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Opioids For real pain managment, do the mylan fentanyl patches suck?

bennyZA

Bluelighter
Joined
Apr 19, 2009
Messages
1,495
Location
A little cutty cove in the Northern Pacific.
I've been on the internet looking for the answer to my question. I have real pain problems and my doc finally relented to taking me off subs (for pain) and using fent patches (I went weeks without subs before). Most forum subjects tend to be about how to extract the fentanyl. I just want to know if the mylan patches (the one's without the gel) actually help. It's been a few days and I feel nothing, at all, on 25mcg/hr. On some websites they say fent patches should only be used in the most extreme pain cases like cancer, but... I highly doubt that. Anyone here have experience with real pain management and use of fent patches.
 
I can pretty much tell you all you need to know about nongel fentanyl patches. I've used one 50mcg/h patch a day, for almost 2 years. It has its fair share of euphoria, even when used as prescribed (by wearing them for over 2 days) and even when you're opiate-naive, but you must go over 50mcg/h to get it and you have to press it against your skin harder and harder to quicken its release, until you're just left without euphoria.
As for pain management, after a spine surgery, that's what the doctors gave me post-op for a few days. The nurse would change my patch every 2 days. The first 2-3 days she'd put a 50mcg/h one, but then she got the order to taper my dosage and would stick 25mcg/h ones later on. It did provide me with general pain relief post-op, I can't complain. However, I was using much more opiates pre-op so it was not enough to cause me any euphoria. I'd usually take the patch the nurse would throw in the trash can and stick it again, achieving almost 75mcg/h and when pressed hard against the skin, that's when I'd experience some nice euphoria.
Now, these patches can't be smoked. You either wear them correctly, or you gum them (search: gumming fent patches) for a faster and more intense release. But if you're solely looking for pain management and not abuse, then I can testify they're quite effective when found the right dosage, and tolerance develops somewhat slowly. Feel free to ask me about anything else, as I said I'm quite experienced with these nongel types.
 
That's good to know about the pain relief part. I think the dosage is going to be hard to figure out. The doc is weary of giving me a high dose so he started me at 12.5, which did nothing, at all. Honestly, I want the 25mcg/h to work and be all that I need, but I do want to get just a little buzz. I'm not try to get blasted on heroin, but a little opiate warmth would be nice. So you leave your patch on for 2 days? My doctor said 72 hours, and he only prescribed me enough for me to take them every 3 days. I have a pretty high tolerance so we'll see... What is 25mcg/hr feel like compared to other opiates once you start feeling peak effects?
 
If your 25mcg/h patch does not give you ANY pain relief at all, then I suggest you talk to the doc about another increase.. maybe one 25 and another 12.5 patch. Now, my personal example was post-op so they changed the patches more frequently since by the third day they barely give you any pain relief anyway, trust me on that. Two patches, like I said would probably cover you (37.5mcg/h in total) when it comes to pain relief and MAYBE give you some small and very subtle opiate buzz. But if you're serious about this, I suggest you up the dosage to 50mcg/h. You'll probably cover your pain AND get some nice buzz going, well until tolerance builds up, that is. It feels pretty much like... a typical opiate, really, just without the nasty side effects. Now, I don't know you or your tolerance (how much oxy/h/anything did you usually take?) so I can't be very accurate on this. Now, there's info that the patches usually take a while to start working (4-10 hrs by some sources) but personally, if I cut a strip of the patch and gum it, the relief starts in a matter of few mins. But even if I wear it, it still doesn't take much to start and the peak comes very soon. Anything else you wanted to know?
 
So... Just an update. The mylan patches are super interesting when it comes to pharmaceutical opiates. Since the OP, I've been wearing 25mcg/h. I feel essentially nothing. My doc is an eastern european hardass, but recently he said to me that he's sick of trying to come up with ideas for my pain control, and I should just come to him with suggestions. He also told me to wait 3-5 days to feel something (wtf kinda opiate is that?) He also won't prescribe anything for the breakthrough pain.

So what I'm getting at is that either:
1.) I do need to wait 3-5 days to feel anything
2.) I need a higher dose (probably 50mcg/hr considering how weak 25mcg/hr is)
3.) That they just suck in general

That being said, aren't these supposed to be super tamper proof and the least recreational of all potent opiates? Cause I did the gumming thing, and wow! I was wearing 25mcg/h transdermally and like I said, felt nothing. I put 1, just 1 on my upper gum (accidentally 1/4 was on my teeth, it was cut in half so less than 12.5mcg/hr) and within about 30 min I had a great nod going. People say fentanyl sucks for recreational effects, I'm going to call bullshit on that.

I read all about extracting it with isopropyl alcohol and all these other methods to get passed the polymer-matrix. Well, the gum thing works just fine. I went to sleep with no pain, and feeling awesome. Woke up with no pain (for the first time in years) and was feeling awesome.

As for my tolerance... I used to take a heroic amount of OC after my accident, 300-400mg/24hr, then they gave me 24mg suboxone a day after finding out about my addiction. So my tolerance is ridiculous. Even after a month + with no opiates (including subs), it took 200mg of high quality #4 heroin to get me feeling real good. I didn't even feel ANYTHING with 40mg of OC.

In about 1.5 months I'm going to be moving to a place where I can't really be fucked up anymore, so I'm trying to get as much "fun" in as possible in before I gotta move. I can't be in pain though. So I think I'm going to have to "persuade" or just tell my doc to give me 37.5, and then probably 50 considering my tolerance.

So with my tolerance, do you think 50, transdermally, would be a strong enough dose to give me pain relief.

(sorry for the long response, I write for a living, so this comes easy to me)
 
The reason you need to wait 3-5 days to fully assess the effects of a fentanyl patch is because it takes that long to reach steady blood levels because of the way the fentanyl is absorbed by the skin.

A science-y explanation:

On applying the TDDS (Transdermal Drug Delivery System) to the skin, a drug concentration gradient is developed and the drug starts to move down the gradient. A second drug reservoir is established in the stratum corneum. As the drug moves further into the skin, it is absorbed into the local capillary vasculature and is then transported into the systemic circulation.

As a result of this absorption process, there is a delay between TDDS application and the development of a desired minimum effective concentration (MEC). This delay varies between drugs. There is an initial period in which drug concentrations are hardly measurable. The time to reach steady-state plasma concentrations varies considerably and may be achieved completely only after two to three patch applications. Thereafter, the steady state is maintained for as long as a patch is applied. The advantage of TDDS is that continuous drug delivery is provided with better patient compliance.

After removal of TDDS patches, drug concentrations decrease gradually. The rate of decline depends on the drug's context sensitive half-time and whether a reservoir has been formed in the skin.

It sounds like you have rationalized getting high as opposed to strictly using the patches for pain relief and not abusing them. If you want them to be effective for your pain, don't abuse them.

Also if you don't wear the patch every day it is not going to be as effective as if you wear it every day, for the reasons explained in the quote above.
 
If your could tolerate 24mgs of bupe, a 25mcg patch isn't going to do shit. Your dose is way too low.
 
So... Just an update. The mylan patches are super interesting when it comes to pharmaceutical opiates. Since the OP, I've been wearing 25mcg/h. I feel essentially nothing. My doc is an eastern european hardass, but recently he said to me that he's sick of trying to come up with ideas for my pain control, and I should just come to him with suggestions. He also told me to wait 3-5 days to feel something (wtf kinda opiate is that?) He also won't prescribe anything for the breakthrough pain.

So what I'm getting at is that either:
1.) I do need to wait 3-5 days to feel anything
2.) I need a higher dose (probably 50mcg/hr considering how weak 25mcg/hr is)
3.) That they just suck in general

That being said, aren't these supposed to be super tamper proof and the least recreational of all potent opiates? Cause I did the gumming thing, and wow! I was wearing 25mcg/h transdermally and like I said, felt nothing. I put 1, just 1 on my upper gum (accidentally 1/4 was on my teeth, it was cut in half so less than 12.5mcg/hr) and within about 30 min I had a great nod going. People say fentanyl sucks for recreational effects, I'm going to call bullshit on that.

I read all about extracting it with isopropyl alcohol and all these other methods to get passed the polymer-matrix. Well, the gum thing works just fine. I went to sleep with no pain, and feeling awesome. Woke up with no pain (for the first time in years) and was feeling awesome.

I'm glad to hear that. Wasn't that exactly what I said, anyway? As for your tolerance, I think you're waay overestimating it. Don't get me wrong, I believe you took those, but since then your tolerance has dropped a lot. I can tell - half a 25 patch by gumming gave you a nod. So to answer your question again, yes... 50mcg/h will probably do the trick but if you keep gumming, expect tolerance to build like any...
 
Yea, I don't plan on gumming anymore. And yea, it pretty much is exactly what you said :) I guess I just wanted to confirm it or something.

So since my last post he said to try 37.5 and get back to him in 2 days. It's been a day since I increased and still pretty much no pain control, but I mean, it's only been a day. If there is no pain control I think he's probably willing to go to 50mcg/hr especially since I'm moving to a place where I NEED the pain under control, but most likely no higher than that. You also said 50mcg was probably what I needed considering my "overestimated" tolerance. I hope you're right!

I abused the shit out of the meds they gave me right after the accident (for 2+ years), and eventually OD'd, which made the pain way worse. So they refused to give me anything but Suboxone for pain, which worked for like 3 days. I kept taking them cause, well, it was better than nothing. Finally he prescribed these fentanyl patches when I told him I just couldn't deal with the pain and the subs were bullshit. Where I'm moving I can't really abuse the patches, so I'm excited in a way if they work. Stick on a patch and presto, pain free... I really, really hope. I don't want to abuse my meds anymore, I really don't. I'm sick of being an addict.
 
Well I suggest you give 37.5mcg/h a chance for a while... maybe a few days or one week. If after that you are absolutely sure there's no pain control, your doc will probably give you a straight up 50mcg/h patch. I based what I said on your post - you said gumming half a 25 gave you something of a nod, which means your tolerance is relatively low at the moment. I'm no doctor but I'm quite sure on that. Still you know yourself better than anyone so use your best judgement and see for yourself. I mean, in theory, your optimal dose could as well be 75mcg/h to keep you completely pain-free, for all I know...
Yeah, I know what you mean... once you're labeled as a drug addict, you can say goodbye to most opiates, it's like you're marked forever on your forehead as an addict.
Well yeah, in theory, that's what the patches are supposed to do. Personally, I don't find them THAT effective considering that after the second day, they pretty much stop working in my experience... and they're prescribed each for 3 days, so you do the math.
However, everyone is different, you just gotta see for yourself. :)
 
Well, my doctor doesn't care that 37.5 is only a slight improvement. I mean, I don't really feel even the slightest buzz and pretty much no pain control, and he told me to get back to him and I told him that. He said he wont give me 50/h patch. I hope that if in a couple weeks I come back to him he'll be willing. I think I'm going to put 50mcg on next morning when I have to change them... We'll see.

On another note. Just found out I have to put my life on hold because I need to have "open shoulder" surgery. Really serious operation. If this much fentanyl doesn't have an effect, I don't know if they will even be able to control my pain. Which will be a lot, for a long time.

Oh yea. One more question. Does the sticky glue of the patch contain the fentanyl or is it in the plastic itself? I just ask cause a patch came off and I put it back on with some surgical tape, and I'm wondering if it is useless now.
 
They usually take a while to start working. Put them on before bed, with an added layer of protection so it wont come off (a large, square bandaid 10cm x10cm) and then see in the morning.
I think the fent its in the adhesive so if it comes off its pretty much ruined unfortunately.
And don't worry about the surgery the docs know what they're doing. Nobody will leave you crying in pain, they'll put you on smth stronger post op.
 
be careful
you don't want to raise your tolerance.
It sucks, but use as directed. You need this for pain. Very easy to rationalize with opiates.
 
It takes about 3 days to "normalize" when switching meds to fent patches. In reality, it takes about 6 days before you know if that dose is gonna be right or not.

My personal plan is to use the pain meds for my pain, and smoke a little weed if I wanna get high.
 
fentanyl in general is a poor ass opioid, i find it no way euphoric at all, when wearing the patch, i itch every second, i puke every minute, a hiccup whenever i smoke a cigarette, im completely irritated and way too sedtated i end up taking the patch off, idk why people like fentanyl so much...its not even a euphoric opioid, its more for anesthesia during surgery. dont get me wrong, fentanyl has POWERFUL painkilling effects for folks with physical pain, just find ur right dose so ur not too sedated or lethargic.,..
 
^sounds like you're taking too much if you're puking, etc. tobacco will cause that as well though. but you're right - fentanyl isn't euphoric at all; it's extremely heavy and sedating and that's about it.

take it easier by dropping your dose and you may find it a little more enjoyable.

as a chronic pain patient who has used the patches for an extended period of time in the past i can assure you it's the bees knees for pain management.
 
Some people do not tolerate certain meds very well. For opiatekrzy, it seems like Fentanyl does not agree with his system at all.

Here is the other thing. Fentanyl is SOOO potent, that using more to get high can put you in the danger zone for ODing quicker. A good nod feels nice. Shallow breathing, confusion, and a reduced rate of breathing can be a scary thing.

But yes, it does work for many people. Fortunately, there are many meds, and ER meds that you can try until you find one that works for you and you can tolerate. There is no one drug fits all solution.
 
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