Harm Reduction Requesting assistance for extraction from legally RX'ed Fentanyl Patches for IV (variety of brands and dosages available!)

[CharsScars]

Hello friends!

You may not have seen my introduction post, so allow me to sum up a bit here to catch up the why this matters...

I've suffered extraordinarily disabling traumatic and severe accidents a few times in my life that have left me with daily injuries and challenges that I've unfortunately been unable to find resolution to after nearly a decade of trying (though the problems themselves stretch back to my single-digit age childhood).... Unfortunately, this has left me with daily chronic pain that is treated with the strongest opioids available, as well as a mix of other medications, including Fentanyl patches (for the baseline), and Dilaudid tablets (for breakthrough pain).

Unfortunately, despite a long stable RX for many years, I had a degradation in condition about 2 years ago that resulted in an increase in dosage that I had fought long and hard to go down from a long time ago.... ¯\_(ツ)_/¯

So I'm back to 100mcg q48hr (yes, I'm one of those people that needs them ever 48 hours instead of 72 hours, something about my body chemistry and going into withdrawal....so says the pain doc who has 30+ years of experience...)

Anyways....I'm in constant severe pain, and it is increasingly making it impossible to do what I need and want to do on a daily basis. We're chasing more surgery, more diagnosis, more treatment, after several attempted surgeries, treatments, therapies, and while I was able to find equilibrium for a number of years where I was able to find balance, that's gone now. Even with the increased dosages, and even with trying to increase them more and more.

(And, in my introduction post....there seems to be limits to what I can metabolize orally with the Dilaudid, from many tests and experiences we've tried....anything over a certain number is a waste, so we've recently turned to giving myself an actual IV and crushing tablets via a Silent Knight, using Sterile Water at a ratio of 1ml/mg in the crush bags, shaking them hard, letting the binder precipitate settle, drawing up into a 10ml syringe with an 18ga needle, and then pushing through a 0.22um wheel filter into a either a sterile vacuum vial or a fresh 3ml or 10ml syringe depending on if it's for a little later or right now. Then of course injecting via the IV and flushing with saline flushes purchased from medical supply...Additionally, there seem to likewise be limits to what I can metabolize transdermally with the Fentanyl patches....sadly....we've tried adding additional patches...and the pain doesn't decrease any more, as strange as that sounds...I can overlap patches, I can add a 25mcg, a 50mcg, a whatever....it just doesn't matter)

So on to the help requested.....

I have, from the literal years that I have been on these meds, piles of patches of various brands and dosages!

I have 75mcg patches of the Mylan brand.
I have 100mcg of the Mallinckdrodt brand.
I have 50mcg of the Alovgen brand.
I have 25mcg of the Mylan and Mallinckdrodt brand.

It looks like all of these are matrix type patches from what I am able to tell...

I have the absolute MOST of the 75mcg and 100mcg patches, so my preference is to use them for any of my extraction purposes!

I have pure methanol (laboratory / research grade), and I have ethanol in the form of high quality drinking alcohols, which as I understand it, both of which Fentanyl is soluble in. Also, as I understand it, while methanol is highly evaporative, it's also highly toxic, and makes it somewhat "iffy" for making the Fentanyl something you're able to put into your veins...

I also understand that the chemistry recommends citric acid in order to create Fentanyl Citrate. I have citric acid (food grade) as well.

It is my understanding that I could, and potentially should use ethanol to extract this most effectively for IV usage. These are matrix patches. As there are differences between the brands, which one would I have the most success with? Should I cut them up? I know CERTAIN brands of the matrix type can be taken apart (I have some of my used 100mcg, to experiment on, and for the life of me, I haven't been able to separate any of the layers...but...I suppose I could keep trying?).

What is the most effective way that I can extract the most Fentanyl from (preferentially 75mcg or 100mcg) some of these patches, and, I'm going to make the assumption that it is a COMPLETELY extraction, perform an IV injection of (to test, 10, then 20, then 50mcg, finally perhaps up to 100mcg) Fentanyl, exclusively for PAIN RELIEF reasons? I stress that I am opioid tolerant already, wear Fentanyl patches daily.

Spoiler: Possibly triggering statements hidden

It's 100mcg q48hr, and there are times that we have a single patch on, there are times we overlap patches, there are times, we just say "screw it", and leave them on for days, and forget and realize "oh" that I've for 4 or 5 of them on still, and none of it matters, sadly....there just seems to be an actual limit to what I can metabolize transdermally, and what I can metabolize orally....

Honestly, I know this seems irresponsible, but, please don't feel that way. The first time we forgot to remove a patch when putting one on, early on when I was wearing them, we realized that I was wearing two patches about 8-10 hours in, and went to the EMERGENCY ROOM.

Needlessly as it turns out.

The hospital itself ended up doing this to me about 6 months later. A nurse neglected to remove the old patch when replacing the new one. It's when we discovered that I just couldn't metabolize enough. So we would sometimes overlap patches to try to prevent the "withdrawal" type effect. This led to overlapping them for 1-2 days to try to get better pain relief, to forgetting to remove them entirely (while having Naloxone on-hand ALWAYS), to having 3-4 of them on at the same time, to realizing that it didn't really matter whether I had 1 or 4 on, the pain relief was the same. I could take all of them off and go to the hospital/doctor or for days....it just didn't matter.

Same with the Dilaudid. I could take 2-3 2mg tablets. Or I took 7-8 2mg tablets. The effect on pain was identical. I once tried to take 10-11 2mg tablets because very early on, I foolishly tried to do something physical when I was adjusting to my injuries. I was literally shaking with pain and thought it might help. It did not. There was no difference. But we found that if I space out the tablets over the course of 30-45 minutes, it can help.

¯\_(ツ)_/¯

To this day, I've never been "high" from any of these meds. Don't even know what it feels like. No "elevated mood", no "giddiness", nothing. Just barely touching the extreme chronic pain from crushing my spine and my body in ways that the human body barely survives.

The only substances I've ever found to be psychoactive were alcohol ("Wine makes the heart merry") and ketamine (yay for that). Not THC, nor any Opioid.

If anyone can help me extract the Fentanyl from these patches to be in less pain, and as safely as possible, I would be DEEPLY grateful!

 

[TheAcetylationGame]

So I’ve only had the patches once but when we used them for IV I believe the method we used was to cut up an adequate dose from the patch by dividing the total fentanyl content of the patch by our desired dose to get the amount of doses in a patch and say for example if you got three doses out of a patch, cut it into thirds and you want to put the piece of patch in a spoon with a small amount of citric acid and a syringe full of water and heat gently for a min or so and then throw a cotton in there and draw up the liquid to inject or plug or whatever, I believe you could get a little bit more out of there by repeating the process again but it seemed to quite effectively draw out the fent into the solution

I would be very careful tho, I was and am a long time opioid addict, doing this could very easily result in you having to much and ODing if you do not calculate your dose properly, the patches are designed to release a large amount of medication but over a prolonged period

 

[CharsScars]

So I’ve only had the patches once but when we used them for IV I believe the method we used was to cut up an adequate dose from the patch by dividing the total fentanyl content of the patch by our desired dose to get the amount of doses in a patch and say for example if you got three doses out of a patch, cut it into thirds and you want to put the piece of patch in a spoon with a small amount of citric acid and a syringe full of water and heat gently for a min or so and then throw a cotton in there and draw up the liquid to inject or plug or whatever, I believe you could get a little bit more out of there by repeating the process again but it seemed to quite effectively draw out the fent into the solution

I would be very careful tho, I was and am a long time opioid addict, doing this could very easily result in you having to much and ODing if you do not calculate your dose properly, the patches are designed to release a large amount of medication but over a prolonged period

Thank you for taking the time to reply.

It was my understanding that the fentanyl was only loosely water soluble?

Would this method need more like an ethanol such as vodka which would then be of course 60% water and 40% ethanol to bond with the fentanyl?

My only concern of course is that, do I boil it off or let it evaporate?

If I’m working with a 100mcg patch, that’s ~10-11mg of fentanyl per patch.

It’s somewhat difficult to cut the patch up into 100 pieces of equal size. Even if that is an incredibly tempting way to try it. Certainly 200 pieces if I wanted 50mcg doses.

I’m not really sure how to proceed.

 

[TheAcetylationGame]

Thank you for taking the time to reply.

It was my understanding that the fentanyl was only loosely water soluble?

Would this method need more like an ethanol such as vodka which would then be of course 60% water and 40% ethanol to bond with the fentanyl?

My only concern of course is that, do I boil it off or let it evaporate?

If I’m working with a 100mcg patch, that’s ~10-11mg of fentanyl per patch.

It’s somewhat difficult to cut the patch up into 100 pieces of equal size. Even if that is an incredibly tempting way to try it. Certainly 200 pieces if I wanted 50mcg doses.

I’m not really sure how to proceed.

well if I recall correctly the addition of the citric acid was to modulate ph in order to increase solubility. Yeah my tolerance was such that I didn’t need to cut the patch up into many pieces. I’d wait until you can get some more info from someone more familiar with the patches tbh

 

[CharsScars]

well if I recall correctly the addition of the citric acid was to modulate ph in order to increase solubility. Yeah my tolerance was such that I didn’t need to cut the patch up into many pieces. I’d wait until you can get some more info from someone more familiar with the patches tbh

Ah! Understood.

I’ll do more research. From my chemistry class, the citric acid should create Fentanyl Citrate which is a slightly “heavier” molecule. And of course what they use for injection ampoules as well. As compared to the patches which are not the Citrate form. But that was my understanding.

 

[CharsScars]

I’m looking for anyone else who may have any input.

I’m planning to examine my two different brands of 75mcg patches and see which one would be easier to cut into smaller pieces not including the potential non-medicinal border area.

With that having been said, after that, assuming I’m able to cut it into a piece or pieces that I can estimate the rough dimensions and/or dosage then I would assume that I should be able to “boil” this in ethanol (let’s say 40%, vodka? Should I try to get a lab ethyl alcohol of 100%) and perhaps citric acid to extract the fentanyl and form fentanyl citrate from the patch?

Am I expecting a liquid or a powder at this point?

I do have methanol but I still want this for IV injection. As I understand methanol would result in a potentially toxic reaction that would be more harmful to inject, even if it is easier for pulling the fentanyl into solution without boiling and then it simply evaporates…

Any advice is still very welcome!!