Persian most likely, as they don't have the funding for ongoing management for anything that can be done in primary care
I've never had Butrans, although I have had (deep breath)
Pregabalin, gabapentin, amitrypitline, oxcarbazepine
Coproxamol, Codydramdol, dihydrocodeine, tramadol, sevredol (oral morphine), Oxycontin (modified release oxycodone), OxyNorm (instant release oxycodone) and fentanyl patches
I didn't get on with the fentanyl patches personally, as I developed a tolerance REALLY quickly. Continuous release meant there was no scope for me to take less on a good day, and my body developed tolerance very rapidly - so I was using my breakthrough meds just to get a baseline, within just a couple of months. However others have amazing results. So definitely worth giving it a try!
The only caveat with management in primary care is that IME GPs don't tend to understand the difference between tolerance, dependence and addiction
Every so often a GP will tell me they are addictive. Yes. I know. But as my pain consultant said to me when I was in his room crying after the top surgeon had said there was nothing we could do to fix my back, panicking that I was going to get addicted to the pain meds if I took them for the rest of my life - he said I'd been on strong opioids for 7 years at that point, and if I was going to get addicted, I'd have done so WAY before that time.
I have a significant tolerance. I have some degree of dependence. I am not addicted