Weaning from high-dose opioids (fentanyl and oxycodone) two case reports

Abstract

We present two cases of weaning from high-dose opioids (fentanyl and oxycodone. The first case concerns a 26-year-old patient with mitochondrial syndrome and neuropathic pain in the lower limbs, addicted to high doses of transdermaland transmucosal fentanyl (transdermal fentanyl 150 g/h in the form of patches every 3 days and transmucosalfentanyl 300 g/dose applied intranasally every 1 hour). The second case concerns a 32-year-old patient with chronicpost-traumatic pain and post-traumatic stress disorder, addicted to a high dose of oxycodone (1600 mg/day).Unfortunately, only in the first case, the desired effect was achieved discontinuation of fentanyl and remission of pain.In the second case, the patient resigned from further treatment in the pain management clinic despite achieving theintended therapeutic effect switching oxycodone to buprenorphine and reducing pain intensity