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!!

 

[CharsScars]

So…

I’m reporting back on something that I’ve done since this many times.

However, I no longer do, as I suspect minor vascular damage. Among other possible complications that mercifully I have avoided.

I cut a patch into pieces depending on the size that work out to be approximately 1mg.

I’ll then take a sterile syringe and place the patch piece inside of it. Once done, I’ll draw high proof vodka into the syringe (though I have considered 100% ethanol). Up to the 10ml mark.

This sits to absorb and extract the medication.

After shaking well to distribute the medication evenly in the liquid, I’ll take a 0.22um wheel filter to push 1.0ml into a new syringe.

Afterwards, I’ll add 10ml of sterile saline (saline flushes ordered from medical supply), for dilution.

I have then injected this. There’s a very slight burn, but compared to intravenous potassium, ha. My arm was about to get torn off by me to stop the potassium drip pain.

However, what I can’t tell, is if it was successful at extraction. I wish I had chemical testing to verify!

I’m very likely pass the metabolism limit for fentanyl by actually wearing the patches because nothing changes. No decrease in pain, and no mental changes.

I’ve even waited a reasonable amount of time (for safety, more than 15 minutes) to confirm it wasn’t slow to take effect. Then used more.

I think my body is truly broken. I’m in agonizing pain and even the medications meant to help with that seem to have caps on how much they can help.



Does anyone anyone anyone please have any suggestions on how to better extract medications from these patches?

 

[LucidSDreamr]

I’ve explained in many past posts how to extract and inject the mylan patches. If you use the search function.

But let me tell you….its a waste. 3 hours of very heavy pain relief vs the 48 hours of moderate pain relief you get by wearing them.

Wearing them is the way to go. Heat them with a heating pad if you need a boost of dose at any one time .

 

[LucidSDreamr]

So…

I’m reporting back on something that I’ve done since this many times.

However, I no longer do, as I suspect minor vascular damage. Among other possible complications that mercifully I have avoided.

I cut a patch into pieces depending on the size that work out to be approximately 1mg.

I’ll then take a sterile syringe and place the patch piece inside of it. Once done, I’ll draw high proof vodka into the syringe (though I have considered 100% ethanol). Up to the 10ml mark.

This sits to absorb and extract the medication.

After shaking well to distribute the medication evenly in the liquid, I’ll take a 0.22um wheel filter to push 1.0ml into a new syringe.

Afterwards, I’ll add 10ml of sterile saline (saline flushes ordered from medical supply), for dilution.

I have then injected this. There’s a very slight burn, but compared to intravenous potassium, ha. My arm was about to get torn off by me to stop the potassium drip pain.

However, what I can’t tell, is if it was successful at extraction. I wish I had chemical testing to verify!

I’m very likely pass the metabolism limit for fentanyl by actually wearing the patches because nothing changes. No decrease in pain, and no mental changes.

I’ve even waited a reasonable amount of time (for safety, more than 15 minutes) to confirm it wasn’t slow to take effect. Then used more.

I think my body is truly broken. I’m in agonizing pain and even the medications meant to help with that seem to have caps on how much they can help.



Does anyone anyone anyone please have any suggestions on how to better extract medications from these patches?

You could slightly improve on this extraction method but by shooting and smoking these patches you blow through the whole script within two days.

Then you’ll have nothing.

It’s not gonna work…what will you do when you run through a month supply in a few days?

Maybe high dose methadone from a methadone clinic might be better.

Wearing a 100 mcg patch is no where near as opiated as 200 mg methadone per day some of the addicts get. So it might be better analgesia. Methadone is way harder to kick than fentanyl but not sure if that matters to you.

What about just wearing multiple patches?

 

[Them Witches]

I can identify with you. I have been on Rx opiates/opioids for 38 years. Do you have a PICC line or a Port to infuse with ?

At your stage in the game, it is time to take Clonidine with your pain meds. I have been on Clonidine for 25 years. It is strong and is hard to get past 1.2mg out-patient. The IV formulation hits differently & is very sedating. It is used in pain management and with cancer patients were the narcotics have lost their effectiveness.

I am not trying to poop on your program but Fentanyl patches are junk for opioid tolerant patient with chronic pain syndrome even at 48hrs. I have had them and absolutely hate them. They same with Dilaudid orally. It is only Oxycodone HCl 30mg's and Methadone 10mg's for me because both of them high oral bioavailability and both store in the system very well.

If you are using your PICC line or PORT to convert PO tablets, tell your doctor that the Fentanyl patches are not staying stuck "it must be the oil on my skin." Get either Oxycodone 30mg, Oxymorphone 10mg, Methadone 10mg to add to the Dilaudid.

 

[CharsScars]

You could slightly improve on this extraction method but by shooting and smoking these patches you blow through the whole script within two days.

Then you’ll have nothing.

It’s not gonna work…what will you do when you run through a month supply in a few days?

Maybe high dose methadone from a methadone clinic might be better.

Wearing a 100 mcg patch is no where near as opiated as 200 mg methadone per day some of the addicts get. So it might be better analgesia. Methadone is way harder to kick than fentanyl but not sure if that matters to you.

What about just wearing multiple patches?

I have lots of extra patches at the moment after being on them for so many years. Between the 100mcg and the 75mcg, I have probably 25-30 of each extra. And keep in mind, I’m only trying to get the pain relieved. Not get high. I couldn’t care less about that.

Right now I’m on 2 x 75mcg every 48hrs for 150mcg, and I’m ALSO on hydromorphone which has gone up from 2mg to 4mg. And that went from every 4hr to 1.5 tabs every 4hrs. I’m still in pain.

I have osteomyelitis and I have compression fractures and bulging/herniated discs as well as nerve root compression. My dosages were stable for many years but they keep escalating and nobody has any answers.

I have considered asking for methadone instead as I’ve heard that it has potentially better pain management. I really don’t know what to do about it right now.

Occasionally I get ketamine from a reliable plug and test it with reagents EVERY SINGLE TIME. I usually use that intramuscular but occasionally intravenously. With help.

I’ll look for your post.

Does the same apply for Malinkdrodt brand too?

 

[CharsScars]

I can identify with you. I have been on Rx opiates/opioids for 38 years. Do you have a PICC line or a Port to infuse with ?

At your stage in the game, it is time to take Clonidine with your pain meds. I have been on Clonidine for 25 years. It is strong and is hard to get past 1.2mg out-patient. The IV formulation hits differently & is very sedating. It is used in pain management and with cancer patients were the narcotics have lost their effectiveness.

I am not trying to poop on your program but Fentanyl patches are junk for opioid tolerant patient with chronic pain syndrome even at 48hrs. I have had them and absolutely hate them. They same with Dilaudid orally. It is only Oxycodone HCl 30mg's and Methadone 10mg's for me because both of them high oral bioavailability and both store in the system very well.

If you are using your PICC line or PORT to convert PO tablets, tell your doctor that the Fentanyl patches are not staying stuck "it must be the oil on my skin." Get either Oxycodone 30mg, Oxymorphone 10mg, Methadone 10mg to add to the Dilaudid.

I found that I had morphine ER and it was the only other thing that was “ok”, otherwise I was chasing the rollercoaster of pain. The patches give me a baseline but the tablets are for breakthrough. We’ve had a patch come off without me realizing, and wow was the screaming bad. I was ready to die.

I had clonidine patches to try it, and SEE if it worked to help opioid induced hyperalgesia, but I noticed no difference. Are you suggesting that the IV version is better than the patches? How often is it infused? I had a midline a few months ago but it’s gone now. I put in IVs a few times a month but find that for some reason, they cause a superficial thrombophlebitis every single time. And usually like clockwork within about 2-4 days. They don’t do that in the hospital for some reason even though I don’t take heparin or blood thinners (except for some times), but still I have never been able to figure out why my home IVs do this and the hospital IVs don’t! We use the same brand of IV catheter and extensions, saline flushes, etc. But it still happens.

I’m trying to find an excuse for a PICC. I’m on oral antibiotics for the osteomyelitis I’d like to go back to IV.

And the most comfortable I have ever been was in the hospital recently a few months back. I was on a PCA. It was a very high dose of Dilaudid but I was comfortable. It was 1.0mg constant over an hour, and 0.5mg every 10 minutes, thus 4mg per hour IV (I didn’t have to push it but I could). Aside from some bugs replacing the syringe when it was going to be empty, I was comfortable. I want to try to get a PCA at home to use as needed via palliative care.

Honestly, I’d much rather figure out what’s wrong with me and not have any meds whatsoever.

But that’s the dream.

 

[LucidSDreamr]

I have lots of extra patches at the moment after being on them for so many years. Between the 100mcg and the 75mcg, I have probably 25-30 of each extra. And keep in mind, I’m only trying to get the pain relieved. Not get high. I couldn’t care less about that.

Right now I’m on 2 x 75mcg every 48hrs for 150mcg, and I’m ALSO on hydromorphone which has gone up from 2mg to 4mg. And that went from every 4hr to 1.5 tabs every 4hrs. I’m still in pain.

I have osteomyelitis and I have compression fractures and bulging/herniated discs as well as nerve root compression. My dosages were stable for many years but they keep escalating and nobody has any answers.

I have considered asking for methadone instead as I’ve heard that it has potentially better pain management. I really don’t know what to do about it right now.

Occasionally I get ketamine from a reliable plug and test it with reagents EVERY SINGLE TIME. I usually use that intramuscular but occasionally intravenously. With help.

I’ll look for your post.

Does the same apply for Malinkdrodt brand too?

I never had nakinkrodt only mylan

 

[Them Witches]

I had clonidine patches to try it,

The tablets are what you want. They are IR and direct, so direct they can be taken on a full stomach & still work 100%.

Clonidine patches are available containing 2.5, 5.0, or 7.5 mg clonidine, which are designed to deliver 0.1, 0.2, or 0.3 mg/d of clonidine for 7 days, respectively. So the top daily dosage on the patch is 0.3mg. I have the 0.3mg IR tablets and take 3-4 daily which would be 3-4 days of the strongest patch in 24hrs.

I like (400 MME) Morphine ER 200mg twice per day. But would rather have (380 MME) Oxycodone HCl 30mg x7 and Methadone 10mg x 4 daily. The ER/CR versions have lower blood plasma levels compared to IR @ 4hrs. This is why I like the Oxycodone HCl 30mg & Methadone 10mg b/c I am basically dosing something every 2hrs with Clonidine every 6-8hrs.

However, having Methadone allows for some room to work a custom program. Another words, SWIM could take Oxy 90mg, Clonidine 0.3mg, and Ativan 1mg to start the day. 4hrs later take Methadone 40mg. 4hrs later take Oxy 90mg with Ativan 1mg. Bedtime Clonidine 0.6mg, Vistaril PAM 200mg, Lunesta 3mg, and Benadryl 200mg.

I would suggest getting Clonidine HCl tablets, Vistaril PAM 50mg-100mg every 6hrs, Adding a Benzo like Ativan will help make the opioids stronger. Taking Lunesta at night makes the morning dose of opioids stronger.

 

[emkee_reinvented]

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?

Without any knowledge on the actual question, from making plant extract s.
I know some liquour stores sell 96 % drinkable [when diluted !] Ethanol.

Will be a bit of a search online, depending where you live. But over here,
only one liquor store sold it. And Pharmacy s, but these let you pay for it.
While in the store it was about as expensive as any likewise amount Ethanol.

A very reasonable price i recall. Cheaper then top brand s Booze.
Feel very shitty for your condition. And finding out your body has some sort of ceiling with certain drug s. Which is weird, no idea if it is common.

I only had OxyCodone once, prescripted Opiod s and thought it was a very good med for the purpose. My only experience with Kratom for Dental procedures.
And the occasional gifted Tramadol, later the RC o-DSMT. Which kinda matches strong painkiller s. But you probably already have taken OxyCodone too ?

Not that i have anything against IV, i have a Needle phobie. Picked up in my youth.
So even the consideration to me, seems people really desperately need it.
Nobody pokes a needle in a vain for fun the first times. I d shit my pant s.

Proble seem s to be injecting Fentanyl or HydroMorphone not ment for IV.
Is there any chance this would something you could discuss with your dr ?
To prescribe inject-able s, and as result reduce the harm.
Of IV-ing tablet s and patches.

No clue if and too what degree its dangerous ? But in general its dis-advised.
You seem very thorough, and in a state of pain you feel you need it.
As dr. i would prescribe inject-able s, or search/ offer other option s.
In theory, as sadly it don t work that way in everyday live.

Is that optional ?