Comments and suggestions on this would be greatly appreciated! Not recommended for opiod/fentanyl naive people. The below procotol is suggested when one has achieved a steady state with 37.5mcg/h fentanyl transdermal patches. Deviations will require commensurate modifications.
A way is suggested of extracting fentanyl from patch for intranasal and/or oral use which is working with slight deviations from Oxymorphone's protocol. The suggested way avoids alcohol in the end product which is a good thing IMO, is useable in a discreet manner. Some additional detail is added (for example, the colouration of the adhesive) in the interests of harm reduction.
- If used patches are being reused, the remaining fentanyl is calculated as accurately as possible. The more information available on the length of use of a given patch, the better. The total amount of fentanyl originally in the patch minus the number of hours used times the patch dosing is used for this calculation. So if a 25mcg/h patch contains 4.2ml total fentanyl, and a 12.5mcg/h patch contains 2.1ml of total fentanyl, and they were used for 67 hours, then this would be 6300 - (37.5*67) = 3787mcg, or ~3.8ml, of fentanyl.
- A ceramic bowl with a hot pot can be used to create a water bath, with the patch(es) and solution in the ceramic bowl, and water in the hot pot surrounding it, and gentle heat is applied. The patches are immersed in 70% IPA (~50ml) and then stirred routinely until ~75% of solution was evaporated. Another ~50ml of IPA was then added (2 IPA additions total, but more could be can be used depending on one's patience). It takes about 30-45m for 50ml of IPA to evaporate in the ceramic bowl which gives an idea of the amount of heat applied. Halfway through the process (during the first readdition of IPA), the now white looking adhesive is easily rolled up and removed with a fingernail from the patch and both the rolled up adhesive and patch are put back in the solution. The patches and adhesive are removed from solution towards the very end when about 1ml of IPA is left and the solution is allowed to dry completely.
- 4ml of sterile water was added to this residue and thoroughly mixed with the tip of the measuring syringe. (This is the main deviation from the OP; no alcohol is used which leads to nearzero irritation of the nasal passage.). This would represent ~1mcg of fentanyl for 1mcl of H2O. A P20 pipette (which measures up to 20mcl) was used to evaluate the first doses. Doses were gradually increased in 20mcl increments until an effect (see subjective description below) was felt, to ensure extraction was performed reasonably. Effect was quite immediately noticeable at the lowest dose and there was no need to go above 100mcl.
- 6ml of 0.05% oxymetazoline hydrochloride nasal spray (OHNS) solution was added to this bowl and the residue thoroughly mixed and the contents (now 12ml) emptied into an empty nasal spray bottle using a filtered syringe. Another 6ml was used to repeat this process. So total solution in nasal spray bottle was ~16ml, representing 250mcg of fentanyl for 1ml of solution. One drop from the nasal spray bottle was observed to be equal to ~25mcl of solution measured using the P20 pipette, so 25mcg can be expected per drop if extraction was done well. Dose accordingly and extremely carefully!
- Oral use is definitely possible and doable, assuming a 33% bioavailability (in contrast to 89% for intranasal use). Instead of OHNS, lemon juice is preferable.
Comments:
- Intranasal effect at dosings of 50-100mcg of fentanyl subjectively (see subject parametres above, i.e., currently dosing on 37.5mcg/h transdermally) leads to a quick moderate euphoric, hypnotic, pleasurable outcome that peaks at 10-20m and appears to last about an hour. High doses were not evaluated. It appears there is a dose buildup at repeated dosings of 10 minute intervals. 6.5 minutes is the intranasal half life (in contrast to 2.5m and 3-7h for IV and transdermal), so dosing every 10 minutes 3-4 times leads to a situation where excessive fentanyl is building up and this is the stage at which caution must be excercised.
- Oral use leads to a slow moderate, euphoric, hypnotic, pleasurable outcome that is noticeable 1-2h and then tapers gradually, lasting about 4-6hrs. This is perhaps the only way of making fentanyl usage "last" for long periods without repeated dosings.
- It appears that the OHNS solution definitely dissolves the fentanyl. How optimal this process of using 4ml H2O + 16ml OHNS in getting all the fentanyl residue out from the bowl is unclear, but it definitely avoids the pain of having IPA (or other alcohol) in the nasal spray. Benzalkonium chloride is the solvent used in OHNS which is readily soluble and acetone and ethanol (as well as H2O), it is an antimicrobial. and and it apparently doesn't sting even on open wounds, so it may be that an even more dilute solution of OHNS or just straight Benzalkonium chloride is useful as a solvent for IN use. This might be useful for extracting other opiates as well as substances like THC (for a IN tincture). Any input on this would be much appreciated.
- Note warnings about OHNS long term use (rebound effect).
Further potential improvements to try out:
- Soak the patches for longer in the IPA before starting the process. Previous studies have shown that a 500ml room temperature IPA (presumably 70% ) soak removes ~88% of the fentanyl in a drug-in-adhesive patch over 180m. Above, about 100ml of 70% IPA was used with heat and about 120m. While one may gather that at least 80% of the fentanyl was extracted, it is not clear how much more was extracted due to the high potency of fentanyl.
