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AFOAF wants to know if there is a way of extracting the gel from Watson brand fentanyl patches for the ability to chew somehow. He regularly is prescribed the Mylan brand patches and cuts them into smaller pieces to chew on. He now has a box of Watson brand gel pouches and would be interested in a way of cutting them into smaller pieces to chew on or extracting the gel to put on something to chew on. He has heard aout freezing the Watson gel pouches but found this to not work. Any help would be greatly appreciated.
SWIM is prescribed the 50mcg/hr fentanyl patches monthly for chronic pain and his preferred brand is the Watson gels. However, SWIM tends to smoke a significant portion of his medication rather than use it bucally which is what your friend is doing when he chews his Mylan patches.
That being said, SWIM does have some tips for using the gel from Watson patches (or any other brand containing gel) bucally. There are some significant differences in this method than when using Mylan (or other matrix) patches but the results are pretty much the same. In fact, SWIM's method using the gel bucally should be quite a bit more efficient than any method involving chewing a patch or portion of one. Also, this method will work with fresh patches as well as patches that have been worn.
Place the patch on a flat surface like a desk and use a credit card to push the gel to the far end of the patch.
Use a safety pin, sewing needle, or other SMALL sharp object to puncture a hole in corner of the patch on the same end where the gel has been pushed as per step one.
Use the edge of the credit card to push the desired amount of gel out through the hole in the patch. Be careful as it is easy to force out more gel than is desired.
Use a flat object to scoop up the gel and place it high on the gums under the UPPER lip. The upper area of gums under the upper lip is the most desirable spot to place the fentanyl gel because it allows for quick absorption and it is an area of the mouth that is relatively free from saliva. While the gel can be placed nearly anywhere in the mouth, i.e., under the tongue, under the lower lip, against either cheek, etc, there is no better location than under the upper lip because when placed there it is less likely that the gel will be accidentally swallowed or mixed with saliva, moving it away from the gums themselves which provide the point of entry for the drug.
When the desired effect wears off then repeat steps three and four.
Using this method allows for the buccal administration of fentanyl containing gel and is perfect for those who prefer not to smoke the gel.
Additionally, when all of the gel has been depleted from a patch DO NOT throw it away! There is still a considerable amount of fentanyl contained within the sticky membrane on the bottom of the patch. These "empty" patches can be used to achieve the same effects as the gel that they once contained. SWIM describes the method below.
Use a pair of scissors to cut off the clear adhesive border of the patch. This portion contains no fentanyl and is only there to help the patch stick to skin. The desirable part of the patch is the cloudy looking portion in the center that is bordered by the sticky adhesive part. The bottom of the cloudy center part is sticky as well but it is easy to tell it apart from the border because it is NOT clear.
Once the clear border adhesive is cut away SWIY is left with the rectangular center of the patch (the part that once contained the gel). Using the scissors, cut the patch width wise into four roughly equal portions.
SWIY is now ready to enjoy some fentanyl. Select one of the portions and peel off the plastic cover. SWIY will notice that one side of the patch is somewhat sticky while the other is not. The sticky side is the side containing fentanyl. Place the patch under the upper lip with the sticky side touching the gums. Wait 10 to 15 minutes and enjoy the fentanyl salvaged from a supposedly empty patch.
SWIM is quite happy with his Watson gel patches and will not accept matrix patches of any kind. In fact, if the pharmacy only has matrix patches in stock then SWIM will drive to as many pharmacies as necessary to find one that carries the gel patches.
SWIM hopes that this information helps your friend
It would be possible to dry out the gel before ingestion. SWIM recommends using a mirror to spread out the gel onto in a thin layer. Then once it has dried it can be scraped up easily using a razor blade. HOWEVER, SWIM urges caution when using dried gel because it is very hard to estimate a safe dose because the amount of powder left behind will be VERY small. In a 50 microgram patch the total amount would be slightly less than 5mg with the rest being in the adhesive bottom of the patch. 5mg would fit on a match head and is enough to kill most people. Therefore, it is much safer and easier to dose when in gel form because the 5mg is spread throughout the gel.
In addition, the only ingredient that would be removed by drying the gel would be the small amount of alcohol in the gel. The remaining inactive ingredients (the gelling agent, etc) will still be there. They will just be dry. This is why SWIM recommends dosing with gel.