You can't puke up the patch. It's much stronger and more effective then Vicodin (which is a medium strength pain reliever). Besides Duragesic (AKA Fentanyl) is a "long term" opioid whereas Vicodin is a "short term" one. "Short term" pain relief is mainly for breakthrough pain (morphine is actually one of the most effective in that it starts working in about 30 minutes). "Long term" narcotics such as Duragesic or Oxycontin are used to moderate the ongoing day to day pain. The patch is good for 72 hours at a time.

Does he have a swish & spit numbing solution also?

I had several breaks due to equipment failures and missed a couple of days because I was too sick.