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Recovering drug addict Afraid of starting the Butrans patch

ShortyPSShortyP Posts: 6
edited 10/14/2014 - 8:28 AM in Pain Medications
Hello, I am new to this site and posting in general. Thank you in advance for Reading/Listening/Commenting. I'm 53 years old and have had thoracic and neck pain for about 25 years.

10 years ago I finally went to a PT and got a huge amount of relief. I've continued going to him ever since, mostly on a maintenance level. I've been doing the stretching he showed me at least once a day and sometimes 3 or 4 times depending on the level of pain I am having. Each stretching session I do will last between 5 and 30 minutes with a minimum of 45 minutes a day. I also go to a massage therapist at least once per week. I am physically active and do Crossfit 4 times a week and surf on the weekends.

My Neck and Back pain has been fairly manageable with the Physical Therapy, stretching, massaging and exercises I do, until about a year ago when every thing my GP had tried (Diclofenac, Naproxen, Motrin, Tramadol) didn't work, but Hydrocodone did. I've never wanted to take any type of medication if I didn't have to especially a narcotic, but Hydrocodone seemed to be the only thing that gave me any relief.

This scared me because I'm a recovering drug addict with 20 years since I altered my reality with anything, and know that my internal wiring is a little different than normal and Hydrocodone could really put me in a tricky place and jeopardize my personal well being. But I had to get some relief.

The Pain management doctor ordered an MRI and put me on 2 - 5/325 tablets a day. The results from the MRI showed that I had 4 Cervical Vertebra that were bulging with one of them about 5cm out. My Thoracic Vertebra had 5 bulging with the middle one 5cm out as well. She told me that 5cm isn't that much, but I should slow down on my athletic activities.

Within a couple months I was up to 4 and then 5 tablets a day and my Pain management doctor ordered 2 epidurals, one for my neck and one for my back. I did the one on my neck 2 weeks ago and got a little relief, but haven't done the one in my back yet (should have been today, but doctor canceled).

Any way I got off the Hydrocodone a week ago (Partly by choice) and have been detoxing and feel terrible and my back is on fire. I told the dr. that I don't want to take any narcotic again and we have to figure out something else that works. She gave me the Butrans patch and Neurontin. I started the Neurontin last night, but when I read about the Butrans patch it says its an opiate and can be addictive. I don't want to go through this withdrawal again and cannot afford to jeopardize my life taking something that I could get addicted to all over again.

I heard the Neurontin will take a couple of days to start working and I am willing to white knuckle it for a few days, but I terrified to start the Butrans patch if it means I will get addicted.

Thank you so much if you have read this far, I know its long but I'm pretty desperate for some relief.

The doctor doesn't think I will get addicted. Maybe she is right. What I'm afraid of is that she may not understand the nature of a recovering drug addict and I could get all messed up and addicted to the patch.

If anybody has any help or suggestions it would be greatly appreciated. Thank you.



  • Was the increased amount of the hydrocodone done on your own or was it at the direction of your medical doctor?
    There is a difference between tolerance/dependency and addiction. Addiction is a set of behaviors and self medicating, and using deceptive means to obtain substances, amongst other self destructive behaviors.
    Tolerance and dependency issues come from anyone who is on medications, whether it be pain medications or other medical conditions , having adverse effects of suddenly stopping the medication.
    As far as the butrans patch goes, have you discussed your concerns with most pm offices have strict compliance standards that the patients must meet in order to continue to recieve pain medications. If you feel that you can manage the pain without the use of opiates, then by all means , that is what you should do for as long as you are able to do so.
    That being said, if I were you, I would discuss your concerns regarding the medication with your doctor, and talk about your fears. He/she may be able to reassure you in choosing medications that might be more helpful if you prefer them.
  • Thanks Sandi. The increased hydrocodone was as directed by my PM doctor. It was really clear to me that over a 8 month period I built up a tolerance to the medicine. What scared me was the reaction I had when I realized I couldn't go without the hydrocodone. In my past life I never was a pill user, but I know the feeling of being addicted to a substance and the thought of that happening to me again is scary.

    The feeling of relief is a very slippery slope for me and the fear I experienced when I realized I was dependent on the hydrocodone was enough for me to stop them completely and deal with the pain as it is. I'm not sure that I would be able to do it again like this without my falling back into the old behaviors I used to live in. That may sound unrealistic after 20 years of clean time, but for me the chemical reaction my body seems to be so different than normal people that get addicted to a substance.

    Anyway I am taking your suggestions and will be talking to my PM doctor about why she thinks this patch is not addictive and if there is some other options.

    Thank you very much.

  • I'm so terribly sorry that you're struggling like this. Did you stop the Hydrocodone 'cold turkey' or slowly titrate down? I've stopped using narcotics on several occasions & always slowly reduced my dose. Fingers crossed, I've never had withdrawals. Butrans is a very smooth pain killer & although anything can be abused it would be a very deliberate action with a patch, not just taking a little more, then a little more & ending-up in trouble. I understand your fears. It's a choice only you can make but please remember that untreated pain can be very damaging to your body long term.
    Although its important to stay active I had to accept that I now had restrictions & limits on what I could (& should) do as my spine degeneration progressed. Having said that my Dad has the worst spine I've ever seen & he plays competitive seniors golf most days! For me, everything to do with my spine & pain care is a complicated balancing act...with your past addiction I know it's even more so for you.
    I wish you all the best whatever you choose. ;-)
    Osteoarthritis & DDD.
  • mcjimjammmcjimjam Posts: 307
    edited 10/14/2014 - 5:51 PM
    For what it's worth, I'm on the highest strength Butrans patch (20mcg/h) and I've never felt any kind of high from it. It relieves the pain but it just doesn't produce that opiate feeling in me, probably because it is a slow release product, extremely slow release, given that it lasts a whole week. Is there someone you trust who could hold on to the patches for you and make sure you use them as directed? Maybe a spouse or family member?
  • I pretty much stopped cold turkey. I was taking 5 per day for quite some time and went down to 1 a day for 4 days. The last one i took was on friday. I physical detox is about gone, but the mental stuff is still going although today was a tolerable day until about 11am. I took a Neurontin last night and got a good nights sleep. I feel some relief just hearing suggestions from you guys. I really appreciate you guys sharing your the insight, experience and suggestions with me. I really need the help right now, because i want to exhaust all my options before i ever go back to the opiate type pain meds. I had an epidural in my neck a couple of weeks ago and have gotten some relief from it and have one for my back scheduled for thursday of this week. Hoping and praying it will work. Thanks again.
  • you will experience discontinuation syndrome or withdrawal. It would have been easier physically to taper off the norco......but I can understand your concerns and feelings regarding using the opiate medications.
    There are other classes of medications that can help, and if your pain is mostly nerve related pain, then gabapentin , at the right dosage can make a huge difference in the pain levels. If the gabapentin doesn't work, there are medications such as Lyrica, or cymbalta that can also be trialed. Those class of medications need to be titrated to effect, meaning that the dosage range is rather large, especially for Lyrica and gabapentin ( Lyrica has a range of 25-600 mg per day) , while gabapentin has a range of 100 mg-3600 mg per day , so if the current dosage doesn't give you much relief, talk to your doctor about increasing your dose if needed.
  • Sandi, Thank you, Thank you, Thank you.... for understanding and the information. I'm getting some hope that I will be reasonably comfortable in the future and possibly without an opiate.
  • We wish you the best in getting pain relief that you are comfortable with.......
  • After any kind of spine injection a pain flare is very, very common. Usually lasting a week or so before the steroids start to do their stuff. I take ice blocks (the plastic kids sort you put in the freezer) & ice on the way home. I then ice regularly for the next week & usually that keeps my 'flare' to the minimum.

    Best of luck with the injections & the other meds. Narcotics are only a part of pain management & not always necessary. I've had 2 kids & made it through pregnancy (& another time because I'm stubborn) without meds. People often underestimate the amount of relief you can get from all the natural & conservative stuff. Have you read things here about "The Blend"? I've found it really important to develop my own blend. Try everything (within reason) keep what works & ditch the rest. I was surprised how much the airomatherapy massage oils help me. Visualization & meditation. Physical Therapy, specialist yoga stretches & massage. Supplements...magnesium helps me. Boiling hot epsom salt baths... There's a lot out there!!
    Osteoarthritis & DDD.
  • You guys are so awesome. I just ordered one of those long ice packs 5" X 18" that I can hang over my office chair. So thanks for the ice pack reminder.
  • I wanted to check in and let you know that I had the epidural on T6 & 7 Thursday and this morning I'm my back is a little bit better although it just started talking to me as I was logging in. I am hopeful today will be better than the past few days where I was white knuckling it from about noon on. The Neurontin seemed to work a little at first, but doesn't seem to be doing much from about 10am. I haven't even gotten to the full dosage yet so I'm not giving up.
  • sandisandi Posts: 6,342
    edited 10/18/2014 - 4:20 AM
    Make sure to use the ice on the area, before it flares up too much.......I also found that sometimes heat helps ease the pain more, so I took a small pillow cover ( for throw pillows or socks,) and filled it halfway with instant rice, and heat it in the microwave for about a minute.....it conforms to my back and is comfortable, and stays warm for about 10 minutes at a time.....sometimes switching between ice and heat helps more .
    Hang in there with the gabapentin, it should start working as you get closer to the dosage they want you at.....
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