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Suggest Ways To Manage Pain While On Fentanyl And Hydrocodone

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Posted on Fri, 4 Sep 2015
Question: I have been taking 600 mcg fentanyl pops 4 times a day and on an 50 fentanyl patch for 15 years . There is a back order on the pops from the maker and the Dr. Upped my patch from 50 to 75 mcg and put me on hydro codon pills 10mg 4 times a day . I am petrified. I'm already hurting extremely bad and can't hardly stand myself . What is going to happen to me? My body is so addicted to the pops and I'm so scared please advise.
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Answered by Dr. Dr. Matt Wachsman (7 hours later)
Brief Answer:
cannot say in your particular case

Detailed Answer:
but there's several incontrovertible relevant truths. If someone has cancer for more than 15 years it is high time to begin management on the basis that it is not going to be immediately fatal. The fatal dose of narcotics, however, does not rise as much as the tolerance to them.

If someone is having really bad dependence issues those need to be addressed.

Let us start with the good news. Going up on narcotics ends withdrawal. So, if someone were out of narcotics and couldn't get them, the withdrawal peaks in 2-3 days with short acting and 3-5 at most with long acting. At the peak of withdrawal other narcotics lower the withdrawal. Beginning suboxone or methadone will lower narcotic withdrawal issues at that time.

and high dose fentanyl pops with a patch is a high dose. Without changes it is random to say it is going to be a risk of fatality now if someone has been on it stably for many years. And, other sedatives/alcohol or other drug itneractions do not have any safety margin at this dose. And would be a reason to not be on that regimen.

The symptoms of withdrawal can be SAFELY damped down some with clonidine and anti-nausea medications.

So.. going into withdrawal fairly severely with some medications to damp it down some.. followed by switching to a more reasonable dosage or perhaps more wisely switching to a regimen geared toward addiction recovery.

Furthermore, if someone is on a potentially dangerous amount of narcotic, having a naloxone pen is a good idea.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Ways To Manage Pain While On Fentanyl And Hydrocodone

Brief Answer: cannot say in your particular case Detailed Answer: but there's several incontrovertible relevant truths. If someone has cancer for more than 15 years it is high time to begin management on the basis that it is not going to be immediately fatal. The fatal dose of narcotics, however, does not rise as much as the tolerance to them. If someone is having really bad dependence issues those need to be addressed. Let us start with the good news. Going up on narcotics ends withdrawal. So, if someone were out of narcotics and couldn't get them, the withdrawal peaks in 2-3 days with short acting and 3-5 at most with long acting. At the peak of withdrawal other narcotics lower the withdrawal. Beginning suboxone or methadone will lower narcotic withdrawal issues at that time. and high dose fentanyl pops with a patch is a high dose. Without changes it is random to say it is going to be a risk of fatality now if someone has been on it stably for many years. And, other sedatives/alcohol or other drug itneractions do not have any safety margin at this dose. And would be a reason to not be on that regimen. The symptoms of withdrawal can be SAFELY damped down some with clonidine and anti-nausea medications. So.. going into withdrawal fairly severely with some medications to damp it down some.. followed by switching to a more reasonable dosage or perhaps more wisely switching to a regimen geared toward addiction recovery. Furthermore, if someone is on a potentially dangerous amount of narcotic, having a naloxone pen is a good idea.