Fentanyl + Whiplash Help Please!

Hello everyone.

I am in a relationship with someone who has suffered a severe neck whiplash injury in a car accident. As far as I understand it, the nerves in her neck and shoulders are constantly sending signals to her brain, which cause her to have something like tension headaches (for a lack of a better word). She is constantly in a lot of severe pain, this even though she is on morphine medication. Her doctor prescribed the Fentanyl patch a few months ago after a particularly long stretch of severe pain. She was on another less potent patch before (I can't remember the name now), and that worked ok'ish, but she developed a rash, so she was taken off that patch and was given morphine pills that she was supposed to use just until the Fentanyl patch arrive. As I mentioned, she didn't use the patch and is therefore still on the morphine…and she is really struggling with pain. Often crying herself to sleep.
She has tried most if not all of the alternative medicines and therapies, including message therapy, physiotherapy, acupuncture, and chiropractors, etc. With the exception of reiki, non of them really seem to work for her.
In the past a few things gave her some temporal alleviation for the pain:

1) The first 'quick' remedy that I discovered was cold water. She went for a short swim in the very cold autumn Danish sea water, and she was on a happy high for a few hours after that and seemed on the whole like her old happy self. Now that it is winter however, it is too cold for that.
2) Reiki message therapy seems also to help relax the muscles in her neck sufficiently enough to allow for some relief. However, the reiki must be applied for several hours (at least 2hrs it seems) before she feels the effect. It is costly, and she has small children which makes such outings difficult to do all the time.
3) I also discovered that by using medicine combinations, one can relief more of the pain, compared to just using the morphine for example. The WHO recommended opioids combined with meds such as paracetamol - and she tried this a few times when the pain was extremely bad, and it did work. But as far as I understand it, it doesn't always work. And she is worried that taking all those pills every day will damage liver/kidney.

She really wants to get off all her medication, and hates the fact that she is probably addicted to the opioid medication as it is. We have had some arguments in the past about this, because for me, I would rather choose addiction and not have maddening pain every single moment of the day. When she first got the Fentanyl patch I did a quick search online and saw that some people said it made a huge difference in their lives, and have been using it for years without problems or side-effects. I was very excited and was hoping to see if this would make her feel better again. Fentanyl, however, as you all are aware, is as strong as it gets, and one of her greatest worries is not only the potential side effects but what will happen if she tries to get off this meds. How bad is the withdrawal symptoms? How long does it last? Is it difficult to go back to less potent medication after it? She of cause also read the instructions leaflet that came with the patch, and that potential side effects scared her and doesn't even want to try it. Are there really no GOOD alternatives? Are there no less potent medication that sit between the strength of morphine and Fentanyl? And how difficult is it to go off this Fentanyl medication? I read somewhere some people say this patch will kill you. Is it really that bad?? All meds are bad in my opinion, but what are ones options if you have such bad pain? I also read somewhere that some people cut this patch up, so they won't get the full dose. Is this an option? She hasn't tried the patch yet, so maybe it wont work for her, but it might?? Is it possible for her just to try the patch, or a small strip of the patch at least for a few days, to see if it helps? How long will it take before her body adapts to this higher dose? (ie, how long will it take before it will become difficult for her to go back to morphine if she doesn't like the patch?).

If you are reading this, and you have EXPERIENCE in this field. Can you please comment and give me any tips or advice as to how I can help her please? What medication, surgery or treatment worked for you? Please be as specific and detailed as you can.. I will appreciate any information or help that you can give.
And also: do you know of any renowned whiplash/pain specialist anywhere in the world that helped you or someone you know with their pain? Can you write down the contact details of this doctor please and how the doctor helped? I get the feeling that the GP she goes to now is not an expert in this field. And in Denmark it is a nightmare to get an appointment with any doctor at the best of times. She really needs a very good specialist.
Thank you kindly for your help.

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First I need to say- you can NEVER cut up Fentanyl. THAT, will kill her. Amung other ways. It is extremely dangerous and she's right being so cautious. I got prescribed it after one failed back surgery leaving me waiting for another with two majorly herniated discs, a crushed nerve toot causing severe nerve pain, and have a high tolerance to opiates. Even with such a debilitating pain that makes it hard to get up, I wish I never started on the patch, and chose a different long acting medication instead. It makes me VERY tired, nauseous, burns, and after two months 72 hours no longer works as I start to go through withdrawals on the second day. Technically I should be becoming a 48 hour patch user, but instead I find myself on these sites because when my four 50 mcg patches are gone, I will start to wean down and get off of them. I have no energy outside of the first day, am so irritable... I was just way better off on pills alone so will go through the absolute he'll that I know is coming, especially if I feel it while on it- to get away from it. Yes, it works great for some people with minimal side effects- but regardless, they will all have to increase their doses, shortens their duration, and one day go through a withdrawal that all literature says is like coming off of heroin. Happy? NO :( My body will not take to lesser medication for a while after cuz its so sedan to such a strong medication. All I can say, is research it til exhaustion. I have small children too... Feeling this way, is not an option. On another note, I have degenerative disc disease in my entire cervical spine as well as have had serious whiplash myself. I suffer from continuous migraines due to neck spasms. It sounds like somehow your girlfriend's headaches/cause is different, so its REALLY hard to advise... I have had spasms for 8 years, migraines for about 12... There's much I would like to advise but can't due to these differences. Tension headaches Vs migraines and to have a Dr state it is linked to the neck, I would suggest a second opinion... Especially before moving forward into something so drastic as the patch. Narcotics don't work for migraines, the actually give you rebound headaches OFTEN. Maybe something like xanax, which is a muscle relaxer plus anti anxiety med which will help the muscles not spasm, and keep her more relaxed and at peace- hopefully keeping a headache at bay. I use preventative migraine treatments, muscle relaxers, rescue meds like relpax for when I do get the migraine, and keep myself away from stress and negativity. Ligaments take such a very long time to heal... Unfortunately, I personally don't feel the next itself ever does :( I hope she has had an mri to rule out anything in her discs... The crying herself to sleep worries me, makes me feel really bad. I can relate to discouragement if thats part of it. Sorry for any typos as I have a very wild toddler right now and am finding it very hard to focus, I just couldn't see your inquiry going unanswered. I hope it helps somehow.

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I have been on Fentanyl on and it for over two years and can assure you that for me it has been excellent. The First time I had it prescribed I was in a bout of pain that was getting increasingly worse. I went onto the patches for just a month, enough time for my muscles to properly relax and the built up tension to go. I found patches much better than pills- pills, if taken for a long time, can corrode your stomach lining, make you nauseous and damage your liver. My First few days on the patches were not great- I felt quite sick and very tired, but the pain improvement was quick and excellent. I also had some Cyclizine prescribed forthe nausea which worked a treat! After A month I had a managed stopping off the patches and had no withdrawals at all. I honestly feel worse when missing my morning cup of coffee than I did stopping Fentanyl. A few years later, my passion increased again to mean going back on the patches. I now take either the 37 or 50 patches and while I'd clearly prefer to be of them, my quality of life is so much better.

As for dose concerns, cutting up patches isn't sensible. The patches are structured ina way to release the medication evenly over the patch. If you cut it up you will no longer get an even dose and it may release the dig quicker than intended, or slower, either way not giving youa reliable dose. The patches are available in multiples of 12 so consider adding for a really analogue patch to start, adding paracetamol or something like tramadol if the pain is still getting through.

Overall, if you trust your doctor, remain honesty with then about your concerns, and do exactly what they prescribe you should be safe. It's when you start mixing drugs or altering doses that you will get into trouble.

Best of luck and do keep us updated

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Do Not Cut The Patches...it could be fatal for either of you if it got to your mouth.

I have been on Fentanyl patches for almost 10 years. I had to change the brand because they were not sticking and I got a rash.

I am on 125 mcg. The dose has been the same for 7 years. I occasionally have to take something lighter for breakthrough pain.

I have been suffering with various illnesses for 23 years. This medication has saved my life. I doubt if I could tolerate the pain without it. I have tried everything out there for pain.

Talk to your Dr if your girlfriend has not started the patches and definitely do not take the morphine also without Dr's advice.

Side effects at the beginning were nasea, and diarrhea. It only lasted a few days. The patches take a few days to build up the med in your system so your Dr may prescribe something until it works.

Please read and respect all the directions. The. Patches are very strong so when applying them be sure to follow directions.

If I have a hot bathfor too long I have gotten too much of the medication and it made me very lethargic, be careful.

I personally, will not change from this medication if I have the choice. It is easy. No forgetting to take meds. The best thing is the constant level of my pain. I function now. Yes i have breakthrough pain but that is usually my own doing. Not listening to my body telling me to stop doing something, LOL

Good luck in whatever you both decide. A chronic illness belongs to both partners, not only the one with the physical pain

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Well, I believe the other posters have covered the issues with cutting the patch, seeking other opinions and etc. Which I am very glad to see, because there is no way that this much ongoing pain would be caused by a simple whiplash injury. Those are very minor and resolve quite easily in just a few days of not regularly moving the neck and flexing the muscles. This definitely sounds like something more serious.

And yes, there are other medications in between Morphine and Fentanyl that she could try, some examples include Oxycodone, Hydromorphone and Hydrocodone.

They are still narcotics, but not as potent and crazy as the Fentanyl.

And another thing I think you should explain to her is that there is a difference between being addicted to a medication and just being dependent on it.

Addiction occurs when someone takes them because they like the way it makes them feel, such as the high they may get or the euphoria. The problem is that those are side effects that eventually wear off, so they have to keep taking more and more to get those feelings back, which is quite different than just taking something as prescribed to relieve your pain.

That is when dependence happens, it can happen with anything you ingest regularly, even your morning coffee. Your body just gets used to having that substance added on a regular basis and if there is a sudden withdrawal of it, some withdrawal and rebound effects may occur. They can be uncomfortable and miserable, but are nowhere near the dangerous, life threatening withdrawal effects that an addict experiences.

In most cases, dependence can be resolved when someone is ready to discontinue something just by doing a slow, carefully timed taper of the substance.

Does anyone else have any advice to add?

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