AboutNigel Simmons Expertise I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised.
Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner.
I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question.
Consider.. would you want me to discuss your care with a friend or relative without your knowledge?
Experience Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients Previously Sysop on CompuServe UK Professionals forum.
Question I'm rather surprised at the answer you gave Jeremy B. on 4/20/08. He stated he had been taking 100 mcg fentanyl patches for several years and wanted to know what type of withdrawal symptoms he would face if he just stopped "cold turkey". Fentanyl withdrawal is absolutely horrible. I personally went through it and I was "weaned off" it by a pain management doctor. He told me no one should stop fentanyl "cold turkey". I talked with several people who endured the same horrible symptoms while going off fentanyl. When my original doctor put me on the fentanyl he never informed me that I would become "dependent" on it. Since then I know of many people who were in the same boat. Now every pain doctor I see says there's absolutely a great risk of developing that dependency. I would hate to see someone stop "cold turkey" and have a serious problem. Thank you for your time.
Answer Charlie
You are indeed correct that fenntanyl withdrawal can be an issue for some patients, and "cold turkey" would not be advisable for the majority. In addition, most withdrawal problems with fentanyl, like many other drugs is due to a psychological need/dependency, rather than a physiolgical one.
However, in Jeremy's case he was to undergo surgery where his analgesic needs would be reviewed and adjusted as necesssary. So in effect there would be no "cold turkey". With efficient pain management, it should be possible to replace his fentanyl use with alternative analgesia used on a demand basis, and if the surgery is successful, the need for long-term analgesia should no longer be an issue. Despite this, my answer did address the possible need for ongoing or occasional pain relief.
I also stand by my statements regarding synthetic opiates which are too often prescribed and consumed to excess and do clearly result in users becoming addicted.
I hope this better explains the rationale behind my response.
