3 ms·
Have you tried the Butrans patch? It is buprenorhpine and as of February, 2018 there is no legal restriction on it under CDC/FDA policy: unlimited prescriptions
by rjurney 7y ago
Have you tried the Butrans patch? It is buprenorhpine and as of February, 2018 there is no legal restriction on it under CDC/FDA policy: unlimited prescriptions. No special license required to prescribe it (it is against regulation to use the patch for addiction). It is now generic ($160/month with a coupon, usually requires a prior authorization), and doesn't:
* Get you high
* Make you drowsy
* Addict you (yes, you'll have a tolerance, but no it won't be a problem)
* Give you cravings
* Stop your breathing
Each patch lasts a week and if they stick to my oily skin (I once dumped a 10 day heart monitor in 8 hours), it will stick to anyone. And you know what? It's not that much less effective than morphine. And it's even refillable.
Have you tried all the non opioid options? Lyrica, Gabapentin, Trifexis, Cymbalta, Nortriptyline (and other TCAs), etc? Lyrica is for nerve pain but Gabapentin and the others are used for all kinds of pain. CBD has limited evidence for helping nerve pain, but be aware that it has a long (>24 hour) half-life and can make you slightly high if you take enough daily (yes, in high enough doses it is psychoactive). There is good evidence for glucosamine/chondroitin for arthritis. There is limited evidence for tuermeric/curcumin (and its cheap!) for helping pain. There is limited evidence for SAM-E (but not if you've ever been manic) for pain. Are you on an NSAID? What about Tramadol? And for me, prednisone is a lifesaver for flights and conferences - I can't do either without it, but obviously you don't want to take it a lot. Great for flareups.
Have you tried compounded topicals? I have 9% Lidocain (store is 4%, pharmacy 5%), 9% Diclofenac (insurance covers 1$), 8% Tramadol (no mental effects), 2% cyclobenzaprine and 0.2% clonidine. You can pack in 30% of medicine, though I take 31.2% cause they still fill it. Topicals never helped me much - in particular lidocaine did shit. Until I tried 10%, that was magic. Most pain is felt on the skin - even organ pain, so you should definitely try this if you haven't. You can get a custom formulation fit exactly to your pain.
What about the various interventions offered via injection/rhizotomy? Do you see a physiatrist? Have you been to see an interventional anaesthesiologist? If you're really suffering have you asked about a spinal stimulator?
If you try most everything on the list, they will write you opioids even today, if buprenorphine doesn't cut it. Maybe you've tried all this stuff but most people I encounter on Quora aren't even anywhere near the end of the road and have given up.
Many people are unwilling to take drugs that affect the brain, and I always conclude they must not hurt very much because I'd take a pill with a 90% chance of curing me and a 10% chance of killing me.
- avgDev 7y agoGood list. I tried some items on the list, I am still working on seeing what works. Currently trying PT to see if tendons will improve, and NSAIDS but those don't seem to work.
- rjurney 7y agoGood to hear, never give up. PT is the first way to go, and it’s worth trying different forms like Yoga, anything that can work the painful part gently, and retrying it periodically if it doesn’t work. If you’re missing opioids, I’d definitely request the Butrans patch. Sorry, I’m an enthusiast:) For me it’s side effect free, maybe a very, very slight sedation, but I’m not even sure it is so mild.