Hi All,
I would like to share my wife's opioid tapering regimen with anyone who may find this helpful.
Opioid Tapering
My wife had been on the fentanyl patch for years - prescribed by our family physician.
In 2006, she started on a 50 mcg patch which was to be changed out every 72 hours. The purpose, to alleviate constant, intense pain (loin pain haemetura, tumour in remaining kidney - the first kidney was removed in 1996 due to cancerous tumour - not qualified for a transplant due to her mother taking thalidomide, too many internal anomalies that would make for a very unlikely match).
Very quickly we found that the fentanyl dose and frequency of the dose were lacking - it was increased to a 75 mcg patch every 48 hours. This was all during 2006.
In 2016, a few months before I retired, my wife was prescribed nabilone for nausea and to help her sleep. This worked very well and when we did our research on the drug - we were surprised note that nabilone is synthetic THC!
Over the next couple of months (the start of 2017), we came to the conclusion that real cannabis would be a better answer than nabilone. Not trusting the quality/availability et al of buying grey market cannabis here in Northern Ontario, we decided to start growing in June of 2017. With much help from this site and youtube and lots of trial / error / frustration initially - we stuck with it and now are growing successfully.
During the same time period my wife became a medical marijuana patient. Indica oil was the preferred substance at the time and works very well, but also very expen$ive to purchase. With our GYO licenses, we are nearing the point of independence from dispensaries. Now we use dry decarb in capsules (size 0) and also vape a few times per day (CDB - daytime, THC indica blend - evening). Still use some indica oil purchased from dispensaries. If you get your GYO license with the help of Bodystream here in Ontario, you are allowed to continue to purchase prescribed cannabis products for a period of time (this I presume in case of garden failure). We know this because once my wife had her GYO renewed - yearly renewal with Health Canada, she was cut off by her provider. Has anyone else in Ontario or the rest of Canada had a similar experience?
Tapering Method
- The plan was to wear the 75 mcg patch for increasingly longer periods of time up until 72 hours of wear time (remember she was wearing the 75 mcg patch for 48 hours since 2006). The comment that I have regarding the time increments is to make haste slowly, in other words the tortoise wins the race. We started with 1/2 hour increments say for three days, then increase to a 1 hour increment for three days, then try to go to two hours after three days, et al. This will require getting up at odd hours to change the patch - well worth it!
- At that point, start wearing a 50 mcg patch starting with 48 hours and increasing it to 72 hours as outlined above.
- Following that, start the process over with 25 mcg patches until again wearing for 72 hours.
- At that point, we had wanted to drop down to a 12.5 mcg patch, unfortunately we could not get access to them.
- Instead, we started blocking the patch with a band aid 10% at a time and also increasing the amount of area blocked each time and we stayed with the 48 hour wear time progressing until the complete patch was covered. The reason for blocking was to avoid cutting the patches which could cause the patch to release the fentanyl all at once.
As of March 21, 2019 she has been fentanyl free.
The tapering process took around 6 months start to finish after a couple of false starts. This is not a cut and dry process.
When things get tough, you may not be able to increase the patch wear time for a couple or three changes. That's OK - don’t go backwards.
We had no help from our family doctor other than prescribing the patches as needed.
The doctor’s solution was to use methadone instead of the cannabis!
“The world is full of people who have never, since childhood, met an open doorway with an open mind.”
―
E.B. White