Suboxen Patch Vs. Butran Patch

Been taking 80 mg oxcy for 3 years for major back operations, three of them XLIF. Now was taken suboxen and the pain is still pretty bad. Stop oxcy July 8 had surgery June 20. Now went to new patch called Butran 10 mg. Been on for two days and still have back pain. Any ideas?

Hi there...welcome to HW...Sorry to hear of your pain..

I'm a bit confused on what you are saying...You say "now was taken Suboxone and pain is still bad"....

Are you now on the Butrans patch as well as taking Suboxone?

As far as I know...Suboxone does not come in a patch. (just in pill form or "film" form)

However...there is the same medication (buprenorphine) in the Suboxone and the Butrans patch. The difference is the Suboxone has naloxone in it as well.

The Butrans patch usually takes 3 days to a week to really start building up in your system to start feeling the best pain relief. That is why it is dosed to change every 7 days...

Usually Drs. want a patient to stay on a new medication for at least a month or so (barring any actual allergic reaction) to see if it is a good fit.

When do you see your Dr. next?

Post Edited (Snowbunny21) : 11/19/2012 2:29:33 PM (GMT-7)

I was taken Sub to get off the 80 mg oxcy. little too much. but had XLIF and pain is still there just moving to T12 thru T 5.. Just wanted to see if the sub film 8/2 that i have been taken is blocking the effects of the butran patch. doc say it does take a few days. I am new to posting. Not new to pain meds though. been taking opiates since 9-24-07

and thank you for your reply, Snowbunny
sorry about that

When you say "little too much" do you mean you were taking more Suboxone than prescribed? Or just meaning that you think you were on too much Oxycontin?

I apologize for having a bit of trouble understanding some things..That can happen on a message board...LOL..

If you don't feel you are getting appropriate pain relief...then contact your Dr. to see what they say. I wouldn't think that the same medication could block itself out....And the naloxone in the Suboxone is usually not enough to do that. It's not the same as say Narcan that is used in the ER to reverse a drug overdose.

When Suboxone is given for pain management...it is in different dosages so it works for pain relief.

I just think that it will take more time to switch over to the Butrans patch fully.

But I would call your Dr. with any questions you have as no one here is a medical professional...we are just other pain patients:)

Feel free to keep posting as this is a wonderful place where we all understand what it's like to live with chronic pain...

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SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

I agree with snowbunny, it does take a few days, if it was introduced without your previous medication ; but my understanding, is that the naloxone in the suboxone takes 3-4 days to leave your system before any opiates would have an effect. So if you just stopped the suboxone and started the Butrans, you could be in for a rough couple of days. My only question is, why your doctor prescribed Butrans, when it says right in the little leaflet that comes in the box, that it is not proven effective for patients who are already opioid tollerent? This seams like a very irresponsible move on behalf of your doctor. I don't know if using the suboxone will improve your success with it, as I've not heard of Butrans being prescribed after suboxone, it just seems to me that this medication, even though it will probably offer a little relief when it takes effect, it will not have the effect that it could have had if it were prescribed under the proper circumstances.

Just a few tips on the Butrans, having been on it also. I always put mine on the upper arm, and covered it with an elastic band, the one I used was actually a small elastic knee brace, this kept shirts and stuff from tugging at the corners, as well as kept it at a consistent temperature, for consistent medication release. Don't hit it with soap, or water from your shower directly, this is easiest if you have it on the upper arm. Also, if you want it to work properly, dont walk outside in the cold without some warm layers on, it is temperature dependent, and will not release enough medication if it gets too cold. If it does get too cold, don't run hot water on it or stand by the heater, it could cause a deadly over release of medication, just rub your arm for a minute or two, at a point below the patch, to warm the blood circulating in your arm, or wherever you place it.

Good luck to you, and keep us posted on how you're doing. And give the patch some time to take effect.

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Matt
dx: just had L3-4 XLIF and ILIF, gotta see what happens. Disc bulge in T12-L1, ddd through rest of lumbar region. Gastric Bypass 2003, bleeding ulcer in pouch 2005, full small bowel obstruction 2011. Left shoulder has Bursitis, tendonitus, separated bicep muscle (I was told all the muscles look like string cheese lol, or a frayed rope), and arthritis of the Glenoid and humeral head.

Matt, I too put on upper left shoulder muscle off the top of begining biceps. perfect spot. My concern was that the suboxen got me off opiates but the pain is getting the best of me. So my doc said instead of suboxen, we use butrans for pain offset. I just do not want to back to 80 mg per day of oxcy, too much. sub worked but pain is coming back in upper back. XLIF twice, two minucus too, torn rotator cuffs too.

thanks for replying. really do like hearing your input thank you.

Now that I have received feedback from this board and I am beginning to trust more,,,, let me make my story a little more clear for you two. I am n AA too for the last three years. Also I forgot to mention that was 80 mg of oxcy was for three times a day. 320 total per day. had surgery, then went right to suboxen. I had little pain and wanted to stop taking oxcy. Doc said to go to 60 then 40 then 30 etc. I wanted to rush it and now I feel that maybe I hurried too fast through this.

SJ22,

Just a quick note to welcome you here to HealingWell and the CP forum. I hope you'll find everyone here as I do - very supportive and non-judgmental.

I have experience w/ just about every med except the suboxone, butrans, etc. So, hopefully, others can help you in that area....

But just wanted to stop in and welcome you here.

Take care --Tina

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Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to e-mail me or ask on the board. Thanks!

thank you Tina. Appreciate it...

Thanks for sharing more information....

It does sound like now that you mention you were really on 320mg a day of Oxycontin that you tapered down way too much and too fast.

Since the Dr. wanted to have you taper slowly....can't you still do this and speak with him?

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SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

I went to him today and he said put two patches on. I do have a few 80 mg oxcy left, but I am not sure if I take them with that patch it will do nothing bc the Butran patch filled my receptors but not like suboxen? Will the oxcy work with the Butran PAtch? I just put patch on Saturday Nov 17.
I think the oxcy will work bc the butran patch has opiates in it too? Any idea there? I did not ask doc about that.

Hopefully you will start to get better pain control over the next few weeks.

Unfortunately we cannot say whether you should use the Oxycontin with the patch. You really need to ask your Dr. this (you can call the after hours number or first thing tomorrow am)....It could be dangerous to do anything on your own playing around with opiates like this.

SJ, congrats on AA, I've been sober for 16 yrs. My advice as a sponsor, knowing the addictive mind, if the doc has taken you off of the oxy, get rid of them since there is only a few. Dispose of properly. No temptation left. And not worth any potential drug interactions. If you tapered off too fast, water under the bridge. It's done. You're off it. Get rid of what's left. It's like looking at one last beer in the fridge and wondering "what if?" Not worth it.

I'm not familiar with the patches, and I know that people become dependent - not addicted, big difference - on large doses. But as pointed out above, if the current patch you are on should not be used with an opiate, you have your answer. Dump the opiates, stay with the patches you were given, and understand 2 things
1)They take time to work - they have to build up to a certain level in your bloodstream and stay at a certain level to have an effect
2)Follow the directions - As was posted above, there are ways to make sure you are getting the correct dosage as intended since they are temperature sensitive. Keeping them at a constant temp is following Dr's orders, as that stuff is usually laid out in the little pamphlet that everyone just throws out. And follow the tips on keeping the thing attached.

That being said, if you've given it the old college try, say 3-4 weeks, and you find your pain worsening, or find any other symptoms that weren't there before, call your doctor. If you start developing a rash at or near the patch site or trouble swallowing or breathing, get thee to an ER ASAP.

Patches are not like pills. Oral or IV meds hit harder, as they kind of enter the bloodstream all at once. Time release patches build up slowly, but hold at a more constant level. You may not get the same level of pain relief as you would with oxy, which may have brought things down to a 3 temporarily, then as they wear off the pain level climbs back up. But the patches may be able to keep things to a 5 longer term, without the rollercoaster. And that's easier to get used to than the constant up and down.

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Short version; Osteoarthritis, scoliosis, lumbar spondylolisthesis, sciatica, hip dysplasia, bipolar disorder, migraines, macular degeneration, TIA's (they think), insomnia, and a rogue's gallery of other things...
~ ~ ~ ~ ~
God, grant me the serenity to accept the things I cannot change, The courage to change the things I can, And the wisdom to know the difference.

You should not take the Oxycontin and the Butrans at the same time, 20mcg p/h is the max safe dose on Butrans, and more opioids stacked on top of it, is a high risk for respiratory distress! There are certain meds that they use as break through meds with it, I'm not sure what they are. Also, if you still had any suboxone in your system, the naloxone would undo any effect of the oxycodone, hence you would have successfully wasted a pill.

My advice is to only use the medication that you are cleared for at this time, if your PM does a urin test, and it comes back positive for an old, no longer used, medication, you get dismissed. Also, there's the risk of overdosing, either from the combination of meds, or from just not being tolerant of the same dose that you once were. Don't start down that slippery sloap of "well it will be ok this one time", that path has a bad ending.

Keep in communication with your PM, it's important that they know if your medication doesn't work, and they can bring you into the office if they see a problem with it. Good luck, and give the medication some time to work, they started me on the 20 mcg p/h patch, and it was my second week before I really fealt it's full effects. Take care, and keep us posted.



PS, just a thing about the Butrans, if you start feeling bad muscle aches around your joints on the 5th or 6th day of the patch, especially around your chest/shoulder area, apparently that's a normal (but very unpleasant) side effect.

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Matt
dx: just had L3-4 XLIF and ILIF, gotta see what happens. Disc bulge in T12-L1, ddd through rest of lumbar region. Gastric Bypass 2003, bleeding ulcer in pouch 2005, full small bowel obstruction 2011. Left shoulder has Bursitis, tendonitus, separated bicep muscle (I was told all the muscles look like string cheese lol, or a frayed rope), and arthritis of the Glenoid and humeral head.

Thank you all very much for your replies they mean a great deal to me. Advice well appreciated and will heed your thoughts.

living Color, I just had the chance to really read all of what you wrote on my desktop. WOW. Powerful stuff. Yes you are right in that just having them around is a problem. No more pills around. No more oxcy and they were disposed of properly. I did go back to doc and he said they cannot start at 20 mg so he said to put on another patch. They only give you FOUR so it has been ten days now and I think things are better. Granted the pain is still there but becoming more tolerable. Thank you for the advice. This board is great. I wish I found it 4 months ago!!

Just wanted to let you all know that pain is gone and suboxen is working great. Use maybe one per day, half in AM and half at night. No more of anything else, and feeling like a million bucks.!! Thank u all

Thanks for the update! Glad to hear you are doing well:)

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SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

One of the best feelings is that I do not have the urge to have any opiates at all! It is a feeling that I NEVER thought I would get rid of in my lifetime. I thought I was hooked for life. For the Love of GOD and AA and NA I am a survivor. Feel like I am young again. One other warning for MEN who take Opiates, you loss a great deal of testosterone and that has to make you fell horrible. Mine was 128 and now taking Testim for this. Been on it for one month today and it does make me feel much better. We will know more in 30 days for blood test.

XLIF three times L-1 thru L-5 over period of three years. Last operation was July 2012.

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Had Lami L4 in 2008. First XLIF in July 2009, then another XLIF June 20, 2012. L1 thru L5 all brand new. T12 thru T5 all bulged still. Played Football for 16 years.

We really appreciate that you felt comfortable enough sharing your story with us here. Even though this is a site for those who don't have addictions, we pass no judgment on those who struggle with this issue. My mom is a recovering alcoholic for over 25 years now!

To add to that being a person in chronic pain, it makes the journey harder for you in getting the pain relief that you need. Thankfully you found a good Dr. and a good combination of treatments/meds that are giving you your life back! In many ways:)

The testosterone issue is an important one for the men here at HW so hopefully they can learn from the information you posted and talk to their Drs. about being tested.

We love hearing happy updates!!

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SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

Thank you so much and have a wonderful NIGHT ! Appreciate your input!

XLIF three times L-1 thru L-5 over period of three years. Last operation was July 2012.

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Had Lami L4 in 2008. First XLIF in July 2009, then another XLIF June 20, 2012. L1 thru L5 all brand new. T12 thru T5 all bulged still. Played Football for 16 years.