dependent on it, rather than addicted. Withdrawal happens to people physically dependent on a drug, which does not mean it cannot happen to drug addicts, because they are also physically dependent on a drug.

My latest orthopedist has been trying to get me to wean off from Duragesic but he did not succeed. I told him: "It is not in my plans to wean off from Duragesic and it is not in my doctor's plans to wean me off from Duragesic and I like it that way!"

I am worried about Duragesic withdrawal not because I want to stop using it cold turkey (I want to continue using it) but because withdrawal is sometimes caused by drug interactions.