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Opioids Fentanyl Megathread and FAQ

Jabberwocky

Frumious Bandersnatch
Joined
Nov 3, 1999
Messages
84,999
What is Fentanyl?

Is commonly used to treat Cancer patients and chronic breakthrough pain as well as pre-procedure in a hospital setting, Fentanyl is a synthetic primary μ-opioid. It’s approximately 100 times more potent than morphine; 100 micrograms of fentanyl is approx. equivalent to 10mg of morphine in analgesic activity.


Bio-Availability of Fentanyl
Fentanyl's half life averages between 3-12 hours

IV - 100%
Transdermal - ~92%
Buccal/transmucosal - 50%
Smoking - ? (it's efficient but wasteful)

info on buccal fentanyl from this article
Both the plasma fentanyl concentration and bioavailability of fentanyl will vary depending on the fraction of the dose absorbed through the oral mucosa and the fraction swallowed. Approximately 25% of the total dose is rapidly absorbed from the buccal mucosa and becomes systemically available. The remaining 75% is swallowed, is slowly absorbed from the stomach, and then undergoes first-pass metabolism in the liver, with a bioavailability of 33%. Thus, the overall observed bioavailability of transmucosal fentanyl is approximately 50% of the total dose



Popular brands of Fentanyl include Actiq, Durogesic, Duragesic, Fentora, Onsolis, Sublimaze and Instanyl. Generics of the transdermal patches include Mylan, Watson and Sandoz.

Fentanyl was first synthesized by Dr. Paul Janssen in 1960 following the medical inception of meperidine several years earlier. Janssen developed fentanyl by assaying analogues of the structurally-related drug meperidine for its opioid activity. The widespread use of fentanyl triggered the production of fentanyl citrate (fentanyl combined with citrate at a 1:1 ratio), which entered the clinical practice as a general anaesthetic under the trade name Sublimaze in the 1960s. Following this, many other fentanyl analogs were developed and introduced into the medical practice, including Sufentanil, Alfentanil, Remifentanil, and Lofentanil.

In the mid 1990s, fentanyl saw its first widespread palliative use with the clinical introduction of the Duragesic patch, followed in the next decade by the introduction of the first quick-acting prescription formations of fentanyl for personal use, the Actiq lollipop and Fentora buccal tablets. Through the delivery method of transdermal patches, fentanyl is currently the most widely used synthetic opioid in clinical practice, with several new delivery methods currently in development. Fentanyl is classified as a Schedule II drug in the United States due to its potential for abuse.[1]


What’s a normal Dose?

In regards to Pain Management and Polymer Matrix Transdermal Patches, Fentanyl should not be applied to a patient unless having been on an opiate schedule that is equivalent to 14 days use at 60mg of oral morphine per day, which is equivalent to 40mg of oxy - check this converter. The patient is started out on the lowest dose patch, 12mcg/hr, titrating up every 24 hours until stable. Long term patients are generally safe to begin on 25mcg patches.

For “fun” Fentanyl should be approached with great caution, especially to the opiate naïve who wish to indulge – this applies to all methods of administration; transdermal, smoking, IVing, bucally. I will spare the whole “you shouldn’t be fucking with fentanyl” because in the end it is up to the user in the end. The warnings are out there. But I’m just going to declare I wouldn’t advise anyone with a tolerance that is less than, say around, 120mg oral oxy, single dose, to be using this drug any other way than it is intended.

Using the 120mg oral oxy tolerance as a guide, here are my recommendations for dosing for transdermal and buccal Fentanyl. Remember I’m talking the Polymer Matrix ones here, not the Gels or lollypops as I have no experience with them. If someone can give me some reliable information for an IV and smoking dose I’ll add them in as well.

  • Buccal – Start off with cutting the equivalent to 6mcg/hr, so ½ of a 12mcg patch. Place it up against your cheek, avoiding swallowing your saliva, lightly sucking in your cheeks in to apply pressure to it. Make sure it’s the actual sticky adhesive part against your cheek, that’s where the drug is stored after all.

    The buccal route has a much faster absorption rate than transdermal, so expect the initial effects to be present around the 15-20min mark, peaking around 60-90mins. If you start to feel uneasy or overwhelmed at any point in time, take the patch out immediately.

  • Transdermal – Before you go applying anything make sure you have a good 24 hours set aside for when you do this because the patch takes around 12 hours to reach peak levels. Apply 12mcg/hr to your upper body, preferably on the upper bicep, chest area or on your shoulders. The closer to your heart the better as there’s less blood flow on your extremities. Increase your dose up according to how you feel, adding no more than 12mcg/hr at a time.

    It’s difficult to gauge a good transdermal dose to begin with because of the time it takes for the Fentanyl to reach its full effects, but this doesn’t mean go crazy and think you can handle 50mcg/hr straight up. Be patient and titrate up accordingly. You may “waste” a few patches initially but your life is priceless.


Length of Effects

IV - ~1 hour
Buccal - ~2 - 4 hours of the full effects until is starts to dissipate
Smoking - ~30min - an hour
Transdermal -72 hours

Fentanyl Threads of Interest
Is Fentanyl Safe for a Non-Tolerant user?
Fentanyl Dosage Converter
Fentanyl Generics
Extracting Fentanyl from Polymer Matrix Patches
How long does Buccal Fentanyl last?
About to go through Fentanyl Withdrawal - tips
How to PLUG FENTANYL


feel free to throw out corrections. also ideas as to what should be added would be great as well. thought i would get this out there at least so we can start compiling everything in here and come up with a good end product:)
 
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Great job, thanks for putting this together! And thanks for including my extraction thread. ;) This was long overdue, I think all the major stronger opioids are covered for with megathreads now. I'm not sure if there are megatreads for the weaker opiods and if not should they be made? There are a lot of basic posts about hydrocodone, codeine, and tramadol all the time and it might reduce a good deal of clutter.
 
Got an open fentanyl patch, what now?

So last night one of my friends came over with a 100mcg/h fentanyl patch. Well he only had one, and we both wanted to get fucked up, so just putting the patch on wasnt really gunna work. So i cut a corner and started smoking it. I would smoke bb sized dabs at a time, but it never really got me messed up much? I would say i smoked maybe 5-6 bb's throughout the night, and rubbed one one my gums. I have zero tolerance to this stuff, this is my first time messing with anything like this.

I didnt want to just keep smoking it all night because i know how dangerous this stuff can be, and didnt want to overdo it.

ANYWAY, i still have 75% of the gel left in the patch. what should i do with it now? keep smoking it? rub it on my gums? Try to seal the hole with tape and stick it to me?

also, i left it open all night, will that affect it?
 
Switching to fentnyl from Oxy

I've been taking 20mgs OC x3 a day for 6 months, Getting switched to fentnyl patches due to poor digestion of the ER tablets of OC. What MCG should i get? i've been on them before and was up to 100mcg/3 days but i doubt my doc will start me that high..
 
they always start you off really low on the fentanyl. i was taking 120mg of oxy a day and they still tried starting me off on the 25mcg Try telling the dr. you've been on it before. You probably won't get the 100mcg but maybe you'll get lucky and get the 75 instead of the 25mcg ones. good luck
 
I used to be on 30 mgs of oxy 2x a day and 2 mgs of Dilaudid for breakthrough pain, and my doc put me on 50 mcg/hr for 3 days so I couldn't abuse the medicine. I'd start there probably, but you can always get a higher dosage with time.
 
I've been taking 20mgs OC x3 a day for 6 months, Getting switched to fentnyl patches due to poor digestion of the ER tablets of OC. What MCG should i get? i've been on them before and was up to 100mcg/3 days but i doubt my doc will start me that high..

you'll likely be started on 25mcg/hr and work up slowly to an effective dose. you'll need nowhere near 100mcg/hr initally because of your current tolerance.

fentanyl is generally the last resort with pain management so keep your dosage as low as possible while using them for treatment as other opiatesd basically become ineffective even for breakthrough pain.

merged into megathread
 
i have heard of people freezing it and eating little bits at a time.

You can also dissolve the gel and adhesive (bc like 20mcg are on the adhesive itself) with rubbing alcohol on a plate and then when it drys, you can scrape up the white granules w a razor blade. UTFSE for more thorough instructions. I think I got that from erowid.org years ago. I vaporized it in a glass pipe used for meth.

If you have a low tolerance, be very careful- bc a little goes a long way. Non-opiate tolerant people can easily have a fatal overdose from fentanyl.
 
ANYWAY, i still have 75% of the gel left in the patch. what should i do with it now? keep smoking it? rub it on my gums? Try to seal the hole with tape and stick it to me?

also, i left it open all night, will that affect it?

since you've left the patch overnight, unsealed it will have lost some potency.

the safest way to use these is by taking a tiny sized dab and using it bucally (between your cheeks). hold it in there, for around 20 mins, without swallowing your mucous otherwise it's going to be absorbed orally.

merged
 
I was started at 100mcg but was on a huge dose of OC and 4 30mg oxycodone's at the time. As far as taking it recreationally, I took it by taking the gel and rubbing it around my mouth, the gums, the inside of the cheeks, or I would put it under my tongue. It worked that way, but I didnt enjoy the effects as compared with drugs like oxycodone. Im not sure how smoking it would compare, or if smoking the gel is a waste like I believe smoking pills like OC is. Leaving it out overnight open will probably dry some of the med up causing a loss.
 
for people scripted for a few years, when you are on one brand for a long time, have you noticed if you have to change brands it doesnt work as well.

going from watson, sandoz to mylan is awful! it doesnt work.

im having problems going from watson to sandoz... in theory one shouldnt have a problem, but here i am... im def in wd stages right now, tho ive been on this dosage for over a year, the only change was from watson to sandoz..

strange...
 
smokin mylan fentanyl patch

usually scrape the silicone off with my thumbnail, the words come off the patch along with it, and then vaporize it on tin foil and inhale with a pen tube

ive heard people say that there is little to no fent in the goop you scrape off but it is the part that touches your skin so there has to be some... ive also heard people say the goop is where the fentanyl is actually contained

all i know is that when i used to take 1 hit i would feel very "opiated" that nice warm opiate feeling in my brain, and it kind of wears off after a couple minutes even though i remain "fucked up" for a few hours... so i would take a hit every couple of minutes to feel that nice opioid feeling... but my tolerance is now so high that i have to smoke like half the goop to get that feeling that doesnt last very long

so my question is does anyone know how harmful this is and does the goop that i scrape off indeed contain the majority of the fentanyl, im pretty sure my heart beats funny for the rest of the day after smoking it i actually decided to quit smoking it altogether out of fear and now only use pill form opioids, but ive smoked atleast 40-50, 25 mcg patches total


so have i irreperably damaged myself?
 
plastic

i believe what i was smoking is actually the silicone,dimethicone, adhesive.

could contain plastic though i suppose
 
Well smoking the gel from the brand/sandoz patches seems to be bad enough, i have a few friends that have permanent respiratory problems now after abusing those chronically, I mean none of this stuff is supposed to be smoked. I guess the only advice I can give you is to go see a doctor and see if theres anything wrong with your respiratory system, I dont know anyone who even attempted to smoke the Mylan patches, they always used the gel ones. And if they were going to abuse to Mylan ones, they would cut them into pieces and stick them on their gums.
 
yeah i guess i will go to the doctor and have my lungs checked... after reading some stuff about the dangers of silicone inhalation that stonecutters get i got scared and stopped doing them, its been several months since the last time i did it and im not really having any lung symptoms that i can think of

i know a lot of people around this area who smoke the mylan patches the way i described which is how i learned how to do it

the only thing is im getting worried cuz i got no pills left and am going to w/d from long term methadone use very soon and all i got are mylan patches... i suppose i could try sticking one on, never actually tried that
 
That would actually work fine, ive used patches to taper down many times. Your in an even better position because you have the mylan ones so you can cut them into halves and quarters and taper very slowly. If I did that with the sandoz ones I have the gel would leak out.
 
Don't smoke the mylan patches, man.. Inhaling all that plastic/silicone shit has got to be horrible for your respiratory system. I hope you don't end up doing any kind of damage to your health because of it. If you are dead set on smoking fent get the patches with the gel.

Wearing them will take quite a long time to "kick in" (like 8 hours) but it will last quite some time. So in regards to your withdrawals, it will definitely keep them at bay for much longer if you wear it in lieu of attempting to smoke it.
 
Ok (aside from what everyone else has already said) let me get this strait..You were vaping an opiod, obviously getting opiated from it and you're asking if you were vaping an opiate? :)

Vaping that gel was never meant to be a daily occurance. I only did that a few times in my life, because of course smoking that shit isn't good for your lungs, as it's in no way a pure product, come on man. If you get a fent patch, filter and IV (uh, actually don't do this unless you're reading this and laughing because you do this all the time) or WEAR THE DAMNED THING!
 
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