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  #1  
Old 12-01-2012, 09:08
dahliamalloy dahliamalloy is offline
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Couple of questions about misuse of fentanyl patches

Hi,
This is my first thread, and I am quite nervous.
I have read the Fentanyl topics with interest, however I have a couple of questions.

From what I have read so far, there seems to be no real answers to the questions. Fentanyl is obviously not something to be taken lightly, and dosing is difficult etc.

My questions relate to a scenario for a fictional character in a novel I am writing. At this point in FCs story, she has quite a history of substance use. She does not consider herself a heavy user. At present she takes 30mg Oxycodone a day. She supplements this with OTC codeine products. In the past she has experiences with Tramadol, Codeine, Benzos (she derives no pleasure from Benzo's-- only for withdrawal relief).

So in the fictional institution where fictional character works, the disposal of Fentanyl patches leaves A LOT to be desired. And this point in the plot, FC is considering just reaching into that bin and taking a handful out. FC is squeamish about Fentanyl, no prior experience and does not want to go down that road, HOWEVER her Oxy supply is coming to an end....FC realises she is a pathetic human being self medicating anxiety and depression, but such is her life.

FC isn't looking for the worlds greatest high, nor has she any inclination to smoke or inject anything. She merely wants to lessen her pain of the Oxy WDs and continue self medicating to be able to live her life. Thats the kind of flawed character she is, and as she is only fictional no use telling her to grow up and get her shit together....

FC wondered, in the novel, if she just stuck a few used patches on her, would she get any fentanyl? Or must she chew them? She is not squeamish about chewing a piece of plastic thats been on someone elses skin for three days. FC has not examined the patches to know if they are "gel" or not, she remains confused about this, but hopes that when she gets them in her hands she may be able to tell. She does have brand info with the amount of fentanyl in the patch...but how much of that would come out if say she stuck it on her skin, or put it in her mouth?? There may be no answer to this...however if anyone has any knowledge I would appreciate it, so that I can write a realistic outcome of the experience in the story. And of course I would share with all FCs experiences.

Also, if FC were able in the story to get an unused patch (i may be able to tweak the plot!) Well FC doesnt want to smoke it or anything. She is more the type of girl to stick it on her skin and see what happens. She hasn't much of a tolerance, 30mg oxy a day. Say if in the story she got a 25mcg patch, new, and put it on...would she feel anything from this? I have heard that when you start someone on a patch for the first time, it takes 72 hours for the Fentanyl to reach steady state, and they feel no analgesic effects until the second patch is applied on the third day....so would this be a waste of a patch if my fictional character had only one and she put it on her skin?

Any input appreciated , and thank you all for the experiences and information on this site.
  #2  
Old 14-01-2012, 11:00
Petri6 Petri6 is offline
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Re: Couple of questions about misuse of fentanyl patches

There are several weak points regarding the plot, that SWIM can see:

1) Fentanyl would instantly sky-rocket the main characters opioid tolerance.

2) Using already used fentanyl patches means that they have warying contents of fentanyl left in them. This would make dosing very hard and would mean that the dose would have to be carefully titrated every time one swithches from one patch to another. The main character doesn't sound like a person with the patience to do this. So using those already used patches as a source of fentanyl would put the main charater at a serious risk of a possibly fatal fentanyl overdose.

In SWIM's honest option the main character should look into other ways of obtaining opioids. For instance, poppy pods could be a viable option (although they, of course, have their own problems).

Last edited by Petri6; 14-01-2012 at 12:16.
  #3  
Old 20-01-2012, 08:11
catseye Gold member catseye is offline
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Re: Couple of questions about misuse of fentanyl patches

Quote:
Originally Posted by dahliamalloy View Post
Say if in the story she got a 25mcg patch, new, and put it on...would she feel anything from this?
If FC has a low tolerance to opiates and just sticks a Fentanyl patch on, she may end up dead. According to the opiate conversion calculator, 30mg of oxycodone is roughly equivalent to 29mg of oral morphine (with a 35% incomplete cross-tolerance correction). A 25mcg Fentanyl patch (new) releases approximately 60-90mg of oral morphine in 24 hours according to NHS palliative care guidelines.

FC will be aware no doubt that Fent has an incredibly narrow therapeutic dose vs. fatality margin, and patients with established high opiate tolerances can and do overdose even in a medical setting.

As far as taking discarded patches and just sticking them on or chewing them to see what happens (and I notice that FC says "them" as in multiple?) - this would be highly reckless and dangerous. There are news stories here of healthcare workers pulling them out of the bin, chewing them and dying.
Petri correctly points out that there would be absolutely no way of establishing how much Fent remains in the patch, and again with a self-described relatively low opiate tolerance, this would be a Very Bad Idea.

Also, FC mentions that she is not looking for 'the world's greatest high' - that's a good thing because Fent is perhaps the least euphoric of of the opiates/oiods. There is little 'high' associated with it.

FC states that she doesn't want to smoke anything...why is this? Smoking is really is the only approaching-safe method to misuse Fent. Please read the thread about it HERE.

Fentanyl misuse has been the cause of death for a least two forum members here as far as I'm aware.
Please educate FC on the very real dangers of this idea, and think carefully about sending her down this road.
Nobody here is going to tell her to 'get her shit together and grow up' - in fact its quite the opposite, she will find plenty of support and advice in the Recovery & Addiction forums.

Apologies if this post reads harshly, it is not meant to at all
The thing is Fent misuse advice is extremely problematic - the only truly sensible advice would be don't do it but if one is adamant that they are going to, then smoking is the closest they will get to safe.

Please be safe.

Post Quality Evaluations:
Good post -- should be a sticky.
  #4  
Old 23-01-2012, 08:27
dahliamalloy dahliamalloy is offline
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Re: Couple of questions about misuse of fentanyl patches

Thank you for the responses, and also to the people who have PM'd me with advice for my fictional character. I did not find anyone's words to be harsh, I am grateful for the advice and the concern expresssed for my fictional character.

FC did manage to get her hand on 1 x used patches. While she had a very nice time, or rather it helped her get through a difficult week, she rather regrets it, and it's not on her list of things to do again in a hurry.

FC was aware of the difficulty in determining how much active ingredient was remaining in the patch, and for this reason she cut up the pieces very very ridiculously small. And then placed one under her tongue. She would wait 45 mins, and then place another, until she felt a nice warm feeling all over. She had a used 12 mcg patch of the Denpax kind. As this was the one sitting tantilisingly at the top of the bin. She cut that teeny patch up into 12 pieces. She used 4 pieces per day, over three non consecutive days. ((As a side note, the fictional facility where FC works has switched to Denpax recently from Durogesic for the very reason that there is less overall Fentanyl in the patch-- according to the manufacturers--- and therefore less waste and less potential for abuse. So perhaps another brand would be more potent and dangerous, and of course anyone out there should be careful with anything they are doing)).

FC would by no means recommend this to anyone. Perhaps it is blind luck that FC isn't dead. She did notice that some pieces of the patch seemed to have greater effect than others, and this highlighted to FC the difficulties of accurately dosing pieces of these patches. She is also aware that she tended to swallow now and then and probably much of the ingredients got wasted that way.

While FC has a nice warm fuzzy feeling for days, and even found herself motivated to do things like clean the house, which sadly has not been done in weeks, she is left with a lingering feeling of guilt over what she has done. And the advice of people was ringing in her ears the entire time. FC feels this is perhaps an all time low thing for her to have done. And by no means will she make a habit of it. Fishing through a bin to find a used patch that's been on someone's body for three days seems a little but pathetic and desperate. And it's not a path that FC wants to go down. The tolerance issue is also quite a motivator. FC can see how easy it would be to get sucked into a downward spiral, and want more and more, particularly with the ease of access. FC does not want that. It rather frightens her that she did this once. She sees this as a one off recreational experiement, that will not be repeated.

But as for the experience itself, and FC would by no means recommend to anyone trying this, but for FC is was a very warm pleasant feeling, which seemed to linger on for days. She couldn't call is a euphoric high, but she would say it was a peaceful warm fuzzy feeling. And it was a nice respite from the turmoil in her mind. It helped her get through a very bad week.

However, all in all, she feels bad about sinking to this new level. And the whole experience has been a wake up call for her in the cold light of day. FC is going to be heading back to Codeine CWE for the mean time, and maybe trying to find some other ways to cope with her anxiety/depression rather than self medicating.

Thank you to everyone for the advice, and it is with a heavy heart that I inform you of FC's experiement with Fentanyl, because she is not proud of it, and realises that it was stupid. She really feels quite terrible, and this is uncharacteristic of her. She usually enjoys whatever she is able to get her hands on. But she is aware of the dangers and stupidity of what she has done, and the potential to get sucked into a downward spiral. She will be staying welll clear of Fentanyl in future chapters.

Thankyou for the input and listening.

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