Expert: Tracy - 10/11/2008

Question
QUESTION: Hello,

I am a 29 year old female who was in a MVA about 4 years ago. In one year I had two surgeries on my L4/L5 disc.The second was a fusion.My doctor did not want to do it and he said he had never done one on someone so young so I would be back for another surgery within 10 years.Well,it has only been close to 5 and he is right. I got an MRI the other day and I have a herniated disc at T12 and from T12 down to L5 I have narrowing of the spine.I have been on so many narcotics that now it is like taking aspirin.Now I am on sustained realease Morphine and it helps.I am just sick of being in pain all the time.Any advice?

ANSWER: Hi Liz,
   I found your question in our question pool and thought I may be able to help.

Since you have been on narcotic medicines for awhile and are not 'narcotic naive', talk to your doctor about switching you to Duragesic patches. The medicine in Duragesic patches is Fentanyl and it often works better for some people than other pain medicines. The pain relief is not only better but it is also constant. There is none of the ups and downs of pain relief you get with taking pills from the medicine wearing off between doses. The patches deliver a constant dose of medicine through the skin.
The patches are also very convenient. A patch can be worn for 3 days before having to switch it out for a new one, so you can just put a patch on and forget about it for 3 days.

The main drawback to the patches is sometimes they don't stick to the skin very well. There are adhesive bandage covers you can get to put over them to make them stay on better. You can get the covers at any drug store. The company that makes the brand name Duragesic patches used to send boxes of the covers for free to patients that called them about the patches not sticking. I don't know if they still do that or not.

I hope this helps. If you have any questions or need additional information please don't hesitate to ask.
         Thanks
         Tracy


---------- FOLLOW-UP ----------

QUESTION: Tracy,

Thanks for answering that.I did have one more question. I was on the patches for about a month but started seeing alot of ads on tv about people overdosing on it and they died. I was scared after that to use them. When I was on them I felt really drugged out. Thanks for any other help you can pass on.

Answer
Hi Liz,
   Most cases I have heard about of people overdosing on the patches is people who misused the patch, continued to take too many other opiate medicines while wearing a patch or was prescribed a patch that was too strong starting out. Some other things that could have caused overdoses is applying heat to a patch while wearing it with a heating pad or a hot bath (heat can cause the patch to release more medicine than it is supposed to), or they could have put rubbing alcohol or certain lotions on the skin the patch was put on. Those kinds of things can breakdown the membrane in the patch that controls the rate the medicine is released. All of those things (heat, alcohol, lotions, ect...) are mentioned in the information packet that comes with every prescription of Duragesic patches.
If you felt drugged during the month you were on them it is possible the doctor started you out on a patch that was a bit too strong. Also I found that most of the side effects of Duragesic patches (such as headaches and even feeling drugged) go away in about 2-3 months.

 Thanks
     Tracy