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PostPosted: Thu Oct 13, 2011 4:12 pm 
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I am having issues with suboxone. How many are related to it, I don't know. At the very least, getting nausea every day after taking it was certainly a sign that I might have some side effects perhaps from naloxone. & being on suboxone for 8 years now, with the past 6 years things have really been going downhill, it was time for a change. To set my mind at ease, I at least wanted to try bupe without the naloxone. Since I have legit chronic pain issues, I went to a local pain doc today, explained all this to him.

He mentioned Butrans which I am familiar with from researching. On monday, I'm starting with a .5 mcg patch. When I got home, I researched just how much bupe I'd be getting.
What I learned... a shockingly low amount. Like not even 1mg a day. I'm on 8mg right now & was recently up to 24mg. I learned that this .5 mcg dose is for people without any sort of opiate tolerance.

That is definitely NOT me, considering that since I was a teenager I've either been on 80mg oxy's then suboxone the past 8 years (almost 15 years of being on high dose of opiates, & the couple times I've tried to go without, life was unbearable, even after 6 months of nothing at one point, my body never adjusted, as if my body's natural pain killers are gone for good. Sad but true, & hence why I've had to be on suboxone.

But at this point, all I care about is quality of life. I've had none, for years now. Things weren't too bad on suboxone for the 1st 2 years, but the past 6 have been pretty miserable, with all these new health issues popping up as well. I tried getting on Subutex so that I could keep my same bupe dose & see how I feel, but unfortunately my sub doc not only refused, but he damn near threw me out of his office for even asking... despite me having a perfect track record on suboxone, a perfect patient.

So this left me no choice but to see if a pain doc would prescribe subutex (off label) for pain. He immediately brought up the butrans, which sounded fine to me, but again I was unaware just how lose a dose that would give me.
I don't know how bad this is gonna be for me. Even if I got onto the 20mcg patch instead of 5mcg, that is still a low dose. I told him I was on 8mb of bupe, so why would he think 5mcg per hour of bupe is gonna work as I switch over? Am I missing something here?
I'm happy I get to try bupe without naloxone, which may very well help me feeling sick, but now I'm concerned about another type of sick (withdrawal).


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PostPosted: Mon Oct 17, 2011 4:05 pm 
Extremely curious to know how this is going for you or anyone else with chronic pain issues who has tried Butrans for that matter? Keep us updated!


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PostPosted: Mon Oct 17, 2011 4:32 pm 
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It kinda sucks. Not only am I used to 8mg of bupe per day, but I've actually spent the bulk of the past 8 years on 24mg, so even 8mg is a low dose for me.
Now onto the patch, 5mcg per hour... my doc just doesn't understand. Just my suboxone is 8,000 mcg per day. Now this patch only giving 5mcg per hour? Yikes!

When I recently tried cutting down & going without subuxone, I really started having issues when I got to 2mg or less despite taking a year to ween down to that. Yet even the strongest butrans patch doesn't give that much in 24 hours.

I don't think this is gonna work, as I sit here with tissues stuffed in my nose to keep it from running, I'm probably gonna have to go back to the sub tomorrow or sooner. I don't know why this doc thought that this patch could be a good alternative. I wasn't too familiar with butrans, nor was I familiar with how the microgram math worked out, so I just shut up & said I'd try it. Yet he warned me, he said on the 1st day on this patch that he wanted me to go to his office, get my BP checked... as if I'm an opiate naive patient. I don't think he understands just how high my tolerance is. Again, I've spent most my adult life either on 240mg of oxycontin per day, or 24mg of suboxone. 15 years?

I think I'm screwed for life as far as tolerance. There was a point even when I was just about 5 years into taking narcotics, where I went 6 months taking absolutely nothing. When I finally did take something, I thought a vicodan or two would work. LOL! I think it took about a dozen to work even a little bit.

Now I'm 15 years into having the tolerance of a heroin addict. These patches won't work for anybody like me. I need to straight up ask him if he'll prescribe subutex, 8mg, off label for pain since my sub doc won't do it (I wish he would).

I will say...
If I or anybody can cut down to about 2mg or less of sub, then wanted a real efficient way to continue to ween... these patches would be PERFECT. You can go from 20mcg patch, to 10mcg patch, then once down to 5mcg patch, you should have a MUCH easier time of going off the bupe because 5mcg, again, is an opiate naive dose.
I'm VERY surprised I haven't heard about these patches being used to ween people off of sub, given how hard a time some people have doing it.

That is where the conversation needs to be with these patches. Not for somebody like me with the tolerance of 2 horses & looking for pain relief while keeping my opiate receptors filled.
If I had done OK on 2mg of sub, I'd considering going down to that again, & staying with maybe the strongest patch, but I think I'm a lost cause.
Honestly I'm kinda pissed at my docs for putting me on such high doses of narcotics when I was still a teenager, & told that 24mg+ of sub was also a good idea to stay on for the rest of my life. Really limits my options these days.


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 Post subject: butrans
PostPosted: Tue Oct 18, 2011 12:14 pm 
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i too , am very curious about this patch....but from doing the math, it looks as if you should stay on the pills. this is a new purdue (brand) product....big pharma. generally speaking, patches suck as a way of delivering medicine...IMO. I wore a fentanyl patch for 4 yrs ( all brands, sizes) and they don't last 3 days, fall off in shower, during sex, summer heat, u name it.............personally , i just can't stand patches but let us know how everything works out


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PostPosted: Tue Oct 18, 2011 2:50 pm 
I think Indigo makes a good point. I think that Butrans looks really good on paper but so did Duragesic which was a nightmare for me. I developed terrible rashes wherever I'd wear the patches, they in NO WAY lasted 3 days, they fell off all the time and when you're dealing with something that 'strong' and you only get 10 or 15 a month, anything unplanned and you're screwed...


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