Fentanyl Abuse New Article!

Many people are concerned about using this drug, and we have had many posters talk about wanting to abuse these types of meds, so I just wanted to share this article with everyone. {link removed due to being invalid}

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How sad.

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I used the patch for two years properly yet had withdrawal or overdose symptoms frequently when changed to a generic form. I suffered greatly and the doctors had no idea what was wrong. I found out from internet what was happening to me.There is the misconception that only misusers are having problems. I followed procedures correctly and only had trouble with gereric forms. They would release too much or none.

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I have taken this medication responsibly for six years. I have numerous fellow chronic pain friends who have taken it responsibly and successfully. If addicts chose to ignore the very serious warnings, they shouldn't be surprised with the results.

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Well, it really doesn't matter if you abuse it, or use it as prescribed, either way, anything that you take or use regularly, for a long period of time, will cause withdrawal symptoms if you suddenly stop taking or using it.

And yes, even the generics can cause it, because the FDA does allow them to differ by as much as 20% plus or minus in the active ingredient from the name brand, so if you were using the name brand for so long, then switched to a generic that has less of the active ingredient, as they are allowed to do, you can experience withdrawal symptoms.

So it is not just those that abuse that suffer, even if you have never used it other than as prescribed, if you suddenly get a lowed amount in your body, or stop using it altogether, you will experience some physical withdrawal effects.

The basic difference is, since you aren't abusing it, you do not have the mental addiction that adds to the withdrawal problems, and your duration of suffering from it will be much shorter.

But you can become dependent on anything, from your morning coffee to an orange you eat every day at lunch, and if it is suddenly taken away, your body will react to it and have some withdrawal effects.

And sjf, yes, I agree with you, for those that abuse, then come on and complaing about their suffering, well they asked for it and have gotten no more than what they should have expected from their behavior.

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Point well taken. It doesn't take a long time to become accomodated to most opiates, particularly the stronger ones. This is one of the reasons doctors do not prescribe them loosely.

On the other hand, if one is living with and attempting to live productively with chronic/intractable pain, the opiates are often a part of pain mgt. program. We must become well educated concerning our meds. and we can't depend on the docs to do a good job of that.

sjf

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LOL! I well know that, I don't trust my doc or pharmacist to keep me well informed on anything, it was that distrust and the research that I learned to do on my own, which lead me to ending up with a job like this. LOL!

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I made that remark with all due respect for the docs that do their best to stay on top of things. I am blessed to have a gifted pain doc who keeps me moving and we keep eachother informed of whatever information becomes available. Not everyone is that lucky.

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I know what you mean, I adore my doc as well, she is open minded enough to realize that she has no experience with my condition and I often know more about it than she does, but many docs get the god complex going, they think they know it all, or if they aren't familiar with it, it can't exist and you are making it all up.

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Fortunately, mine is not afraid to admit to total confusion. That's a good first step and one I can deal with.

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Yep, I can understand that, much better than the docs who get that god complex and just refuse to believe all your symptoms or pain levels.

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I don't think you can beat the darn surgeons for super god complex status. I am scheduled for spinal surgery (number 8) on the 28th. This is part 2 of a little (?) project that was started in May. My spine started popping and cracking over the weekend and the pain is out of control. Of course, I call Pain Man first as the surgeon is 2 1/2 hours away and Pain Man is my first line of defense. He is alarmed and says to call the surgeon ASAP. The surgeon evidently has god like vision and knowledge as he say I am fine because there is no incontinence.............just stay in bed until the surgery. These Big Boys that operate out of the super hospitals give me a pain that Fentanyl will never touch.

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I actually lucked into a very honest and forthright specialist that my doc's office sent me to, when pursuing my various treatment options, including surgery.

He show us my x-rays and explained that to straighten my spine, because scoliosis is just one of my problems with my back, they would have to fuse from the 3rd verterbrae in my neck all the way down to my tail bone, he also said it would take about 18 months of recovery time, half in the hospital and half at home, then he freely admitted that it would not help with my pain, my mobility, or enable me to work, so it would purely be a cosmetic procedure, therefore not worth it.

Anyway, gee, yead, nice doc, he can diagnose you right over the phone, wow, talk about being good at what you do.

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This remark does not refer to Fentanyl, but to the moderators mention of the 20% (plus/minus) difference in generics to brand name. I take Ativan (1/2 to 1 @ 0.5mg per day) to help prevent seizures and the anxiety related to having seizures. If I switch to the generic (Lorazepam), which of course is so much cheaper, I have withdrawal symptoms and don't feel well at all. Thank you so much for that information! I have been trying to figure out the problem for years.

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You are very welcome, I am glad my information was able to help you, even though it is just in a small way.

This is why I do not hide what I have learned and only provide honest information that can be confirmed.

You are not the first person I have run into that had problems when they switched to generics, and then say there wondering why, since your docs and pharmacists all claim they are exactly the same.

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Exactly! The pharmacists @ Walgreens have always insisted that there is no difference, so I switched pharmacies and just have to be very sure I always receive the brand name. Due to the volume of drugs on the market, this information needs to be out there, especially to those that are unable to respond at a given time or those that don't/can't use the internet! Thank you again!

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The pharmacists and doctors, by law, are not allowed to tell you the truth about prescription drugs, as per FDA regulations. They claim that their reasoning for this, is because they don't want to scare people away from taking needed meds, but I think this is a bunch of bull.

To maintain their licenses to practice, the docs and pharmacist have to tell you that the generics are identical. They are deliberately instructed to lie to patients about it, even if you walk in with the proof in your hands, such as a law book listing this information or the law and info printed from the internet, they are not allowed to discuss the issue with you and admit it is correct.

Now how ridiculous is that? They also reason that this lets generic drugs be made cheaper and gets them on the market faster, but still, it is far to dangerous of a practice and it should be stopped.

Arguments are made, that the 20% difference is not significant enough to make much of a difference, but as you found out for yourself, with some meds, when you were used to taking the name brands, which do have to be 100% of the active drug, then you are suddenly given a generic that only has 80% of it, you can suffer withdrawal.

Some meds, such as Warfarin, have to be so carefully calibrated to make sure the person is on the correct and most effective dose for their condition, that a sudden switch to a pill made by a company that takes full advantage of being able to have 20% less in their pills, could be disastrous.

I had posted this info on another site, many people there thought this 20% difference applied only to the inactive ingredients, so I went and hunted up the articles, info, and the link to the law that allows them to do this, recently I was also discussing it with someone else on this site, and I copied and pasted that information on here, and I am going to do so again, so you can read the info for yourself, and save it for future reference if needed.

But like I said, you will never get your doc or pharmacist to admit it, if they want to keep their jobs and continue in their careers, they can't.

Nothing like a major gag order, huh?

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Some people have disagreed with me when I explained about the 20% plus or minus difference that the FDA allows for generic drugs, some have insisted this was only for the inactive ingredients. So I have done some more research on this subject, and NO! the 20% difference IS NOTjust limited to the inactive ingredients.

Here's an article with some information, and the name of the law that allows this:

http:/­/­counsellingresource.com/­medications/­discount-drugs/­generics.html

***Are There Any Differences Between Generics and Brand-Name Drugs?

...it should be noted that current regulations permit a variation of up to 20% either way in the bioavailability of the active ingredient. (See this Food and Drug Law Institute overview of the Hatch-Waxman Act of 1999.) In one study (Borgheini 2003), a 31% variation was found in the blood plasma levels of a particular medication after a patient switched from a branded to a generic product. (Why does this happen? It may be accounted for by differences in the manufacturing process yielding different particle sizes that are absorbed at different rates, as well as other factors.) ***

So yes, this gives them a leeway of 40% on manufacturing these drugs, they can be significantly different than their name brand counterparts, and in some cases the effect can mean a drug doesn't work at all, or may have too much of the active ingredient, resulting in serious effects or even fatalities!

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Here's the overview of the law in question that allows these differences:

http:/­/­www.fdli.org/­pubs/­Journal%20Online/­54_2/­art2.pdf


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For some of you, I know this will be a relief as you can now know for sure that if a generic seems to work different, it is not all in your head. Simply said, poor quality control and poor testing, means poorly made drugs from some companies.



[email protected]

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I originally became suspicious several years ago, when I first went to the doc about my spinal pain and problems. As I got older, it was getting worse and worse, and I finally had to face that fact that I had to see someone about it.

Anyway, while sending me for various tests, like x-rays and MRIs, and to several specialists to see if there was anything we could do about it, they gave me a mild narcotic pain killer, and back then, my pain wasn't that bad, so the Darvocet handled it well. I mean this was over 7 years ago.

In the town we used to live in, I used Rite-Aid for all our drugstore type needs, they were only a block and a half from our house, so very easy for me to pick up scrips, didn't even have to move the car to get there. The brand they gave me was fine, I never had any trouble. I can't remember, after all this time, who the manufacturer was, but they were always pink pills and worked fine.

Then, while we have his SSDI to live on, my husband decided it was a great opportunity for him to go to college, since he wouldn't have to worry about studying and working at the same time. Anyway, the Ride-Aid here is just awful, so we had to switch to Eckerd. The Darvocet I got there was different, large white ovals, instead of pink, and it was just hideous to use.

Out of the same bottle, I could take a pill, and be fine, worked and no problems, then another dose wouldn't work at all, no effect, like I took nothing, then another dose would make me so sick and I would show all the symptoms of overdose, because it was hyper-potent.

At first, I thought it was just me, but then my husband had a scrip for some when he had a tooth pulled, the dentist gave him Darvocet of the same dosage, and he had the scrip filled at Eckerd, surprise, surprise, he had the same problem.

I also began to read posts online, and talked to friends, who all had similar complaints and all were about a generic form of a medication, so I started hunting to see what I could find out, and I sure learned a lot.

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Both my pain doc and primary are very specific that they do not want their scripts filled with medication produced by a certain manufacturer. I am fortunate that I do business with a wonderful small town Mom and Pop pharmacy whose pharmacist is very customer oriented and will not carry the generics that are notoriously inconsistant.....and they certainly are out there.

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Oh yes, they are, if you do a search online, you will find message boards very easily where people are posting, and you only have to read a few to see which companies have the worst products.

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So this is your job?

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sjf and Verwon (sp?) let's see...this was posted in 2006 and wow, how things have changed with these patches...but the generics are coming in altered amounts, fall off too easily...so everyone wants Duragesic and the drug co. wants more than medicare or medicaid will pay, so you can pay the diff or go generic...it is really sad...in a 31 day month, the FDA is holding back a whole 24 hrs...whether you're out over the weekend (which put me in the hospital) and then my Dr. will look at me and say "You know if you just stop suddenly you are at risk of a stroke" why did you wait too late!! WTH? I have never been more ill than that, since I was put on them and I have been on it all...losing my liver was not my idea of a good idea or fun...but this monthly torture and faxing Rx's due to and governed Federally is sheer madness...it is just not worth it unless you are in a facility...been there too, what's next? The drug companies know they have us over a barrel or in the corner in a ball of shaking flesh...and it is due to abusers...I wouldn't put those things inside my body for any reason...how stupid do you have to be? Then I read that this med is basically legal heroin...wtf? Why didn't we know this 12 years ago? I would rather have dealt with the liver issues or something without Tylenol would have come out...but it has...Fentanyl...we can't win to save our lives!

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I'm nothing but skin and bones! And on fentanyl 100 mcg HR I have chronic back pain T 12 fracture Osteoporosis (bad) and still fighting the after afects of a server case of the shingles, as I sit a year later with all this am I a good candidate for Disability? I'm a mess had to quit work I'm a good old waitress (57) I have a appointment with ssd tomorrow any heads up on this I have to take Fentanyl and Hydrocod 10/325 to 1/2 way live thank for the ear anyone??

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The actual terms for what Susan is talking about is addiction and dependence. We all know what addiction is, and dependence is when your body is just use to having it all the time, because you have been taking it for so long.

And Donna, I don't blame you, the hassles are a real pain. The person I normally see at my doc's office is a lot better than the person I saw when I went in this month, so next month I am insisting on seeing the pain management doc.

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Toni, so sorry you had to go through that but I am glad you have a medical professional in the family.
I have been dealing with chronic pain for 30 years and I can safely say that this is a challenging life. I am fortunate to be in a good pain mgt. relationship with a physical rehab. doctor and remain fairly functional.
While I have no abused my medication over the years, there have been times when we have been able to make significant reductuions in the medications due to improvement of my conditions. A significant reduction of opiates WILL result in withdrawl. This has nothing to do with abuse. The body becomes accomodated to them and when they are eliminated or dramaticly redused, the body goes into chaos. I am fortunate that I must have a cast iron constitution as I go through the process with minimal response. I can adjust to a major reduction in my Fentanyl patch with little discomfort. Others can react strongly to reduction/elimination of a much milder opiate.
It certainly can be a puzzlement. We need to be as educated as possible concerning our conditions/medications and develope the best medical team that we can. Best wishes.

Susan

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I WAS ON DURAGESIC FENTANYL FOR 9 YEARS. I NEVER ABUSED THE MEDICATION, I DID HOWEVER GO THROUGH WITHDRAWL BECAUSE I WAS GETTING IT FROM A PATIENCE ASSISTANCE PROGRAM, AND THE NURSE DIDN'T RETURN Rx IN TIME! THERE WE'RE PROBLEMS LATER ON WHEN I CHANGED DR.'S AND HAD TO PICK UP THE SCRIPT AND TAKE IT TO THE PHARMACY, A LOT OF TIME THEY DIDN'T CARRY IT OR WERE ALL OUT (SM. TOWN) BUT I COULD ONLY USE NON GENERIC FENTANYL, BECAUSE AGAIN I WAS ON A PAP. I HAD A FRIEND THAT HAD TO BE HOSPITALIZED FOR 4 WEEKS BECAUSE SHE ABUSED THEM. I'M NOW OFF THE PAIN PATCHES (BUT EVEN WITH CLONEDINE AND LITHIUM) I HAD SOME WITHDRAWL SYMPTOMS, BUT HAVING A MEDICAL CARETAKER IN THE FAMILY HELPED! SHE KNEW WHAT TO DO AND I FELT A LOT SAFER GETTING OFF OF THEM. NOW I'M A TEST PROGRAM PERSON AGAIN, I TAKE PERCOCET AND THE OTHER MEDICATIONS FOR MY CHRONIC PAIN, AND UNLIKE THE PATCH, MY CENTRAL NERVOUS SYSTEM KNOWS WHEN I'M LATE TAKING THE PAIN KILLER! IF YOU NEED HELP GETTING HELP FOR FENTANYL, CHECK OUT JANSEN PHARMACEUTICA/JOHNSON AND JOHNSON. IF YOUR $$$ IS LOW U MAY BE ABLE TO USE THERE PAP, I DID FOR NINE YEARS, AND ANOTHER Q. WAS RAISED ABOUT GENERIC {vs} NAME BRAND, IT IS ABSOLUTLEY ACCURATE TO SAY THAT THERE IS A DIFFERENCE!!

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Funny that you would mention that...my friend inadvertently picked up a Lorazepam scrip rather than Ativan and both of us noticed the difference. In order to get a new prescription for just Ativan, he had to take the other one into the doctor's office and they counted out the pills remaining before refilling the Ativan. If I was abusing THIS drug, I wouldn't be functioning and the anxiety generated from all this just causes more problems. In fact, I need to call for a refill now and am afraid to deal with the hassle. Having seizures is not fun...

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I can understand how you feel, not only do you have to deal with the side effects of pain meds when you take them, but you have to deal with the attitude of docs, even if you don't abuse them or anything.

I have been on them for several months now, I have never been in my docs office more than a day or two early to get my new scrips, which is when they scheduled the appointment, I have never run out early, I have even taken my pills in and shown them that I have meds left, yet I still get an attitude when I go in. They are just so suspicious of everyone anymore, I know with the DEA regulations they have to worry about doing things right and keeping their license to practice, but for those of us who are not abusing, I wish they could just relax and give us a break.

I am seriously looking for a way to do away with my need for the pain meds at all, so I can tell them to just forget it.

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I'm very glad that this started a conversation. Regarding seizures, I also take generic Dilantin, but I adjusted my own dosage and actually told the doctor what I need to take. It may be that seizure meds are more carefully monitored and of course, I am supposed to have levels drawn. Without insurance, etc, I'm on my own. Oddly, I have had less seizures and felt pretty good. I can tell exactly how I feel...the Ativan covers the anxiety and the breakthroughs. It is just like taking Phenobarbital, the usual drug, but without those side effects so I could work. Since I supposedly also have Rheumatoid Arthritis and other problems stemming from a severe car accident years ago, I stay away from pain prescriptions (like Fentanyl) of any type, because of the problems I've had with other drugs and drug interactions. I'm lucky...aspirin alleviates 75% of the pain and I have no problems with it. The doctor even suggested that I should take a pain pill, but it's not worth the hassle. I have lived and worked with pain so long that it is a part of life especially after reading so many negative posts online.

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