What is a substitute for Fentanyl patch?

You can transition from patches to any other opiate. However, the primary reason that patients are normally prescribed Duragesic is that their pain is constant, chronic, and high enough that the amount of acute pain meds that would have to be taken in its place isn't going to work as effectively. Fentanyl patches are currently the only opiate therapy that lasts for days, not hours. Even OxyContin only lasts between 8-12 hours, and the dose dropoff is very steep compared to Fentanyl.

Duragesic use should never be considered lightly, as it's a life altering decision. Being at the mercy of Federal regulations concerning Schedule 2 opiates is not fun, but in all decisions quality of life must be the paramount factor. If it helps you lead some semblance of a normal life, then it's worth it.