Opinions - Hydrocodone, Norco, Lortab and Fentynl Patches

[SubD]

AFOM has cancer; found in July this year during a total hysterectomy; colon cancer, it has since metastasized to the liver and the lungs.

My friend has decided NOT to do chemotherapy due to a couple of reasons (so far) but the main is her intolerance to pain and discomfort in general.

Since July she has had a hysterectomy, a colonoscopy, a colostomy and also shattered her left ankle thinking she was 20 something again and could jump a fence as a shortcut so had surgery on her ankle and now has pins and plates in her ankle, it's almost healed.

The problem is she a couple fold; A. She is a wimp when it comes to pain/discomfort. B. She "used" to use illegal substances (T's & Blues, Cocaine (these two injected IV) and smoked crack) she walked away from these in 1986. She did not use drugs other than physician prescribed until last year July when she got involved with a man and did crystal meth with him until stopping in December of 2007. (Smoked it then started injecting it). C. She is bipolar with panic and anxiety attacks. D. She lives with her bestestest friend in the world who does a great many wonderful things for her and has been taking care of her since her hysterectomy in July and will be taking care of her until she goes to hospice.

Now, recently her mind has been wandering to crystal meth, she has actually shot it a couple of times in the past month (bunk, pure bunk might as well have been epsom salts). Well her physicians have prescribed her for her bipolarism and panic/anxiety attacks; Prozac, Abilify, Lamictal and Xanax, none of which she abuses.

Her physicians also prescribed her for her shattered ankle Hydrocodone, Lortab, Norco and once Oxycontin and Oxycodone. These disappear rapidly as her friend/roommate has a number of ailments and over does her own doses and ends up needing more before the next refills. She however does share hers when my friend's pills are gone and she had gotten her refills.

Once she shared a 50mg patch of Fentanyl when the pain of the ankle was at it's worst and it worked very well.

This past Tuesday both my friend and her friend/roommate went to the walk in acute care clinic of my friend's Dr's building. She was given a tramadol shot that did nothing and 30 Norco 10/250(?) and told to see her Dr. ~ Later that day she did see her primary care physician and he gave her a prescription for two boxes of five each 100MCG Fentanyl patches and 90 Lortab 7.5/500's.

Her friend/roommate gave her a 25MCG Fentanyl patch to put on which has had no effect whatsoever and both have been taking the Norco's which are gone and now there are 45 of the Lortab left. (her friend/roommate took the majority of the Norco/Lortab's)

This one has been perusing the forums for a few days now and has learned a lot of valuable information which she thanks all for but her main concern for her friend now is:

The friend is not the one doing the "majority" of the pills and as of yet does not have a big tolerance so she is scared to death of putting on a 100MCG Fentanyl patch and yet wonders is there a way to cut the patch in half, tape up the cut edge of the half of the patch and store it, tape up the cut edge of the other half of the patch and put it on to be used as a 50MCG patch instead of the whole 100?

Also being a big fan of the needle she is starting to wonder about doing bitty bitty shots when she thinks about getting high (usually when the weight of the knowledge of cancer gets to be too much or she can feel herself going into a panic/anxiety attack over such although right now she really has no outward or inward signs/symptoms of the cancer although the colon cancer tumor was taken out but a PET scan did show that it had metastasized to the liver and lungs and different areas between).

Also when should my friend BEGIN to show signs/symptoms that would really and truly warrant the pain medicine she is getting and will research further on (morphine, Demerol, etc?) and what would be the best to ask her primary care physician for once the Fentanyl patches need break through pain help?

Thank you all and I hope I followed the guidelines here in getting my friends questions answered.