Has anyone tried Buprenorphine patches?

Hi,

I have been given Butrans patches. They stay on for 7 days. Day 1, 2 and 3 the dose is building in your system and on day 3 it is at it's max. There is no see sawing up and down just constant painkiller all the time, its there when you wake up so no dreadful dip in the morning waiting for meds to kick in, and no lull in the afternoon.

Although I now change on day 6 as they seem to be used up too fast,

You may need to start on 5mg then 10 then 15 (10 and 5) then 20 then build for a couple of weeks to see what dose you need. You may be fine on the 5mg, I was for ages as it just took the edge off the mornings for me.

Good luck and if you want any more info let me know 🙂

To Cascara

Many thanks, Cassie.

That sounds very reassuring. My GP did mention they stay on for 7 days and that you gradually increase the dosage strength.

Just one question well actually two, you mention the dose takes about 3 days to build up, do they have sufficient pain-killing effect in those first few days to replace the co-codamol? Also, is it the first three days every time you change the patch or just the initial 3 days when you start using them?

Thanks again, I think I'll give them a go.

cheers
Cat

It takes 3 days to build to the dose in the body then it stays constant, so first path days 1-3 building then 4 5 6 7constant then change and day 1-7 constant etc.

I was able to leave off the other pain relief as I rested waiting for the patches to work as I started them on a Friday 🙂

Thanks for replying, Cassie. They sound much better than keep popping the co-codamol, I'm definitely going to give them a go.

cheers
CatMac

Good Luck, a couple of things I find help, keep a diary and jot down where you put the patch so you don't put one on the same place for 4 weeks, also no body lotion on the area for a few days before or they seem to not stick so well.

In fact it's handy to keep a pain diary so you know if its doing any good and what happens 🙂

Good points Cassie. I've never been any good at keeping diaries, but I must admit I've currently got loads of time on my hands as I'm unable to go to work, so that will keep me occupied 🙂

Thanks for all your help n this.
All the best
CatMac

I am useless at keeping diaries too but my chiropractor suggested I keep one of my symptoms and now I have over two and a half years of notes. It's far easier jotting down LHL pain ( left hand leg pain) or RHS numb ( right hand side numb etc) I also can look back and show my docs evidence of how the meds do or dont work etc.

I am not into tittle tattling about real life so maybe this is journalling instead?

Try it and maybe you might find a vent too? Also we could always message each other lol to pass the time? You must like cats?

Hi Cassie

Yep, I started my diary a couple of days ago. I've sent it up in Word so I can update while I am sat by my pc during the day. I've backdated it to the beginning of the year and thought I'd better to it before I forgot dates/dosages etc. It's already proving to be therapeutic and useful.

And yes I do like cats, but if you're referring to my user name that is an abbreviation of my first name and maiden name - Catriona McHardy.

Judging from your gravatar, I would say you must like horses! 🙂

Love horses, sadly can't ride anymore, or even look after them though 🙁 thankfully my son has taken on that role for me now.

When are you due to start the patches?

Started the patches Tuesday evening, so 5pm yesterday was my 72hr deadline. I think they're working.

For the past couple of mornings the pain on sitting up in bed was bad but not agony or excruciating like before. Also yesterday afternoon I managed to walk to the kitchen and back (total about 12mtrs) which I havent been able to do for over a week now. I also feel I'm walking more upright and normally come the afternoon/evening, rather than lopsided with my left hip feeling locked. Still need a stick though but hopefully things are looking up.

It would be nice to be able to get out to the car occasionally just for a run out (as a passenger I mean) and change of scenery. I'm fed up with the confines of the dining room (where my bed currently is), living room and downstairs loo! Still I'm hoping to get to sit in the sun lounge this weekend sometime to participate in the Big Garden Birdwatch. One day at a time for me at the mo.

Do you keep horses at home and are you able to get to see them from time to time? That at least would be some consolation if you cant ride any more.

That sounds a very good start then. Did they give you the 5mg patch? I think the pain relief gets better with consequent patches too 🙂

I have only two horses now and yes they are at home and I can hobble out to see them, It is so frustrating not being able to ride anymore but I have accepted that now as there isn't an operation yet that can fix me properly. so it's better than driving myself mad trying lol.
I can recommend memory foam pillows to sit on in the car lol helps with the bumps.

Hope the birds turn up 🙂

Hi Cassie

No, they've started me off on 10mg patches. I've phoned the surgery twice in the last couple of weeks moaning about the pain and nothing I'm on working, and both times had the same doctor phone me back. He's probably fed up with me and thought he'd start me on a higher dose to shut me up ::lol:

Well, either they are doing some good or I'm getting used to the pain as it seems much better in the mornings. My leg still hurts like hell when I first start walking, but I know that's coming now and it's normally desperation for the loo that motivates me!

Sorry to be nosey, but why isnt there an operation that can fix you? What's wrong? I know I'm probably going to opt for an operation if they recommend it as I cant live like this for the rest of my life.

As for the birds, just one magpie in the whole hour I was watching! We usually have loads of sparrows, blackbirds, jackdaws etc but they must have decided to pack up and holiday in Spain or something this year 🙂

cheers for now
Trina

hi, iam using the 20 mcg patches, i find they were ok but think my body is used to them now ,the worst thing i get is when i change a patch where i've taken the ols 1 off the redness and itching is unbearable , anyone any ideas , i've tried aloe vera but thats not working.

Hi BMW1

I've now progressed to the 20mg patches and, since putting the 2nd one on last Wednesday morning, I've found I can get about much more and with much less pain. Particularly during the day, come the evening I'm not as good, maybe because it's better after resting it overnight. Anyway they seem to be working well for me, touch wood!

Luckily I havent had any itching or redness from the patches, so I'm not really the best person to recommend any solution. However, I find for any kind of skin troubles that Calamine lotion or E45 cream work best. Maybe worth a try anyway.

Hope this helps.
regards Trina

hi, iam using the 20 mcg patches, i find they were ok but think my body is used to them now ,the worst thing i get is when i change a patch where i've taken the ols 1 off the redness and itching is unbearable , anyone any ideas , i've tried aloe vera but thats not working.

You should stop using them as this sounds like a reaction, tell your doctor, there are other kinds of patches, but if you ignore it the rash can become very serious and damaging. One lady at my pain clinic hid the red oblongs all over her skin till the doctor saw them and took her off the patches immediately, the marks are still there but now she is on tablets instead.

The areas that have had patches on are also very sensitive to sun burn for a few weeks after so be careful of them.

Hi I am new here but as I can empathise so much given I have discs at L4-L5 that continually prolapse and have done for almost 4 years now. My consultant offered an operation but with only a 10% chance things would improve I did not feel the risk was worth what could go wrong given he gave that a much higher %.

I also have narrowing of the root canals through my spine and hips, arthritis in the spine and issues with the SI Joints.
I take 2 gabapentin three times a day along with 2 paracetamol as physiotherapist and doctor say they help boost the gabapentin.
I take 2 tramadol 4 times daily
2 robaxin 750mg 3times a day
50mg of amatryptaline
And the butrans patch 20mgph

It is now 3 am and due to the pain I am unable to sleep. Due to me falling when I get the shooting pain down the legs I have been given an electric wheelchair to use.
I do not feel doctors fully understand what it is like to be in pain 24/7 and even with all these meds all they do is take the edge off in between bouts of being bedbound when the discs do go and it seems for me that I spend a minimum of 6 months a year in bed cramping up even if all I do is wiggle my toes.
Prior to getting the patches things were much, much worse so I do hope you have found them to be a blessing rather than a curse. Now if only it was easy to remember to change them on time lol.

Hi Blakespops and welcome to the forum. I'm pretty new here myself having only joined in January.

I really cannot imagine what it must be like to have been suffering for 4 years. Mine has only been debilitating enough to prevent me from working for 2 months and that seems an age!

What operation were you offered if you dont mind me asking? A success rate of only 10% seems extremely low. I know from researching online that a discectomy, which is what I'm hoping for, has an 85-90% success rate.

You are also on vastly more medication than I am. Apart from the patches, I'm taking 1 Gabapentin three times a day and 20mg of Amitriptyline at night, along with 8 co-codamol and 2 Naproxen a day.

Since my last optimistic post just over a week ago, I have found the pain has returned to the extent that it is now constant throughout the day and it takes me a good hour to get to sleep as I cant get my leg/ankle/buttock comfortable any more. When I wake up it's no better 🙁
I changed my patch this morning (I was due to change tomorrow evening) just in case the last one wasnt working, but so far no improvement.

Still I have my first appointment with the Spinal Clinic tomorrow, so I will see what transpires.

Keep in touch, there's lots of help and inspiration on this forum from people who understand what it feels like to live with constant pain. I also hope you will soon find something that will bring you long-term relief.

cheers for now
CatMac

Hi CatMac,

The consultant did not state what the op would be just said as I have stenosis not only in the spine but also through the hips the nerve roots are narrow, He said that the problem with having the discs fused was to do with the level of Arthritis already on show and although the nerve roots could be scoped out, as I am only 40 (or was at time) plus given that this can only be done a limited number of times I would end up suffering much more later down the line. He also stated that the disc,s from L3-S1 are slipping because they apear to be loose. (on the scans you can see the vertebrae appear smaller than the ones above as if they have shrunk a little) He did state the risk of scar tissue building up on the bones along with the Arthritis mean until things get much worse it would not be worth having the op until I am in my mid to late 50's

My wife and I spoke it over and we said that as bad as this is I am with all the pain meds, TENS machine, back brace, and various other aids able to cope with things as they are although should they become unbearable so that I failed to have any periods where things had not calmed down or the discs would be prolapsed all the time I would then go for the op.

We do have a 7 year old son and as he was only 3 at the time paralysis and all the things that would go with it were much more scary than having this pain.

Hi Blakespop,

I am really surprised that with all that arthritis you aren't on an NSAID anti inflammatory? Without my Diclofenac I can't walk!

Also depending on what dose of Tramadol you are on you might want to consider upping the patch to compensate and that way do without the Tramadol unless breakthrough pain or the two can conflict. .

lol I sounds like a right old doctor, I'm not, but I do know what works for me pain wise so thought I would share.

I was also given measly odds for a discetomy so refused. I think it all depends on the case. But I am wondering if you truly understand what a disc is and what is can do,they can't 'slip' at all. Have you ressearched what is really happening to you? It does help to understand the pain and it's causes. 🙂

Hi Blakespop,

I am really surprised that with all that arthritis you aren't on an NSAID anti inflammatory? Without my Diclofenac I can't walk!

Also depending on what dose of Tramadol you are on you might want to consider upping the patch to compensate and that way do without the Tramadol unless breakthrough pain or the two can conflict. .

lol I sounds like a right old doctor, I'm not, but I do know what works for me pain wise so thought I would share.

I was also given measly odds for a discetomy so refused. I think it all depends on the case. But I am wondering if you truly understand what a disc is and what is can do,they can't 'slip' at all. Have you ressearched what is really happening to you? It does help to understand the pain and it's causes. 🙂

Hi,

Sorry to hear you have the same issues. I would not even wish this on the ex mother in law..... oh wait maybe I would lol

I was placed on arthrotec about 3 years ago and taken off it last year when other meds were upped. Now my total daily intake is:

100mg Tramadol 4 x daily
600mg Gabapentin 3 x daily
50mg Amitriptyline at night
40 mg Simvastatin at night
1500mg Methocarbamol 3 x daily
plus the 20mcg/hr transdermal patch

The patch I am told is the highest dose available

I fully understand that when people talk of a slipped disc what has happened is it has deformed and is swelling out. In the past 4 years I have been in the MRI suite so many times and looking at the scans it is easy to see the various stages of the herniation as one of the scans I had to be given injections just to allow me to lay down or the scan. this one showed the disc pushing into the area of the spinal column. Others due to time between being at worst or best show all stages. The bottom of the spine should have a nice curve towards the front of the body as you look from the side however my spine curves towards the back in a "c" rather than normal "s". The Doc did say it adds preasure to the discs and only over time did he keep dropping the odds as he tried injections not only into the spine but into the SI Joints too. the pain clinic eve tried acupuncture. Now although I know I should still tell the GP each time I "slip" a disc however I understand nothing can be done so have not been telling him for the past to years.

Adjusting and adapting your lifestyle to lessen the chance of doing harm and to learn to listen to your body is the best thing you can do. I still do all the daily tasks the physio told me to and have long daily showers where the hot water helps relax the back. I have a shower chair to make this easy however still if i twist the wrong way or sneeze even I can have the shooting pains down the legs to the point they have made me fall so many times.

I had a test where they stick a needle in your muscles to test the conductivity or whatever they test and it came back as normal but I have lost strength in my big toes and the doc says these are connected to L4 L5.

All in all I guess I have given up on finding a cure and am ready to settle for my new life as it is.

God Bless and speak soon

Giving you a big gentle hug.

Butrans only go up to 20mg but then there are stronger patches like Fentanyl?

Yep I spent years going to the gp and getting painkillers and NSAIDS, before the final straw lol.

You are lucky you can take the Gaberpentin and Amy, they react badly with me. Time does heal but you are right, that accepting the change is the best way forward. Sadly for me I went from a very fit horse rider, riding 2 or 3 horses a day to a tottering old wreck! You may find that after the c curve comes the l curve, or ramrod straight with no concussion protection which is where I am or maybe my 'l' will bend over with age later?

Another tip I have that I found out by accident when I ran out of meds is that a few days off them and when you take them again, wow they actually work for once lol!

Its sad that people and doctors think that painkillers kill pain, they really don't 🙁

Thought I should end on a positive note " Diiiing!"

Some days when I am going through a good time I do stop the meds until such a time as the pain is again so bad I need them and I agree this does help as the body gets used to them over time.

Speaking to my GP is at times like talking to a brick wall as he reads notes and reports and does not take into count what I am telling him. This is why for the past almost 2 years when have another bad bout where disc is again bulging or pain is simply so bad I am unable to get out of bed even if house was on fire I do not even inform the GP as I know there is nothing he can or would do and even if they took me to hospital I would just have to wait and allow it to settle down in its own time, but at home I have sky tv in bedroom, my laptop and so much better food than NHS food. Added to that my dear darling wife who can care for me when needed, she also it has to be said is without doubt a saint as she puts up with my periods of self loathing where I just wish I could become paralysed as I would have no pain then to my periods where I try and make up for things by trying to do too much as this is when I tend to do myself more harm than good for all the right reasons.

I told GP once I would not care if spine was broken to the point I could not feel anything and his reply was "now I know that pain is never bad enough for people to wish that among themselves, I guess you must just have a lower pain thresh-hold than most people" My wife's jaw dropped and I just told him he was welcome to his opinion no matter how wrong it was however for saying that I hope you are struck down with this for as long as I have had it so that I could come back and ask if you still hold the same opinion. it was so bad it was funny. Thankfully we have other GP's we can see and I hope to never have to see him again.

I also find sitting with a hot wheat bag helps. the aromatherapy oils in it are soothing if nothing else but the direct heat helps with the cramps. Well worth trying, if you do not have a wheatbag try a hot water bottle.

God Bless

An almost boiling hot water bottle does it for me, also those heat patches but they cost the earth.

Doctors don't understand, one told me that having a baby is far worse, well I had my first babe without anaesthetic as she was too quick and that pain is nothing compared to this. Low pain threshold? PAH! what rot they talk.

Sometims I wonder what is the point of the visits.

I have been discharged from the hospital because I refused the op 🙁

Your bedroom sounds like heaven and your wife an angel. I do understand your anger and frustration and well it's more than anger its a desperation too,

I find aromatherapy very good also ice cold crystals, have tried parctically everything, accupuncture made it far worse, actually bought a hot tub/jacuszzi that is brilliant but getting in and out negates the good it does.TENS only works when the pain is less and not burning nerves or it tends to make it worse too.

It is hard to keep real though, easy to moan.