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Bupe buprenorphine patches

^ Honestly, there are good and bad docs everywhere I've been. I found a good doc in London first shot recently... by spending about a week researching different pain docs and reading their online reviews and stuff first. And even then, it was at least 60% luck. (And frickin' expensive.)

Main thing for me, is that with my diagnosis, they can usually feel pretty safe that they won't get in legal trouble for giving me opioids. I take a stack of medical documentation with me to every appointment, including pics of my innards taken during one of my ops. Before diagnosis, I just got a whole lot of 'tough it out', basically because they didn't know enough to realise there was actually something seriously wrong. Mostly 'cos ladies with abdominal pain are just delicate petals who can't take their g-d-given lady pains, amirite? (Sorry, sarcasm.)

Only tips I can give are:

1. If your current docs aren't helping, find new ones. Hang in there and keep looking 'til you get good ones.

2. Emphasise the impact pain's having on your quality of life, e.g. "I'm missing classes because I'm in too much pain to concentrate," or "it takes me hours to get to sleep because I'm in too much pain," or "I'm always grumpy at work 'cause it hurts so much and my co-workers are starting to hate me," or "I'm in too much pain to go for a walk each day like my physio told me to," or whatever the impacts it's having on you. It seems to put it in context for docs more than citing pain scale numbers does, IME.

3. If you have a family member, partner or close friend who can come to appointments with you, take them; then it's not just your word that pain's interfering with your life, since a third party is there willing to vouch for you. My ex-husband had this really angry way of saying, "she even looks like she's in pain when she's asleep," and I'm pretty sure docs sometimes gave me pain meds just so I wouldn't have him yelling at me for making pain-face while I slept! ;)

4. This is just me, but I'm really paranoid about misusing my meds in any way, lest my doctors find out and take them away. So I tend to advise not using them for fun, especially since the more tolerance you build up, the less they'll work when you really need them to. I'm not against fun in general, and my doctors know that I still drink while on bupe patches (usually moderately but not always ;) ) 'cos I enjoy it, but the only time I have fun on my meds is when they finally make really severe pain just melt away and I can get back to having a life again, instead of just curling up in a little ball going 'ow ow ow'. Which is more relief than actual fun, really. (Yes, I am a total square ;) )

Good luck! (Sad to say, you still need it.)
 
Anyone in Canada had Butrans patches yet? Ive been thinking about asking my doctor about them but since I'm on morphine already for pain I'm not sure if bupe would help at all. Not to mention the highest dose that the Butrans patches come in is 20ug per hour.

How well does bupe work for pain anyway compared to say morphine or hydromorphone?
 
paranoid android said:
How well does bupe work for pain anyway compared to say morphine or hydromorphone?
Click to expand...

Bupe's rated as 25-40x stronger than morphine. Plus if you're on oral morphine, the bioavailability of transdermal bupe's about 50%, compared to 20-40% for oral morphine. So the equivalent dose of bupe should be much smaller to get the same level of pain relief.

I can't speak to the experience of switching from morphine to bupe patches personally; I was on ~120mg oxycodone / day before they my doc switched me to bupe patches, and after a really rough couple of weeks adjusting, the bupe worked way better.
 
painhater said:
[...] Also it works great for 5 days then its lacking. Just hate that I will run out b4 month is up if I switch every 5 days and it brings to? If I do switch @ 5 days then im sure bupe plasma levels will stay high enough to do trick on severe chronic pain if I don't switch will levels be cool or am I going thru 72 hour build up cycle weekly? Im not sure im basically not wanting to be in pain as all of us feel. Don't like tabs cause they don't work any more and I just keep eating them to stop pain but that doesn't work so I guess im screwed
Click to expand...

painhater and spikyfairy, just had another idea of how you might be able to get around the bupe dosage from the patches dropping off after 5 days (which I just learned thanks to BL):

Get some cimetidine. It's metabolised the same way as bupe, so uses up some of your body's capacity to break it down, so it stays in your system longer (effectively increasing your dose again, for the last two days when it's running down). Works great for me; might work well for you, too.

(spikyfairy: It's prescription-only in Australia, usually prescribed for heartburn-type stuff, I think. If you had a good/sympathetic doc, I'd tell 'em what you want it for and ask their advice, but your doc doesn't sound great. It's OTC in the US though, so might be possible just to get some sent over from an online pharmacy?)

Or there are other opiate potentiators you might try, like diphenhydramine. The thread where I asked for advice on making bupe last longer is here:
http://www.bluelight.ru/vb/threads/636561-HELP!-How-to-make-bupe-tablets-last

I'd imagine all the same advice re combining with other meds would apply to making the bupe in your patches last longer, too.

ETA: This old thread was kinda helpful for finding OTC meds that might help extend / increase the effects of bupe too:
http://www.bluelight.ru/vb/archive/index.php/t-185032.html

It's about opiate potentiators in general though, i.e. not specific to what works best with bupe.
 
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(spikyfairy: It's prescription-only in Australia, usually prescribed for heartburn-type stuff, I think. If you had a good/sympathetic doc, I'd tell 'em what you want it for and ask their advice, but your doc doesn't sound great. It's OTC in the US though, so might be possible just to get some sent over from an online pharmacy?)
Click to expand...

they're actually indicated for mild-severe chronic pain not respondent to NSAIDS and other opioids. there are specific meds out there to target heart burn/reflux issues.
 
^ Cimetidine? Didn't know it was prescribed by itself for pain, although it does definitely make bupe work longer / better. I'm pretty sure its main use is still heartburn / gastric ulcer treatment, though.
 
my mistake. i thought that was in reference to the bupe patches.
 
Hi there. So I'm still on the patches but have stopped trying to abuse them. I've been put up to the 10mg/week (10micrograms/hour) dose, and they are still working well for my pain..
BUT I have a question I would appreciate an answer to fairly quickly! Going to a concert tonight (Radiohead! eee!) and I would like to take the last 40mg of oxy I've had lying around for a while. I put a new patch on a week ago, and am still wearing it, but it should have pretty much run out of juice by now.. SO, do you think the blockade effect would still be in place enough to make taking the oxy pointless? I have no other intoxicants and would like to be chill and pain-free for the gig. I don't want to put on a new patch because that won't really work until tomorrow.
HELP PLEASE!

EDIT: Never mind, I did it anyway. Seemed to have about the same effect as usual, but I'm not sure because oxy has never been a strong high for me, even in large doses. Prefer morphine.
 
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My routine:

1) Measure the dimensions of the central matrix area of the patch, find out the total mg, then divide appropriately into even areas with pencil (not on the sticky side of course)
2) Using scissors or a knife cut off as many mg as you want
3) Take the number of mgs you've taken, and take that many ml of ethanol and drip it into a spoon or suitable container
4) Take off the shiny foil and apply the section of patch you're using sticky side down into the liquid
5) Soak for 1+ hours (I hear 24+ hours is best, but I'm usually in a hurry)
6) Stick under your tongue for 30-60 minutes
7) Either swallow or spit out the section of patch, the latter is a better option since bupe isn't really orally active so it's worth keeping for additional extractions in case you didn't use it all

I find it's about 2-3x as strong as just sticking a section of patch under my tongue, and avoids having to evaporate off the solution afterwards - it takes the bupe out of the matrix but then it all absorbs back into the patch evenly, just without the prior time release mechanism it seems.

This and eating similar bits of patches *without* the extraction are the only methods I've consumed Buprenorphine so I can't compare potencies, but with low tolerance and a 1 hour ethanol extraction like this, ~1mg of patch is a nice high, and ~2mg is just short of nodding.

Since I got a 40mg patch for real cheap this makes for the cheapest opiate high I can get. I imagine it's worth the longer extraction wait too, so today I'm trying 2 hours at least.. I know the difference between a 20-30 minute extraction and an hour one was quite a lot.

For reference this is with Transtec, but I'm sure it works with Norspan and Butrans.
 
Good to know. But for me, personally, bupe is not worth abusing. It does a good job for my pain, but the "high" is just not enjoyable.
I've gone back down to the 5mg patches because the 10s were actually overdosing me a little bit, I was throwing up in the mornings and stuff. But it still wasn't a pleasant feeling at all, just felt sick and whack and not "stoned" at all.
 
I have the patch 10 mcg and oral subutex and together they work pretty good. What I like best is I feel I have a clear head rather then that clouded feeling I get from regular opioids.

that said...Lol I am starting to hate that saying, I was on 5 two milligram pills a day and that worked best but my doctor is always talking like I am on too much (I was in a clinical trial in 2008 and took 16mg for over a year, tapered off in 2010 but a year later my pain got the best of me so I went back on) So I can tolerate a lot of milligrams the question is where do I hit the analgesic ceiling. I do not think I'm there but I have to think about increased pain and what do I do then if I am at the ceiling?

Anyway, I'm a day and a half away from refill time and I'm on my last patch and did my last subutex two days ago. Yep I took more then 3 a day that he prescribed. that is why I joined here-to see how to better stretch my pain relief. I will not go into WD but the pain is coming back and it is a bitch!

Any suggestions will be welcome

BP
 
Doctor put me on 20mcg at my request. So far along with the breakthrough subutex, I'm doing pretty good.

I know people say that "less is more" for pain relief but when I go below my usual dose, it sucks! I really believe buprenorphine reacts different in every person as far as pain relief and most likely, as a maintainance drug

Glen
 
I would see a new doctor if this was me. bupe for pain? codeine on top of bupe for breakthrough pain?! 10 micrograms an hour !?!?!?!? holy shit. well how is it working for your pain?
 
Quick question. I am on 15/mcg /7days of Butrans. One of my patches came up missing and the only conclusion I have is that my daughter took it and sold it. Are these even worth anything to anyone on the streets? What would they even be worth? I hope this found the right thread. I just want as much info as I can get on this so I can nip it in the butt and she can't tell me I don't know what I'm talking about ;P. Thanks to those that do respond.
Concerned mother :?:(
 
i stumbled on a 20mcg/hr 20mg total butrans transdermal patch from a friend to try to help me with my chronic back pain as i havent started pain management yet. my question is if i wear this patch for seven days, how long will it take before its out of my sytem in case i get drug tested by my doctor in 2.5 weeks.
 
I'd say a week after you take the patch off you should have no more in your system but that's just an educated guess. Maybe 10 days at most.
 
I've always kinda wondered about these...seems like they might be good for someone on maintaince for tapering??? Could be completly wrong about that though. Are they patches just like plastic, or is it gel inside of the patches?? But I've heard so many mixed reviews about using it for pain, a select few saying it works(not very many) and some saying it does..but if I were givin these for pain I would be HIGHLY pissed... I'm on Subs for maintaince and they do not do shit for pain, I had actually hurt my knees and was trying differnt doses(high,low, etc) to no avail until I got ahold of Tramadol, which actually helped my knee pain and gave me a buzz with the bupe. Shame those fuckers got taken off online pharmacies last year, and got put on Schedule IV, Soma's also...that just sucked, didn't ever order them, but hell they would come in handy while on Bupe.
 
This may be a late reply to your question - but in Philly most people don't even know about the patches - let alone are they willing to pay for them. Plus, because there are so many hurdles to jump in order to get "high" - I doubt anyone would pay for one over any of the other avail options on the street.

I could be completely wrong - that's just my experience...
 
I've been prescribed the 20mg butrans patches for a little over a year now & just wanted to share my experience (I went from 15mg oxycodone - amount varied per day anywhere between (2-8) - to these patches - for a week beforehand I had to stick with 30mg of oxycodone per day in order to not feel withdrawals):

1) Yes - u can take other opioids with it - and yes - they will still work. They always do for me.

2) If they last less then 7 days - your doctor needs to submit a prior authorization to your insurance company to request additional patches per month. I ended up getting approved for 8 20mg patches a month - switching every 4 days - due to the same reason. At first my insurance company denied this request - and then my doctor repealed & ended up speaking directly with one of the doctors they have at the insurance company - who then approved the request as long as my doctor submitted an EKG of my heart every other month to make sure I wasn't affected by the "QT" whatever the fuck.

3) The patches only provide me with a baseline coverage for pain - anything more and it's back to the pills.

4) They also almost completely prevent withdrawal if you are popping a few extra Tram, Percs, whatever & suddenly run out - as long as these extras are at a relatively low dose per day.

5) The worst part about these things is how dirty they tend to look by Day 5-7: the lint from my clothes & im not sure what else ends up getting stuck along the rim of the patch - and once I take it off it leaves this dirty/sticky black square mark that's crazy hard to get off. I've also had a patch or two unstick at one edge and expose the center - which im assuming got soaked up & wet during my shower. They're pretty good at staying put - but it does happen on occassion - and it will ruin the patch - so even if you're not due to change it - you'll need to.

6) I agree that minimal coverage from the patch can last up to 2 weeks. It's not enough / but I do notice that when I finally do take it off (if I don't happen to have another to replace it) that it was making a difference after all.

7) Don't even think about getting these guys without insurance. I've had to do it for the last 3 months - disgusting out of pocket.

Hoping this helps!
 
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