These are the words I heard from a middle-aged patient who came into the office a few weeks ago. He said to me: “I hate it. Every 3 days I have to re-apply my Fentanyl patch and I can’t stand the fact that I am a slave to it. All of my doctors tell me that I should just stay on this medicine, but I just don't want to live this way anymore. I feel like I am living my life in some kind of a shadow.”

This patient came in for advice on how to get off his Fentanyl patch. He had injured his back about 15 years ago, was treated well, and had never needed surgery. He was put on a Fentanyl patch for the pain and has been on it ever since. He says the pain is tolerable when he uses the patch, but the pain always remains. Fifteen years later, he still has the same level of pain. He has seen a number of doctors over the years and has consistently been told that there is no surgery that can help him - he just has to live with the pain. His doctors tell him that he should just stay on the patch. The doctors have pointed out that it is working, with virtually no side effects, and there's no real harm in continuing with the patch.

But, he hates having the patch. He knows that he is very dependent on it because anytime he tries to skip it, he starts going through horrendous withdrawal symptoms and he very quickly has to start back again. He is not sure if he is having any side effects from his Fentanyl patch. He has some periods of time where he does not sleep well. At times, his energy is not so good. Occasionally, he is somewhat irritable and grumpy depressed, but he's not sure whether this would be the case if he was not on the patch. He just doesn't know, and there's no way to know.


UNDERSTANDING ACCELERATED OPIOID DETOX


He has tried weaning down and been unsuccessful because of severe withdrawal symptoms. He has a pretty strong suspicion that he really does not need opiate pain medicine, but he really doesn’t know since he cannot get through the withdrawal period to find out. So, he goes on re-applying his patch every three days and feeling disappointed in himself, all the while wondering how much of life he is missing.

This patient represents a fairly typical clinical scenario. He had real pain that was appropriately treated with pain medicines. But now, it is likely that his pain has subsided to the point that he no longer really needs opiate pain medicines. He is just hooked on them and he's trapped in the cycle of taking the medicine, being unable to stop because of withdrawal symptoms and not sure what the quality of his life would be if he was to stop the medicine. He is not really having horrible side effects from the Fentanyl patch; he just has the sense that he is living in somewhat of a fog.

This man has now decided that he is going to detox and take a chance that the quality of his life will improve. Our experience over the last 18 years of detox treatments, is over 90% of our patients have a much easier detox than they anticipated and, they find their pain level after the detox actually improves over what it was while on their opiates.

He is quite similar to Steve, a patient we detoxed and videoed a couple of months ago. You can watch Steve’s story below.



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