What Are Fentanyl Patches & How Do They Work?

Fentanyl patches are adhesive patches that are designed to deliver the potent opioid fentanyl through the skin and into the bloodstream steadily over time for continuous pain relief. These patches are typically prescribed only in the cases of severe chronic pain for which no other pain management treatments are effective.[1] 

The benefits of fentanyl patches include the slow-release action that allows the person to maintain a steady level of fentanyl in their system and the ability to ingest the drug without having to take it orally or see a doctor for an injection. 

Fentanyl patches are only available by prescription and should not be taken without a doctor’s supervision.[1]

What Are Fentanyl Patches?

Fentanyl patches are transdermal patches that deliver fentanyl through the skin. The patches stick to the skin with an adhesive and remain in place for as long as the medication is available. 

Many people prefer these patches because they provide ongoing pain relief without having to get up at night to take medication or remember to take pills throughout the day. With patches, there isn’t a risk that the level of fentanyl in one’s system will drop too low since the dose released is consistent. There also isn’t the risk of mistakenly doubling up on a dose. 

The patches are designed to provide controlled and continuous pain relief over an extended period of time, typically about 72 hours (three days).[1]

Who Should Use Fentanyl Patches?

Fentanyl patches are typically prescribed to patients who are experiencing chronic pain that requires constant maintenance with the use of opioid pain relievers. 

The drug is incredibly strong, milligram for milligram, compared to other opioids that are typically prescribed for the same purpose, such as oxycodone or morphine. It is usually considered a last resort after other pain meds and combinations have not been effective.[1] 

In most cases, fentanyl is prescribed in an inpatient, hospital or hospice setting due to how dangerous the drug can be both for users and those who inadvertently come into contact with the substance. It must be handled with caution and used with care. 

No one should use fentanyl patches without the explicit direction of a doctor. Any extra patches left over after treatment should be disposed of safely and promptly in order to avoid diversion of the drug.

Conditions That May Warrant Fentanyl 

Conditions that might justify the use of fentanyl patches include the following:

• Cancer pain: Cancer can create chronic and severe discomfort in patients, especially during the terminal stages. Patches are often prescribed to cancer patients to avoid the need to swallow pills or undergo painful injections.[2]
• Severe chronic pain: Any patients suffering from severe chronic pain due to accident or injury and those diagnosed with severe back pain, osteoarthritis or neuropathic pain might be prescribed fentanyl patches if other medications have not been effective.[3]
• Post-surgical pain: Fentanyl patches may be prescribed to manage severe postoperative pain in cases when oral medications cannot be taken by patients. 

How Do Fentanyl Patches Work?

Fentanyl patches are saturated with fentanyl in layers, so a moderate dose is released into the bloodstream through the skin at intervals throughout the 72-hour period that it is worn.[1] 

Because there is fentanyl on the surface of the patch, it is recommended that anyone applying the patch to someone who is unable to do it for themselves wear gloves and avoid touching it to anything other than the patient. 

How to Apply Fentanyl Patches

To apply a fentanyl patch, follow these steps:[1]

1. Choose a clean, non-irritated area of skin on the upper body or upper arm.

2. Clean the chosen area with water, removing any soap, oils, lotions or alcohol. Do not clean the area with an alcohol wipe or any kind of soap.

3. Open the patch package and peel off the protective liner to reveal the adhesive side of the patch.

4. Apply the adhesive side of the patch firmly to the skin and press down for about 30 seconds to ensure proper attachment to the skin.

5. Hold your palm over the patch for a minute to allow heat from your hand to activate the adhesive.

How to Dispose of Fentanyl Patches

To safely dispose of used fentanyl patches, follow these steps:[4]

1. Peel the patch away from the skin, being careful to keep fingertips on the adhesive and not on the center area of the patch. 

2. Fold the used patch in half (sticky side in), so the adhesive sticks to itself.

3. Place the folded patch back into its original pouch or another sealed container.

4. Dispose of the sealed container in a manner recommended by your healthcare provider or local guidelines. In some localities, it is required to dispose of these patches in a medical waste bag. Otherwise, ensure that it is thrown away in a trash can that is out of reach of children and pets.

Proper disposal is important in order to prevent accidental exposure to any residual fentanyl remaining on the patch, especially by small children or pets. 

If you have any questions about applying or disposing of your prescribed fentanyl patches, consult your healthcare provider or pharmacist.

What Side Effects Can Fentanyl Cause?

Fentanyl, like other opioids, can potentially lead to side effects. Reactions associated with patches or other formulations of this medication include the following:[1]

• Nausea and vomiting
• Constipation
• Drowsiness and dizziness
• Confusion
• Itching and skin irritation
• Difficulty breathing, such as slow breathing
• Sweating
• Mood changes
• Tolerance and dependence
• Opioid use disorder
• Slowed heart rate
• Low blood pressure
• Urinary retention
• Overdose

What to Do if You Are Accidentally Exposed to a Fentanyl Patch

If you accidentally come into contact with a fentanyl patch, take quick action to protect yourself from potential medical emergency:[1]

• If you touched the patch or anything that the patch touched, wash your hands with soap and water. Avoid touching your face before washing up.

• If the patch stuck to you, gently take it off. Don’t touch the sticky side.

• Stay calm, but get help. Tell a doctor right away or go to the emergency room. Explain what happened, so they can help you.

• Follow the medical professional’s instructions. They might want to watch you for any problems. 

Fentanyl is an incredibly powerful substance, and a tiny bit can have a significant effect, especially if you’re not used to the drug.[5] It’s best to be safe and get medical help if you’re not sure how much you were exposed to or how to respond to the problem.

That being said, there is much misinformation regarding the dangers of accidental and incidental fentanyl exposure. In most cases, if you promptly wash your hands, you will be safe.[6-8]