I love me some Nucynta!!! I've been on and off opiates (mainly hydrocodone) for 15 years due to RA, in addition to unremitting pain after a serious back injury and subsequent surgery to return function to my right leg.
Anyhoo, hydrocodone wasn't working for me any more. I was taking 10x10/325 Norco per day for 2 weeks of every month (supposed to take 5 per day, but 5 was worthless and mindedness insulin the whole month's supply in 2 weeks) followed by 2 weeks of kratom (10g, 2 or 3 times per day mixed in hot cocoa) until I got the next script. My rheumatologist sent me to pain management, as she couldn't prescribe anything higher than what she'd been giving me.
Pain management doc totally understood about the Norco not working any more, talked about opioid-induced hyperalgesia, and newer drugs that I could try. I'd had great success in the past with buprenorphine (BuTrans patch) but insurance decided they'd no longer cover it. He also talked about tapentadol/Nucynta. I liked the fact that it had SNRI activity in addition to mu opioid agonism. He said that tolerwnce, if it occurs in this drug, is very slow.
So, off I went with a Nucynta script in my hand for 120 Nucynta 50mg, to be taken 4 times per day as needed. He said I might have to bump that up to 5 or 6 per day, and to wait a few days in between dose changes. It was difficult finding a pharmacy that had it in stock, though! I took the first pill in the car before we even left the Walgreens parking lot. 30 minutes later I was feeling a bit nauseous and dizzy, but that was it. No pain relief. So I took another one about 3 hours later. The nausea and dizziness returned, still just very mild, and I actually started noticing the absence of pain! I also caught a good buzz. It wasn't as "fun" or as long-lasting as hydrocodone, hydromorphone, or kratom, but it was there. To make a long story short, I ended up taking 6 50mg tablets per day, and so I asked if I could do 2x100mg extended release Nucynta and two immediate release Nucynta 50mg (for breakthrough pain) per day.
6 months on Nucynta now, and it's made a world of difference. I no longer cry due to pain when I first wake up in the morning, and I no longer cry in my car on my way home after work due to pain. I'm a brewer/QC guru at a very small nanobrewery and it's a very labor intensive job. Lots of lifting, stirring (think porridge in an 80 gallon pot, with a heavy 4-foot paddle!!),mconstantly running (not walking!!!) up and down stairs, and a whole lot of general mayhem. With Nucynta, I'm able to brew, bottle, clean up, etc better amd quicker than the 20something big hulking guys who help out occasionally (I pay em in beer). I'm a tiny 47 year old girl and I have more stamina then they do now! And i no longer spend my days off in bed due to pain, passively watching the world go by. It's given me my life back.
Oh, and one more thing... 6 months after starting tapentadol, I can still catch a buzz if I take my two 50mg immediate release tablets along with naproxen, curcurmin and black pepper (they help slow down the phase 2 xenobiotic breakdown pathways in the gut and liver). I know I'm not nearly as dedicated to exploring the limits of my tolerance like some of you kids here (LOL I know, I sound like an old crone!) but it's still remarkable to !e that I am able to feel it after 6 months on the same dose.
I know it's not the right drug for everyone, but if you are suffering Fromm severe chronic pain, maybe give Nucynta or buprenorphine a try. Talk it over with your doc and pharmacist. Better living through chemistry!