DrugBuyers.Com: Fentanyl for Withdrawal from Hydro???

I concur with YawKaw on the Temgesic issue. I wasn't thinking of the antagonist quality. I was thinking more along the lines of the substitution of one opiate for another and that cicumstance wouldn't cause withdrawl. But Temgesic is a rather different animal. The waiting period that YawKaw suggests is valid.
To Rocky, The class of a narcotic really isn't the issue. A person can ingest enough of a C3 to mimic the effects of a C2 and vice versa. I think that the reason Yeppers doctor suggests introducing Fentanyl (C2) for a wean off course is due to the steady dosing. Also when dealing with people who are dependent there are still some psychological issues. Not as severe as those present in addiction but present none the less. When a person has been on opiate therapy long term just the act of putting a pill in your mouth and swallowing it can give a sense of relief. Long before the medication has reached the brain. This is a conditioning of sorts. That is where delivery of medication transdermally comes into play. A borderline addiction (psycological) issue will present early. The patient will begin to complain that he/she is not doing as well on the patch as they were with pills. The complaints interestingly enough will rarely if ever have anything to do with pain. The pain issue should be completely addressed by the Fentanyl. What is happening here is that the habituation of 'popping a pill' becomes evident. People will complain of malaise, nervous tension and perhaps headaches. This is when the importance of an honest and trusting doctor patient relationship becomes paramount. The knowledgeable doctor will see what is happening and most importantly know why. The doctor can then explain that the feelings of general 'unwellness' are caused by the change of habit so to speak. The 'conditioning' of putting a pill in your mouth to facilitate relief can be signifigant. It in no way means that a person is an addict. It is habituation. If I do this, then this will happen....... The absence of the 'act' (opening the bottle, swallowing the pill etc.) bothers some people deeply. This sort of depression is usually short lived. Typically resolving with nothing more than the benefit of a little time. A person who continues to feel bad or requires some intervention such as counseling may have a true addiction problem, but that is a different subject. Once the doctor makes the person aware of the cause it is self resolving. Then there is just the matter of a rational downward titration to avoid the unpleasantness of physical withdrawl. The introduction of the patch as I said before completely (ideally) stabilizes the dose and the person is gently moved away from the habituation of taking pills. Of course at some point (Duragesic is only offered down to 25 mcg) pills will have to be reintroduced. But by that point the amount of narcotic required to avoid physical withdrawl is manageable and getting to '0' doesn't take much time. So there is little or no concern about 'rehabituation'. That type of habituation is an issue for people who have been on narcotics for a looooooooooooooong time. A couple of weeks of pills on the way down to zero doesn't present a problem. It is unfortunate that more doctors aren't progressive or sensitive enough to address these issues. They are very real and can make a person who truly wanted to stop taking narcotics change their mind. The decision to stop narcotic use is a brave one and every effort should be taken to insure the patients success. So the introduction of Duragesic at the beginning of a wean off course really isn't that crazy. If it is employed by a competent clinician it can be highly effective.
Peace, Daisy