Fentanyl Withdrawal Symptoms (Page 18)

I'm trying to wean myself off the Fentanyl patch. I went from 75 micro-gms to 50 now I'm on 25. Having a problem and not sure it is related to the decrease in the med. It's been 20 days on the 25 micro-gm and I'm going crazy. I need to keep rocking, moving in any way b/c my body is very restless. Is this a symptom of withdrawal and what do I do? I cannot take it any more.

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I keep reading that everyone is having withdrawls as they wean down off fentanyl? is this true? the restless legs, flu like symptoms full body pain?? my husband went cold turkey off 200mcg/48 patches we put his last ones on tuesday and these are all the symptoms he is experiencing. so are you telling me he would have had them anyways if he would have weaning like I wanted him too?? Just wondering? Does anyone know how many days to expect to be like this? And when do I start the timer from? would it be the 48hr mark or the 72 since that is what patches are suppose to be?? thanks for any help you can give. its a real nightmare and thats with the meds the doctor gave to help.

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2cor129
It can last a few days or a few months is different for everyone. Im going on 4 or 5 weeks off the stuff and its hell. Im tired alll the time and my joints ack, mostly in my legs. I dealing with it by useing OTC stuff like Tylenol and Motrin and caffine. I wish I never had these patches its the worst. I wich I had a better response for you but I'm still going through the withdrawal myself...

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2cor129, In my case it took about 4 or 5 weeks for the worst of the symptoms to go away and to start feeling like my normal self again. I think it would not have been so hard if my doctor had weaned me off of it more gradually, instead of phasing out over just 6 days. It is now about 4 months since I have used the Fentanyl patch and I still have some muscle twitching and rocking back and forth, but only when lying in bed at night. I can put up with that since I feel so much better overall. I hope your husband doesn't suffer too much but it is worth it to get off the patch.

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Thanks for the info guys really 4-5 weeks, but can you function before that? like work? do you still have pain or just the restlessness? On day four but it seems like this morning was one of the worst yet?? Why do doctors put you one this stuff if they aren't gonna help you off??

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Okay, I've read most of the comments to this post -- and now I'm really frightened. :(

I've been taking 75 mg (up from 50, then 63 mg) Fentanyl every 48 hours for about a year now to treat chronic pain from peripheral neuropathy. The side fx have gotten so bad that my pain doc and I have decided that I should get off Fentanyl and try a different 24/7opiate -- probably oxycontin or methadone. He's given me scrip for the 63 mg dose, and I'm to come back in two and a half weeks. At that time, he wants to switch to 50 mg. and start me on the other opiate -- and then at a time yet to be designated, drop the Fentanyl completely. He says that withdrawal will be somewhat uncomfortable to extremely uncomfortable, but not life-threatening, and that from what he's seen, withdrawal will not be more severe doing it this way than it would be from tapering the Fentanyl over time.

Reading your experiences, I get the impression that tapering would be a better plan -- and that the doc's estimate of 4-7 days for withdrawal symptoms is ridiculous. I'm really scared re: the latter. I have to work. Can you work while you're in withdrawal? For those of you who work, how long did you need to be off work? I can take a week of leave if necessary, but not more.

I'm also concerned because I'm already ON so many other drugs and I don't know whether they will help or hurt me in withdrawal. Notably, I take Lyrica (max dose), Cymbalta (same), Lamotrigine (low dose) for my neuropathic pain, plus oxycodone for breakthrough pain. Already taking Ambien to address insomnia caused by some of these.

Also, can I do this at home, or should I push to have him send me to a detox facility?

Any advice or words of encouragement would be much appreciated!

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Sonja, Your doctor sounds like he knows what he's doing and is giving you good advice. The only thing is, I would try to stay away from the oxycontin because it is so addictive. Try oxycodone or percocet instead, or at least discuss it with the doc. His plan for tapering sounds reasonable to me. There is no pleasant way to get of the Fentanyl, but he's right, it's certainly not life-threatening! I worked the entire time I was having withdrawal symptoms, but I work at home and can take a little nap if I need to. I also did some traveling for work and it was okay. I really don't think you need to be in a detox facility, in terms of my own experience with withdrawal. But it's great to have some emotional support, like a good friend or a significant other who you can lean on and who will put up with your moods! Good luck, it sounds like you are doing this the right way.

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Hello everyone. I am on day 3 without fentanyl or lortab or lyrica, 50 mcg patches 2 x 7.5 painkillers and 50 mg 3 a day on the lyrica. I have been on ever increasing doses of this stuff since a bad construction incident 5 years ago. I had to close my business in Aug 08 exactly one week before my daughter was born now two years later my wife was notified that our insurance was gonna triple at the same time she was returning to full time school to be a radiologist. Well that was all at the beginning of summer and I had a great pain control doc that really worked with me as much as he could, Since July I have been trying to turn to the VA for help. I do have a war time injury that qualifies me for a small disability. Tinninutis and hearing loss also it was the Army that first found my diabetes. So its always been the VA taking care of that (its impossible to get any type of insurance in this state with so much as a funny looking birthmark). Anyway I would have sworn my first day would end in suicide by the time I was making my daughter breakfast. My sister rescued me with (of all things) cannabis. She has a prescription so the only wrong was a little sharing and my brains still in my head. Sunday my second day was a hallucigenic nightmare as I refused even my sisters help. I was able to get Xanax from the local VA hospital, once my wife started screaming that I was gonna off myself without help (graphically and loudly). And that brings me to today although at first I didnt think I was ever gonna sleep. Sevaral trips to the benadryl and xanax bottles finally worked. This morning I actually woke up and thought for the first time I might get this done after all. But I have gotten slower and more jumpy with each passing moment. I can't take the xanax bcause the wife is in school and the lil girl needs someone to keep her safe, fed, and entertained. The wife may kill me tonite.. I introduced her to a fishing pole and a lead weight to try and 'catch her toys' Anyway thank all of you for advice, encouragment, and generally reassurance it can be done.

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Pme, you can do it! Sounds to me like you have your head on straight and every reason to get this done....for your wife and daughter as much as for yourself. Hang in there. If you just persist, it will get better, in my case it took 4 to 5 weeks before I realized that I wasn't feeling horrible any more. Let us know how we can support you.

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Thank you so much, 3DayRider. You've really calmed me down. I was beginning to think that a nightmare withdrawal was inevitable. It occurred to me, too, that people who have a relatively easy time withdrawing from Fentanyl don't necessarily have any incentive to seek out a Fentanyl withdrawal board! The cross-section of people most likely to be here are those who are going through (and have been through) hell and are either seeking advice and support or are thoughtful enough to share their advice and support with others who might be going through the kind of hell that they did. I'm grateful to everyone who has posted, but awfully glad I found you here!

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I just took myself off 150mcg fentanyl. 3yrs at 150mcg, then 2 weeks at 100mcg, then cold turkey just 3 days ago. It is very tough. Shakes, sneezing, terrific body aches. I have only slept 2 or 3 hrs of the last 72. I think I got it whipped though. Feeling a little better withdrawal-wise, but the chronic back pain is still there. Hang in there....good luck to all

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day 22 Fentanyl free.. did anyone else have problems getting their blood pressure under control. My husbands bp is still spiking 160/110 has be the highest and thats with clonidine on board. Ringing in the head and short zaps where he feels like he's gonna pass out. It seems like he takes 2 steps forward and 1 step back. Still 0-4 hours if we are luck of sleep and that is with ambein on board. Seems like the vitimans helped and the acupuncture has helped as well. He still can't drive all that well.. Doctor won't return our calls since he wrote him a letter asking why he let him go so high on the stuff and didn't keep us on a schedule better. I just don't want him to go through all this and then stroke out on me.

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I've had severe spinal pain for a while (~1 year) and it started being diagnosed properly and fixed as of July 2010. The pain itself is being resolved now and I'm pretty sure I can live without the opiates I was put on in July.

At the time I decided I had to stop, last week, I was on about 120mg of oxycodone/oxymorphone. The pill usage was out of control for me, so my doctor I think (wisely) put me on the 50mcg fentanyl patch ~30 hours ago. I am supposed to use this for 2 weeks (5 patches) and then switch to 25mcg and then after that I guess I keep switching down. This method of tapering works for me, for now. The meds I take for my spinal condition make me very nauseous so most of the opioids I've taken has gotten thrown up but I can't tell what my actual daily dosage was.

I am reading all these horror stories but I do hope I can have a smooth taper. My goal is to get off the opiods period. The fentanyl patch has its benefit when it comes to pain but like any other synthetic opiod, it's a two edged sword.

I'm also taking the gabapentin which seems to help.

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Virgil Smith: My husband weened on Oxy in 2008 and it was much easier process once the three days were over so were most of the symptoms. But Fentanyl we are on day 25 and still major symptoms I were you I would evaluate that a little closer. This is nasty stuff and it stores so it takes longer to get out of your system. I would hate to see you with a bigger problem on your hands. But never the less will pray God gives you direction on whats best for you. Also the patches were designed for 72 hours but my husbands body went through them in 48 and we were told that was a malpractice rate.. so to hear 30 hours really scares me! I tell everyone I know unless your dieing stay away from Fentanyl! The side effects are worse than any pills he has taken we still don't know if he will ever stop having the zap's in his brain and his blood pressure is still having highs and lows we are talking 160/110 down to 97/57. Its bad stuff! Be Careful!

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To: Keng52 how's it going?? are you hanging in there? we are on day 25 fentanyl free.. and he still has good days and bad days. Still dealing with zap's in his brain and blood pressure out of wack. The rest of the side effects are manageable. Don't know if he can drive a car yet.. still shaky. Just hoping your are still hanging on and beating this junk. Good luck and hang in there

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Virgil Smith, Stay away from the Fentanyl if you possibly can. Maybe you should talk to your doctor about what people are saying on this site. There is no easy way to taper off Fentanyl. It is really, really nasty stuff no matter how the tapering is handled.

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Hi guys, thanks so much for your comments. I've read these and others and most are negative and a few are positive about fentanyl patches. But I don't have any choice since my PCP who is nice and got me up to 80mg/day oxyCodone wants me in the hands of my pain doc and my pain doc is just hard to get a hold of. I was considering going to the ER the day I got the patches if I couldn't see him and he was catching a flight and I barely caught him before he flew away. :/ I had tried all week to get an appointment to see him.

Crazy, eh? These are all well respected docs who I'm sure if I had pushed would've done the right thing but I'm also an easy going person and wasn't aware of anything about the patches on Oct 8. Anyways, I took the patches. I was on 130 mg/day oxyMorphone prescription before the 50mcg x 5 patch prescription. So this is what I am trying to taper off from and the patches are my tapering method, apparently a relatively new approach that is popular among the docs.

On day 3, I saw my spinal problem doctor who said the patches were an excellent way of tapering off. He talked to me more about the patches than my pain med doc and was aware that you could go down to the 12.5mcgs and suggested a few ways to extend 12.5mcg patch life (heating, wearing it longer, on and off) to wean off more slowly (a 12.5mcg patch would be equivalent to 30mg oxyMorphone). He really honestly believed this was a good way for me to go. So my second opinion was positive and again, this is the guy who is actually treating my spinal condition and has done a great job thusfar in resolving it. In a sense, he's the reason I can taper off, though it was my PCP who discovered my condition that went undiscovered for a year or more and I could've died or been paralysed because of previous misdiagnoses---all the physical therapy and chiropractry (who seem really intent on keeping you as a customer no matter what) is pointless if there's an underlying condition for the back pain like an infectious disease.

For me, the patches HAVE been a godsend in the 5 days I've had them. I was out of control with the pill popping. There's NO way I would've tapered down a pill by myself unless they gave me a daily pill dosing and weaned me off over a couple of months or so (which I asked my PCP for and she could've done it since the pharmacy and her clinic are in the same floor/building and 5 minutes from my home but she refused---this was my first preferred solution before the patches and if any of this goes wrong, you read all this here first). The 50mcg is probably a slightly lower dose than the 130mg/day oxyMorphone so I had a very mild case of the sniffles which was cured by taking my daily gabapentin dose all at once.

What I am going to do: on Oct 20 (day 13), I'm allowed to switch to the 25 mcgs. I am going to try to do that. If it becomes hard, I will get back to the pain doc and see what should be done. If it's indeed hard, I'm going to suggest a 37.5mcg dose to see if it'll work. If 37.5mcg then doesn't work, then it's going to be a daily pill med regimen somehow (even if I have to switch doctors). If it's not hard, I'm going to stay at 25mcgs for a few days and ask for some 12.5mcgs. After 5 patches of 25mcgs, I'm going to switch to 4-5 patches of 12.5mcgs, and then 4-5 patches of 6.25mcgs, and then 4-5 patches of 3.125mcgs, and so on. This is my plan. BTW, I'm using the Teva matrix (not gel) patches that can indeed be cut.

I will report back on what works. Please keep in mind I'm constrained until Oct 20 to these 50mcg patches so it's only after that I can even talk to my pain med doc about doing something different. At this point I'd have been 13 days on the patch. I'm hoping my short time on it is different from other experiences of tapering off. But I am coming down from a moderately high dose of opiods, i.e., 130mg oxyMorphone.

I really really hope this approach works and gives everyone here a chance to see how to taper down from fentanyl. So far going from 130mg/day oxyMorphone to 50mcg/hour fentanyl has been rather painless. :/

Thanks to everyone here who has shared their experience strength and hope!

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I wanted to a wax philosophically a bit about my motivations/reasons. Opiates cause physical dependency very very fast. In many cases, even without euphoria it's bad, but with euphoria, it's crossing into mental addiction territory. At what point do you separate nondependent use from dependent use to addiction? My pill popping (all prescribed, all due to legitimate pain) was getting out of control. I felt I myself couldn't judge if I was experiencing enough pain to be consuming these powerful opioids any more. I bet if you put Mother Teresa or Gandhi in this situation, they'd end up with similar dilemmas.

Make no mistake that when I started in July, these were absolutely necessary. I was in so much pain, had been for months, and these offered relief. They probably saved me from all the ills that chronic pain causes, including depression, etc. The relief they offered was awesome and justified.

Fast forward to now and my spinal problem is being treated successfully. Do I still need opiods or can I just get by with celebrex and gabapentin or even less? I'm basically getting close to zero pain meds to REEVALUATE what I need. If it turns out that I still a few more months of opioids, I can go back. If it turns out that I need to be on chronic pain management, so be it though I hope this isn't the case and there's nothing in my condition to indicate this would be the case unless I injure my spine. However, right now, I feel I'm increasing my tolerance and consumption so much so that the opiods themselves might be the cause of increased pain (a documented occurrence).

I therefore feel I need to back off and reexperience any pain again to determine what to do. This is why I'm doing what I am doing.

To so many who just dropped from 100mcgs or 50mcgs to zero, I can't imagine what you went through. It has to be horrible and I'm not sure why a taper wasn't attempted. To all those who give others (including me) support and hope and encouragement (3day and 2cor esp. now for me), I hope to be in your shoes one day. Thank you so much again.

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I was just given the patch today after 2 years of taking 4 Norcos a day. I had an accident while driving a truck OTR and ruptured L4 &L5. I had surgery last October 2009, and my pain has increased 100% since the surgery. I see a Pain management Dr in January, but the Norco was not helping and my Dr recommended the patch, at the lowest dosage. After reading all these horror stories i am wondering if I should have opted for the Morophine instead, she gave me both options. I told her today that i wanted off all pain meds soon, and she stated that the PM Dr would work on doing that with me. I hope i do not have to go through what others have gone through with WD's, but now I am worried, and need some sort of pain intervention to get back to a normal life, as pain free as i can be. I know the pain will never subside totally, but I'd at least like to get back to the level I was pre-op. I wish i could go back 12 months, I would have never had the surgery.

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Nikonfan, I think if you taper off using the patch, it is okay. I think it is better than morphine which is considered one of the most addictive substances around. You shouldn't be feeling any euphoria or anything from the patch and you should be on a fast track taper (meaning 2-4 weeks). I can't imagine the patch hurting in such a situation.

What I think this thread clearly indicates is that being on the patch for a long time (months and years) is a recipe for disaster. It seems you build tolerance so you need stronger patches. And then once you're at a high enough patch and can't go higher, you can't get off or come down easily.

But for someone like me who was popping pills in a way that could've led to an addiction, the patch stopped that dead in its tracks (it's day 5 now) and I don't FEEL like popping patch after patch on (like someone described here, patches stuck on them---I'm sorry to laugh at your situation but it is kind of funny to imagine that on me).

So the patch so far definitely has done something good. Let's see if I can get off easily or not but I am determined to.

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I've been thinking a bit about what it means to stick on a patch, and I started at 50mcg/hour. By really rough calculations, that's equivalent to 1.2mg of fentanyl/day which is equivalent to 120mg/day of oxymorphone (which is about what I was on, I was on 130mg/day) which is equivalent to 240mg of oxycodone a day! That is a HUGE amount of opioids.

So someone who's on a 50mcg goes cold turkey, it's like coming off 240mg of oxycodone a day cold turkey! No wonder people have trouble. So even a 12.5mcg patch would be like coming off 60mg of oxycodone/30mg of oxymorphone a day. So you really need to keep cutting the patch down to something really tiny, so 6, 3, 1.5 would be where you need to be to get to the equivalent of 30/15/7.5 or 15/7.5/3.25 mg of oxycodone and oxymorphone/day!

These are simplistic conversions based on the table available here:
http://www.globalrph.com/narcotic.cgi

But it should hold I think given how I was started. If I took the patch off now, I'm sure I'd suffer a huge amount, not because of the patch, but because I'd be coming of 120/130mg of oxymorphone a day!

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