Opioids Fentanyl & Dilaudid Question

[Bostonterror]

I have been experimenting with my pain medication because I feel I know my body best and it should be up to me what I put into it and how I do it. I have subscriptions for Fentanyl 50 mcg's and Dilaudid 2 mg. I also take 25 mg of Zoloft.

I never so much as took Tylenol before I had cancer but since being diagnosed in late 2010 with late stage breast cancer which spread to the bone I have no choice.

That being said, I have developed a tolerance to the Dilaudid and take about 12 mgs a day and I use the fentanyl patch by cutting it into 4 pieces and use them orally instead of sticking them to my arm.

My question is.....am I setting myself up for a lot of misery? I do get withdrawals when I stop cold turkey if I have been using regularly but I am able to tough it out , I intentionally do 3 weeks on and 1 week off. The combination of the two drugs is amazing, works really well for the pain, and gives some great warm fuzzies. I know I do not need to take them as often as I do but in my mind I have cancer and should be able to get high if I want.

I am interested to hear anyone's idea on if I should stop combining the two. Is it overkill and setting me up to be totally addicted or should I say fuck it and live it up?

 

[BiggDirty01]

As a fellow pain patient, I think you need to stick to the dosages and usages that your doctor recommends. That doesn't mean you can't enjoy your medications or not take them all the time, but you need to stick to taking your meds more regularly than not. Intentionally setting yourself up for fent/dilaudid withdrawals seems a bit nuts if you ask me, only because I have experienced them and I know them to be quite unpleasant.

Perhaps when you don't feel the need to use your meds quite as much you can just stick your fentanyl patch on your skin as directed so as to receive some around the clock pain relief but not getting high off your medication. It just doesn't seem rational to put yourself into withdrawal 1 week a month when you have a legitimate use for the medications. And from what I can tell, your dosages are not that high or extreme to think that you need be overly concerned with being dependent on your meds.

But all in all, this conversation should be between you and your doctor. Good luck you and feel free to PM me if you wish to discuss further.

 

[Doomed2pain]

^^^ definitely this. I am a chronic pain patient and I take my meds as directed. I have no psychological addition issues as I do not get high off them, I barely get any pain relief. I cold turkeyed my fentanyl last July as I wanted to get my tolerance back down. You are just going to sky rocket your tolerance by doing what you are doing, you really need to stick with how your meds are prescribed.

 

[hwinston]

Anyone in the Baton Rouge area familiar with Fent?

 

[Fire&Water]

I have been experimenting with my pain medication because I feel I know my body best and it should be up to me what I put into it and how I do it. I have subscriptions for Fentanyl 50 mcg's and Dilaudid 2 mg. I also take 25 mg of Zoloft.

I never so much as took Tylenol before I had cancer but since being diagnosed in late 2010 with late stage breast cancer which spread to the bone I have no choice.

That being said, I have developed a tolerance to the Dilaudid and take about 12 mgs a day and I use the fentanyl patch by cutting it into 4 pieces and use them orally instead of sticking them to my arm.

My question is.....am I setting myself up for a lot of misery? I do get withdrawals when I stop cold turkey if I have been using regularly but I am able to tough it out , I intentionally do 3 weeks on and 1 week off. The combination of the two drugs is amazing, works really well for the pain, and gives some great warm fuzzies. I know I do not need to take them as often as I do but in my mind I have cancer and should be able to get high if I want.

I am interested to hear anyone's idea on if I should stop combining the two. Is it overkill and setting me up to be totally addicted or should I say fuck it and live it up?

You should be able to do what you want but be careful w/ the fentanyl I dont think you need an early OD...moderation

 

[Bostonterror]

As a fellow pain patient, I think you need to stick to the dosages and usages that your doctor recommends. That doesn't mean you can't enjoy your medications or not take them all the time, but you need to stick to taking your meds more regularly than not. Intentionally setting yourself up for fent/dilaudid withdrawals seems a bit nuts if you ask me, only because I have experienced them and I know them to be quite unpleasant.

Perhaps when you don't feel the need to use your meds quite as much you can just stick your fentanyl patch on your skin as directed so as to receive some around the clock pain relief but not getting high off your medication. It just doesn't seem rational to put yourself into withdrawal 1 week a month when you have a legitimate use for the medications. And from what I can tell, your dosages are not that high or extreme to think that you need be overly concerned with being dependent on your meds.

But all in all, this conversation should be between you and your doctor. Good luck you and feel free to PM me if you wish to discuss further.

Thank you very much, very good advice from someone who knows how I feel. I will be taking your advice my doctor told me I am doing this because of depression and she gave me ativan (not sure I spelled that right) but it made me nervous instead of calm.

 

[tricomb]

If you have to tamper with your transdermal fentanyl delivery system, your pain is NOT adequately being managed. Speak to your doctor about this IMMEDIATELY, this is exactly why they produce more forms of fentanyl than just transdermal patches. You should ask him about Fentora (buccal tablets) or Actiq (buccal lollipops).

Please do not continue to abuse your patches, people die on their as-prescribed dosages, accidents happen, especially if you're tampering with the fentanyl delivery system. This is a VERY SERIOUS issue that can be addressed EASILY by your pain management doctor, please stop risking your life and speak to your doctor about getting proper breakthrough medication and/or a bump up in fentanyl dosing.

 

[Bostonterror]

If you have to tamper with your transdermal fentanyl delivery system, your pain is NOT adequately being managed. Speak to your doctor about this IMMEDIATELY, this is exactly why they produce more forms of fentanyl than just transdermal patches. You should ask him about Fentora (buccal tablets) or Actiq (buccal lollipops).

Please do not continue to abuse your patches, people die on their as-prescribed dosages, accidents happen, especially if you're tampering with the fentanyl delivery system. This is a VERY SERIOUS issue that can be addressed EASILY by your pain management doctor, please stop risking your life and speak to your doctor about getting proper breakthrough medication and/or a bump up in fentanyl dosing.

Thank you! Exactly why I love this board. Good advice and I never feel like anyone is being judgmental. I appreciate the feedback.

 

[tricomb]

Of course Bostonterror, this is why we are here. Not to judge you, or encourage you to find a better way to abuse your medication, but to suggest a REALISTIC harm reduction alternative. You're a chronic pain patient, obviously, you'll have NO trouble getting your medications adjusted as you need.

Best of luck to you, please checkout the Chronic Pain link in my signature, it's a thread for us chronic pain patients to give eachother support and ask/answer questions related to pain management.

 

[brighton]

.

... I intentionally do 3 weeks on and 1 week off.

Taking smaller, more regular breaks from opiates should leave you with more minor withdrawal symptoms. You could try a 3 day break every 10 days or 2-3 days a week. I have at least 4 days opiate free a week to keep my tolerance down and avoid physical dependence (but my pain can be pretty tolerable at times).

 

[TomRx]

It is common for a pain doc to prescribe one long acting medication such as your Durgesic patches and a fast acting medication such as the Dilaudid for breakthrough pain as it is fast acting. So taking the two together is normal. However I would suggest there may be a better way of accomplishing what you want and using the pain meds as intended and prescribed. Right now I do not have cancer but have chronic pain. I am currently prescribed Oxycontin 60mg 3 times a day as my long acting pain med. If you can get away with what you are taking you likely do not need as much as me. I also take Actiq in a generic brand which is Fentanyl but in a lollypop form which is instant release. They come in 400-1600mcg doses and release over a period of 15 minutes while they dissolves in your mouth. They are transmucousal pops. They actually taste like candy and work great for me. I like the Teva brand myself. Both of these, especially the pops are VERY expensive however my medicare covers them both fully.

Dilaudid does not work so great for me. Also the Oxycodone/Oxycontin seems to give me a bit more energy while almost all other narcotic analgesics give me less energy and make me drowsy. Morphine for example. The Fentanyl seems very neutral so it does not give me energy or make me tired. Anyway I would certainly at least try out the pops since you are taking the patches orally. Since they are 50mcg/hour they are not very strong. They are intended to release that over a 72 hour period so perhaps those 400mcg Actiq or generic equivalent would work well for you and taste good too. Just as long as your insurance covers them as otherwise they are several thousand dollars a month even for generic.

You have real pain if you have cancer and you should take whatever makes you feel better. If you can go a week without them I am wondering how you both deal with the pain and withdrawals. Only you can answer that question but I would not worry about addiction. You will develop a tolerance but why worry about going through withdrawals and or pain if you don't have to? If you end up getting better and want to get off the narcotics then slowly decrease the amount you take so it is easy on you. If you need them take the amount you need to get rid of the pain. If you feel a bit "good" or high and you like it then ok, could be worse side effects from a medication.. Just try to take things in such as way they are consistent and safe for you. Best of luck.

 

[Bostonterror]

Honestly, to be completely truthful...the week I do not take the meds I will tough out the withdrawals for a day or two but I do know someone who has constant access to methadone in pill and liquid form and I take that if it gets too bad. Although I have cancer I do not have 24/7 pain ...it has spread to my bones but I am still an active person and live a normal life. Lately I have been taking these meds and sleeping a lot. I feel like I am constantly spinning my wheels. I hate being dependent on anything. My oncologist always tells me addiction is normal with chronic pain. My state has legalized medical marijuana but I am so uncomfortable to even ask my doctor about it. I am afraid he will think I am just after drugs.

Hey TomRx, thanks for your reply. I am going to ask about the lollipops. The more I read about what I am doing with the patches the more concerned I become about overdosing. When I wear the patch it does nothing other than give me waves of sickness that even my zofran can not handle.

Cancer sucks but it's not the end of the world. The medication part has been the hardest for me. It's been hard to find a right combination.

 

[chase_in_56ace]

b very careful with the fentanyl patches. I know many people who have overdosed by tampering with the delivery system. it seems to be 1 of the more dangerous opiates and easiest to overdose from. that being said 12 milligrams of dilaudid a day is not a very high dose at all. you need to speak to your pain doctor immediately as there seems to be a lot of room to work with your prescribed medications. however experimenting yourself is never a good idea. good luck to you and I wish you future success in dealing with your pain.
Ace.

 

[Badstones]

I think she should look into the pops/lozenge.
<--- Loves em.

-Sunshine.