Opioids About to face fentanyl withdrawals

[Half Price Mice]

My 60 year old mother has been on fentanyl for 17 years. For the past ten years, she has been on 150, changing the patches every 48 hours.
Well, yesterday she went to her PM Dr who told her that this month and next month will be the last time she receives fentanyl.
They are offering her 120 mg of ER morphine instead. They are NOT offering a taper. They claimed that she wouldn't go through any serious withdrawal, but this seems pretty fucking unlikely. I'm terrified for her.

Also, I've been cheeking her used patches for about five years.

I am prescribed 4 15mg IR oxycodone a day, but have found that the oxy doesn't work nearly as well as the used patches. So I use the oxy every other day; I don't even want to be AWAKE on the oxy days at this point.
I expect to get pretty sick myself.

I would love to hear from people who have experienced withdrawal from being on a high dose of fent for years, but I'd also love pretty much any advice and discussion that could be helpful.

There are more details, but I didn't want to make this first post an essay.

I guess my main questions are: how sick will my mother get? Should she try to taper herself in these last two months?

And how sick so you guys think I will get?

If people are willing to offer suggestions and advice, I would like to keep this thread going for the duration of our experience, and also, perhaps, to get my mom to join the forum.
I know this community is full of love and light; I've been lurking for a decade.

Thanks in advance!

 

[herbavore]

I'm going to move this thread to Other Drugs where I think you may get better advice. However, do not hesitate to make another thread here in TDS for support with what you will be going through--both yourself and concerning your mother.

 

[Chris42393]

So if i understand correctly, she is switching from Fentanyl to ER morphine, correct? If so, there should be no withdrawals, if the transition is within the same day (ie. today is her last day on fent and tomorrow is her first day on morphine, for example). There is no point in tapering her off, if shes going to be on another medication. Both are opiates. Hopefully that makes sense.

 

[Larimar]

She will be fine but don't exspect her to share with you any more . Start tapering your self . Good luck

 

[tacodude]

Look into kratom for yourself

 

[Lost_Vet]

I agree that the step from Fentanyl to Morphine shouldn't be a huge deal if its done right. However everyone reacts differently so keep a close eye on her (as I'm sure her Doc will) to see how she responds. I do have a concern about you. I detoxed from 200 mcg daily to none and it wasn't easy, although possible. I highly recommend you taper starting right now. Also, I highly encourage you to read Tacodude's post on Kratom. When I thought I couldn't go any longer, Kratom pulled me through it. Good luck and good thoughts sent your way. Stay in touch.

 

[losangeles1993]

Start the taper right away with what you have left and what you will get next month...it should make the withdrawls a lot more easier ...still bad but not as bad...

 

[Chronicpain54]

See, I disagree with you guys. As a member of a pain clinic that played "Every 3 or 4 months we will completely change your medicine and there's nothing you can do " club, I can say with almost certainty that grandma's body will not handle a change from 150 mcgs patches of Fentanyl changed every 2 days to 120 mgs ER of morphine well AT ALL. That is a huge difference. Yes, she will get pain medicine but it's a joke compared to Fentanyl.

At one time I was on 50 mgs of Methadone, 75 mgs of IR oxy, 50 mgs of Norco, 4 Soma a day and Lyrica. I have a tolerance. Switching me from fentanyl to morphine was cruel because I felt no pain relief but serious withdrawal. I ended up leaving that clinic because I was a guinea pig, not a human.

My only suggestion is that you have your mother wear her patches 3 days instead of two and lengthen the time between changing patches until she is struggling. She's on a high dosage. That should at least allow her to build up some extras. Then she can take 60 or 80 mgs of morphine ER while wearing a patch for 4 days until she can get weened down. Fentanyl is a b*tch and I hope I'm never put back on them unless nothing else works and I'm confident I won't get changed again.

Or...if they want to change her to 120mgs morphine then at least give her a break through medicine. It's almost an inhumane change of meds with no help until she gets used to it.

Pain Doctors are told that all patients should be put on the equivalent of 200 mgs of morphine a day. They could give her an IR med without going over 200mgs.

I know all this because my doctor told me about it when it happened and has spent 2 years lowering my doses. I still exceed the minimum of 200 mgs/day because Methadone is 8 to 1 on their charts. Oxy is 1.5 to 1 so she could get 60 mgs of IR a day, or 80 mgs of IR morphine with the ER version.

You should cut your usage of Fentanyl way back now. You have 2 months but your mom needs to keep her patch on 3 days or a little longer so it's less for you to use. Find a way to make your medicine work. Ask for gabapentin and a low dose benzo.

Having a tolerance to Fentanyl when it isn't prescribed to you is scary. Taking huge doses for 10 years like your mother has is nightmarish and may end up with her being so sick that she'll require the hospital.

 

[finis]

Your mom should ask for immediate release Tramadol for break through pain since Tramadol is not figured into the morphine equivalencey. She should also ask for tizanidene muscle relaxers, and Temazapam for sleep. You did not say what type of pain she endures but if it?s arthritic everywhere like mine Arthrotec, an old arthritis drug, is excellent, Voltaren Gel is the same med in a topical if stomach problems occur. All of this would be true for you also if your pain in arthritic. Do Not ever take Lyrica. I was prescribed this drug when opioids reduced and the side effects were horrid. I have just completed withdrawing from Lyrica and was it the worst I?ve experienced. My heart goes out to both of you.

 

[Hodor]

Your mom should ask for immediate release Tramadol for break through pain since Tramadol is not figured into the morphine equivalencey.

Tramadol carries a risk of seizures, especially in people with a decreased liver function, or who are on other meds that inhibit their liver enzymes (both are pretty likely for an elderly woman). Furthermore, a slower metabolism of tramadol also decreases its conversion to its active metabolite, meaning she will need an even higher (and potentially even more dangerous) dose to get sufficient pain relief.

 

[Chronicpain54]

I agree. She would need large dosages of Tramadol to even hope it would work, which could be really bad for her. You could call the doctor on your mother's behalf and ask that he add some breakthrough medicine to her new script if he doesn't want his ass sued. Or take your mother to the doctor's office about 5 days into her nee regime and let him see what he's doing to her fragile body.

 

[mostly-human]

Honestly, through my extensive history, I believe she'll be fine.

 

[Jabberwocky]

It is possible to find another pm doctor who will be more humane in the transition off fent?

 

[Half Price Mice]

Honestly, through my extensive history, I believe she'll be fine.

I guess everyone is different. i REALLY want to believe that she'll be fine. but i myself switched from 50mcg fentanyl changed every 72 hours, to 100mg of norco, and it was pretty damn rough. Keep in mind that she's on 150mcg and has been for over 15 years. have you switched from something like fentanyl to something like MS Contin with no ill effects?

@Larimar ?
@Chris42393 ? have you guys had any experience with this sort of thing?

 

[Half Price Mice]

It is possible to find another pm doctor who will be more humane in the transition off fent?

There is one other doctor in the area, but he won't see her.

Sorry for double posts. Is there a way to "mention" a user in a post so that he or she gets a notification so as to continue the converation?
And can someone explain to me how to multiquote?

My mom just picked up her last prescription; i've been trying to get her to start tapering but she still hasn't done it.

As far as Kratom: i will still be on 15mg of oxycodone 4 times a day; i just won't have the used fent anymore.
Will Kratom work in conjunction with oxy? i was under the impression that your receptors needed to be free of opiates for Kratom to do much.

Here is another question i'm wrestling with: should i ditch the pain dr and try going to a suboxone clinic?
I have a problem where i have a serious affinity for opiates, but am also legitimately in a lot of pain. i broke my back in five places about 3 years ago-compression fractures.
I like the used fent because i can make it last for a good solid 24 hours. I take the fent the days that my mom changes it and oxy on the off days, but i am miserable throughout all but a few hours of the off days. i guess what i'm saying is that aside from pain issues, i just flat out do better on opioids. i was on sub, for instance, for a couple of years, and they were the happiest, most productive years of my life.

So the idea of being on, say, 12mg of suboxone sounds appealing. Those of you with experience in such things: would you rather have the sub or the 60mg of oxy?


edit: ok, i'm REALLY sorry for the double post. i just saw the rule against bumping. it wasn't my intention; rather, i just wanted to respond to multiple posters. i will not do it again.

 

[tacodude]

Don't ditch your pain doctor.... I honestly got little relief from bupe. I found oxy nasally to be a lot stronger than any ROA, but that send to just be me. I would always end up nodding off small doses though that I would barely expect to feel.

 

[Wrongguy]

Gezz... Referring to the OP mother as elderly and then also frail. I don't think 60 classifies someone as elderly. As to the frail, I don't think we have enough information to determine if that's the case whether she has been on these medications for years for legitimate reasons.... Sorry I just had to say it...

Anyways... Others have more experience in this than I do but when switching from one med to the other when know effects my be coming its best (in my book (not a real book), keep in mind my book has no sources listed or fact checking done..... ) its best to do what you can to curve those effects should you get them.

So for this, as others have said, a cut back on the fent to prepare for the switch would be advised. Switching meds is always a little rough especially if the new one doesn't work as good as the other for an individual. The size of the cut would depend on meds and the equivalentcy of the two.

 

[Half Price Mice]

Don't ditch your pain doctor.... I honestly got little relief from bupe. I found oxy nasally to be a lot stronger than any ROA, but that send to just be me. I would always end up nodding off small doses though that I would barely expect to feel.

so you're saying that, for sure, you think 60mg of instant release oxy is better than 8-12 mg of suboxone?

i was on suboxone for a couple of years and it was fucking great; they were the best years of my life.
BUT, i was kind of using it off-label.
i was drinking a liter of liquor a day back then and i was dying.
The suboxone got me pretty fucking high at first, and OBLITERATED my alcohol cravings. it saved my life.
it also seemed to work wonderfully as an antidepressant.

That being said, i didn't have an actual opiate habit at that point.

Jesus, guys. I'm starting to get scared.

 

[Half Price Mice]

Just an update: it has taken much, much longer than we thought for my mom to lose the fent.

This is because they decided to switch her to a intrathecal pain pump and have been fighting the insurance company about it.

They have approved the trial. Meanwhile, i've managed to save 120 oxycodones.

Does anyone have experience switching from fent to pump?

 

[Val21]

As a chronic pain patient of 12 years and counting. I can only speak for myself but I went from 50 mcq of fentanyl to 25 and now 12. I suffered withdrawals and a huge increase in my bone pain. I went from being functional to bed bound. And this is with oxycodone 90 mg a day for break threw. I’m now being reduced again. I would suggest to your mom that she try’s to start tapering herself down before her doctor cuts her dose so drastically.