Any advice about BuTrans patches

[PersianCatLady]

Hi,

Long story short.

I have been suffering from gradually worse and worse back pain ever since I fractured my L3 vertebrae seven years ago.

Initially I was in hospital for six weeks and prescribed morphine, tramadol and diazepam but within a year I was managing with just co-codamol 8/500.

Anyway after a year or so the pain started getting worse so that was increased to co-codamol 15/500 and then later to co-codamol 30/500.

Basically now I am taking 8 of these tablets a day, every single day and it is not all that effective at controlling the pain. I have also started to feel nauseous quite often and occasionally I actually vomit.

As I thought that the codeine might be causing this for a couple of days I just had paracetamol and I felt exactly the same in my stomach but in much more pain.

Anyway this has led me to the conclusion that I don't actually want to be taking these co-codamol tablets every day any more.

After having a bit of an internet search I read about Butrans patches and to me they sound like the ideal solution to my issue. However this morning when my GP called me and explained all of this to her she simply said "BuTrans patches are morphine patches so we don't prescribe them here".

I am fully aware of Butrans patches containing an opioid but I didn't think that they contained actual morphine.

So my question is does anybody else have any experience of these Butrans patches and was the doctor wrong in what she said?

Many Thanks

[Roomba]

They contain Buprenorphine, which is about 40x stronger than morphine. I think that they're usually prescribed by pain clinics.

There are lots of other drugs that you could try before you went for something as strong as Butrans patches, I would have thought. I'd are another appointment to talk about what your options are.

[PersianCatLady]

Roomba
Thanks for your post.

Whilst buprenorphine is 40 times stronger than morphine, a 5mg Butrans patch can be applied and left in place for a week which then constantly releases 5mcg per hour.

I really like the sound of no more taking all of these tablets which I think are hurting my stomach and I also like the ide of not waking up in the night in pain because the effects of the co-codamol have worn off.

Does anybody else have any other experiences or comments?

[donemychristmasshop]

Bump?

[AnnaMagnani]

Buprenorphine is a type of synthetic opioid so very similar to morphine. Your GP will not want to prescribe it for you because it is essentially exactly the same as your co-codamol at several multiples of the price, and because we now know that opioids don't work in the long term for chronic pain.

You've already found out opioids don't work for chronic pain as you are having to increase your co-codamol from 15 to 30 and they don't work as well as they used to. We are also finding out other things about long term opioid use such as it having effects on the immune system.

I'd suggest you see your GP asking if there is anything else for your pain and having an open mind. Sadly there may not be a lot on offer.

[PersianCatLady]

Anna
The opioids are the only thing that allow me to have a life and have some time free of pain.

Since I made this thread I have gone onto just codeine tablets because I am now allergic to paracetamol (who knew that was even a thing??)

I have had a preliminary pain clinic appointment and I am going back in a week to hear what the team has decided that can do for me.

I am feeling very hopeful because the doctor who I spoke to at the first appointment seemed very hopeful that the pharmacist on the pain clinic team would be able to prescribe me something that works to provide a level of pain relief all day.

I am hoping to start teacher training in September and I really don't want anything but especially lack of adequate pain relief to get in the way.

You sound as if you work as a HCP, what do you do for patients who have chronic pain due to an injury that really want to get on with their lives?

Do you allow them to have the medications that enable them to live life to the full or do you (like my GP) have ideas about opioids that prevent your patients from functioning on a day to day basis??

[retirednow]

You poor thing, chronic pain is utterly miserable. Has the doctor done any tests to see why the pain is getting worse. Pain clinics are the specialists, there are other long acting tablets and patches they might suggest, I hope they can sort it out for you.

[PersianCatLady]

You poor thing, chronic pain is utterly miserable. Has the doctor done any tests to see why the pain is getting worse
They have said that it is just the result of fracturing my L3 vertebrae and getting older apparently.

If I lie on the sofa all day then it doesn't hurt. When I had noro a few weeks ago, I barely moved and it was the first time I didn't notice having back pain in years.

But I am not prepared to give in and do nothing with my life and it could be a lot worse, I could have ended up in a wheelchair and unable to do anything at all if I hadn't have been kept immobile after my accident.

[retirednow]

Is there no surgical treatment available. Is it nerve pain, different tablets work for different types of pain.

[PersianCatLady]

Is there no surgical treatment available. Is it nerve pain, different tablets work for different types of pain
The pain ranges from being a constant ache to an agonising deep pain right in the part of my spine where I fractured my L3 vertebrae. I would say it that it is more a bone pain then a nerve pain.