Duragesic, the skin patch form of fentanyl, is a highly potent opioid that is prone to abuse, dependence and addiction. It should only be taken as prescribed by a doctor.

Duragesic is the opioid fentanyl in a skin patch dosage form. It is classified as a Schedule II controlled substance in the U.S. under the Drug Enforcement Administration (DEA). As such, it has a legitimate medical use but is at high risk of causing abuse and dependence, which can lead to addiction.

Article at a Glance:

  • Duragesic is an extremely potent opioid that comes as a skin patch and can be abused in many ways
  • As a Schedule II controlled substance, the drug puts people at high risk for dependence and addiction
  • Side effects are similar to other opioids and include gastrointestinal issues
  • Rehab facilities can help you overcome a Duragesic addiction and put you on the path to recovery

Duragesic Addiction

Duragesic should only be taken with a doctor’s prescription. Patients who take Duragesic as prescribed may still develop a dependence or addiction, as the drug belongs to the class of highly addictive opioid drugs. People who have become addicted to Duragesic can abuse the medication in different ways, including:

  • Applying more patches than prescribed
  • Changing patches more frequently than instructed
  • Injecting extracted fentanyl
  • Chewing or swallowing patches
  • Inserting patches into the rectum
  • Inhaling gel from the patch
  • Making the patch into a tea

What is Duragesic?

Duragesic is the brand name for the fentanyl skin patch. Fentanyl is a powerful opioid pain reliever that’s 80 to 100 times more powerful than morphine. Duragesic is long-lasting and has a slow onset time. It’s typically prescribed for the management of chronic pain. Because it is so strong, the drug is only prescribed to people who are opioid-tolerant, meaning they have taken the equivalent of 60 mg or higher morphine doses every day for at least a week.

Signs, Symptoms & Side Effects of Abuse

Common side effects of Duragesic include:

  • Gastrointestinal side effects like nausea, vomiting, constipation or diarrhea
  • Sleep-related side effects like drowsiness, fatigue or insomnia
  • Dizziness
  • Excessive sweating
  • Feeling cold
  • Weight loss
  • Headache

Addiction can occur in stages that worsen over time. If someone begins to struggle with Duragesic use, the first signs are often behavioral, such as:

  • Social withdrawal
  • Avoidance of family or old friends
  • Spending an excessive amount of time with new friends
  • Losing interest in things
  • Mood swings
  • Irritability
  • Sleep problems or abnormal sleep patterns
  • Missing appointments or deadlines
  • Problems with work, school or family
  • Reckless behavior
  • Legal problems

If these signs become noticeable in yourself or in someone you love, do not hesitate to seek professional help as soon as possible.

Duragesic Overdose

Duragesic suppresses the autonomic respiratory drive by acting directly on the brain stem, which is the area of the brain that controls breathing. The drug is a potent central nervous system depressant. Especially if a person is not tolerant to opioids, even a low dose of Duragesic can cause overdose and death.

People who have taken too much can deteriorate rapidly from poor coordination to unresponsiveness. The person may be able to respond to questions with short phrases one moment and be unaware of their surroundings in a matter of minutes.

Before the onset of an overdose, several warning signs may be present.

The primary symptoms of Duragesic overdose include pinpoint pupils, decreased level of consciousness and severe respiratory depression. Respiratory depression, or slowed breathing, is often the ultimate cause of death when an overdose occurs.

Fentanyl patches can result in a fatal overdose after just one dose. The amount of Duragesic necessary to overdose varies dramatically among individuals. For this reason, doctors practice extreme caution when prescribing Duragesic, often giving patients the lowest possible dose until they become tolerant to the medication.

In the event of an emergency, or if you believe you are witnessing an opioid overdose, call 911 immediately. If available and used correctly, naloxone can be used to help reverse an opioid overdose while waiting for help to arrive.

Duragesic and Alcohol

You should not mix alcohol and Duragesic, as combining the two substances can produce dangerous effects. Because both substances depress your central nervous system and your respiratory function, using them together puts patients at high risk of overdose, coma and death.

Long-Term Consequences

Even if you have taken Duragesic as prescribed over the long-term, abuse, dependence and addiction will always be risks. This is because of the way the drug works on the brain’s reward system.

Duragesic Withdrawal

If you are interested in stopping an opioid treatment, set up a meeting with your doctor so that they can gradually lower your dosage over time. This tapering off strategy will help your body adequately adjust to less and less of the medication. Duragesic should never be stopped suddenly or “cold turkey,” as this can produce unwanted withdrawal symptoms.

If you are having difficulties managing withdrawal symptoms, you may want to enter a medically assisted detoxification program. This provides patients with a safe place where they can detox while they access medically trained staff.

Everyone experiences withdrawal differently and you should never be afraid to ask for help during this difficult time.

Withdrawal Symptoms

Common withdrawal symptoms from opioids like Duragesic include:

  • Nausea/vomiting
  • Anxiety
  • Insomnia
  • Hot/cold flashes
  • Sweating
  • Cramps
  • Runny eyes/nose
  • Diarrhea

Remember, do not suddenly stop taking Duragesic as withdrawal symptoms may become enhanced and more uncomfortable.

Withdrawal Timeline and Symptom Duration

When you stop taking Duragesic, withdrawal symptoms can start between 8 and 24 hours after the last dose and may last for 4 to 10 days. However, everyone experiences withdrawal differently. Factors contributing to how long you may experience withdrawal symptoms include your age, metabolism, organ functions, how long you have been using Duragesic, your Duragesic dosage levels and more.

Duragesic Addiction Treatment & Detox

The Recovery Village has many resources and programs for patients looking to recover from Duragesic addiction. Before patients enter either inpatient or outpatient Duragesic rehab, they are required to detox from Duragesic. Once all of the medication is safely removed from the body, patients benefit from individual and group counseling sessions and recreational therapy activities during their time at The Recovery Village.

Inpatient Rehab
Inpatient rehab is a program that allows patients to live on campus at one of The Recovery Village’s designated inpatient centers while they recover from addiction. This treatment option is especially beneficial for patients who have been diagnosed with severe addiction or those who may find it difficult to recover due to distractions from their home life. In the inpatient rehab program, patients will learn how to manage their unique addiction challenges from professionally trained staff.

Outpatient Rehab
Once a patient is finished with inpatient Duragesic rehab, they will continue their treatment with outpatient rehab. In the outpatient program, patients will live at home while they come to The Recovery Village for their scheduled treatment appointments. Some patients who have less severe addiction may actually begin their recovery with outpatient rehab rather than participate in an inpatient therapy program. Following outpatient rehab, aftercare options, including teletherapy, are available to ensure you have the support you need as you reenter life without Duragesic.

Choosing a Rehab Center

Choosing a rehab center is an important step in a patient’s journey to living a happier, healthier substance-free life. You may want to set up a meeting with your doctor to discuss which features you need to seek in a center to make the most informed decision possible.

If you or someone you know is suffering from Duragesic addiction, get help as soon as possible. The Recovery Village has many resources and treatment options for those looking to overcome their substance abuse disorder. Contact our helpful representatives to learn more and discuss our treatment options.

a woman wearing glasses and a blazer.
Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
a woman wearing glasses and a white robe.
Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

FAQs & Related

How is Duragesic used?

Duragesic should be used on a regular schedule and applied to the skin as directed by your doctor. It should not be used to treat sudden pains. Because the fentanyl releases slowly from the patch, any dose changes may take up to 6 days to reach equilibrium in your body.

In the event of an emergency, should naloxone be administered to reverse a Duragesic overdose?

An opioid antagonist such as naloxone (brand name Narcan) must be administered as soon as possible to reverse the effects of Duragesic on the body. Naloxone is the most commonly used opioid antagonist. When administered nasally or intravenously, naloxone can negate the drug’s effects in seconds with just a single dose. In cases of severe overdose, multiple doses may be necessary. Naloxone reverses the effects of opioids by forcing them to release their bond with opioid receptor sites in the body. If you suspect an opioid overdose, you should always call 911 after giving naloxone, even if the person starts to feel better. Naloxone can wear off within 90 minutes, and the person can overdose again if they still have high fentanyl levels in their body.

How long does Duragesic stay in your system?

The windows of time in which the fentanyl in Duragesic can be detected in your system will vary between the type of test you are administered. A rough estimate as to how long it can be found in your system is as follows:

  • Urine: can be detected up to 3 days after its last use.
  • Blood and plasma: up to 12 hours after its last use. Fentanyl’s major breakdown product norfentanyl is detectable in the blood for up to 10 hours.
  • Saliva: It is unclear how long fentanyl is detectable in saliva.
  • Hair: In general, 1.5 inches of hair growth shows the past 90 days of drug use.

U.S. National Library of Medicine. “Duragesic.” October 15, 2019. Accessed July 26, 2020.

ARUP Laboratories. “Drug Plasma Half-Life and Urine Detection Window.” January 2019. Accessed July 25, 2020.

Griswold MK, Chai PR, Krotulski AJ, et al. “A Novel Oral Fluid Assay (LC-QTOF-MS) fo[…]rted Heroin Overdose.” Journal of Medical Toxicology, December 2017. Accessed July 25, 2020.

Salomone A, Palamar JJ, Bigiarini R, et al. “Detection of Fentanyl Analogs and Synthe[…]in Real Hair Samples.” Journal of Analytical Toxicology, May 1, 2019. Accessed July 25, 2020.

Drug Enforcement Administration. “Fentanyl.” Accessed July 26, 2020.

National Institute on Drug Abuse. “What are some signs and symptoms of some[…] a drug use problem?” Accessed July 26, 2020.

World Health Organization. “Clinical Guidelines for Withdrawal Manag[…]e in Closed Settings.” 2009. Accessed July 26, 2020.

Guan, Wei; Schneider, Ronald; Patterson, James. ““I Am in Pain!”—A Case Report of I[…]al Fentanyl Patches.” The Primary Care Companion for CNS Disorders, 2011. Accessed July 26, 2020.

Anne Arundel County Department of Health. “Naloxone: Frequently Asked Questions.” Updated September 9, 2019. Accessed July 25, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.