Butrans Patch for pain control

Hi, I was on methadone for 5 yrs following a back injury, and hydrocodone 10/325 for breakthrough pain.  I have 4 ruptured disks with nerve involvement in my lower back.  Also have osteoarthritis in my back and hips as well as fibromyalgia.  I tapered down from 40mgs to 10mgs of methadone, and my last methadone was 8 days ago.  I was having bad side effects from the methadone, vitamin and iron deficiency, mood swings, constipation and no sex drive.  Just needed to be free of that drug....I also take 150 mg Effexor XR in the am, and Trazodone 75 mg at night for depression and insomnia.  

  My current doctor has prescribed the Butrans patch for me, have not started taking it because I don't want to become addicted to anything else.. Could you give me some information about Butrans- is it effective for pain?  I am doing well without the methadone, but have been using marijuana to help with the withdrawal/cravings and my chronic pain.  I know I can't do that all the time...I need to take a medication that is effective for pain that I can take while working.  

And finally-  what about Lyrica?  I was prescribed Lyrica 2 years ago, but could not take it with the methadone, made me very tired so I stopped taking it after a couple days.  Can Lyrica be taken with Butrans?  

Thanks in advance :)

[Julia M Aharonov, DO]

I want to commend you for getting off Methadone.  It is not easy.  The fact that you recognized that it was necessary and committed yourself to tapering it is impressive.  It seems like your doctor did a good job of helping you with that process.
Butrans is an opioid receptor agonist-antagonist, meaning that it binds to various opioid receptors and can both partially stimulate and block them.  It can be just as addictive as other narcotics, even though it does not produce the same euphoric effect.  It can certainly be used for pain control, but so can Lyrica as well as other newer medications that have been successful for chronic pain and fibromyalgia.  I think that with you history of addiction you should try non-narcotic medication as  the first option, since you already made such a heroic effort of getting of Methadone.   Discuss with you doctor all your options before going back to narcotics. Good luck.