Massachusetts

and they are often walking and talking on very high doses. We don't use it on most patients. But, some really need it. The government has made the ordering process for our team a little harder a few years ago and those changes did make sense. I hope they don't make any more changes.

I'm a pediatric hospice nurse

100 times stronger than morphine is NOT a danger to the patient if the prescriber is well trained in prescribing the medication. Morphine is measured in mg Fentanyl is measured in mcg.

The biggest issue with Fentanyl is that it comes in patches that are like stickers and you put them on the skin and they slowly disperse over 3 DAYS. A well trained doctor often converts oral narcotics to Fentanyl and starts at a low dose then goes up and up on the patch as the pain increases. The patient usually requires breakthrough pills and the more breakthrough pills they require the higher the dose of patch they require. Cancer is a bitch so the doses pretty much always goes up because that crap is growing inside. If the patches don't work well we go to IV meds. IV morphine and dilaudid is often more effective than the patch and you can get that breakthrough medicine in the patient's system way quicker by pushing a controlled button than taking a pill.

The people with addiction issues often cut open the fentanyl patches and take a 3 day dose all at once. The lowest dose patches are 12 mcg. The highest dose patches are 100mcg. Patients are often on more than one patch.

The issues with the patch are similar issues with oxycontin. When people break oxycontin pills, a pill that is supposed to go in over 12 hours is taken all at once. Fentanyl is a 3 DAY DOSE that people are taking all at once. So damn it would be easy to overdose.

Patches are good for people like kids who hate taking pills and don't want needles. They are also good for people who have trouble keeping track of short acting vs long acting pills.

There are people who really need this medication in my opinion.

I don't know what the government should do. Educating people about the dangers definitely is important.