i can tell you that buprenorphine sublingually is on of the smoothest opiate pain med. i have had, i imagine with the patch it's even less peaks and valleys. i know that they are using Suboxone/Subutex for breakthrough pain with patients already stabilized on the patch. one advantage of buprenorphine is that it has a ceiling effect at around 32mg/24hrs. so the risk of respritory depression is less but it still has kick.