switching from methadone to butrans(buprinorphine)patch fro severe pain

[kidscharityguru23]

Was in a horrific motorcycle accident and after 3 wks in a coma woke up to find that the docs had me on methadone because after 40 hrs of life saving back surgeries(and broken neck,broken arms and leg) they couldnt get me to come out of coma without this strong med. Ive been on a continuous dose of 45mgs with oxy 5s in between.After only a short time my moods/personality began to change from me being a happy family man to a hermit that was very down and snapped at the smallest things to my wife and kids.The last visit i had at the pain clinic I expressed my concerns and said that since this med was not helping my pain that I wanted off since the cons far outweighed the pros.Her suggestion was butrans which is buprinorphine delivered through a patch that lasts for 7 days.She was aware that I was not off the methadone and the oxys and told me to try it.I was not aware of the drug that was in the patch until i got to the pharmacy and when I saw Bupe I immediately asked about precipitated w drawals since I was not off the methadone yet.She told me very straightfaced there would be no problems with that.Having worked with Suboxone(w naloxone) I was aware that if you are still on a full aganist that switching to a half one(albeit the highest dose of 20mcgs/hr)when still having the full on your receptors causes horrible w drawals!The next day I still did not take the patch and called the pharmacist again.She again told me that what I was worried about was wrong.I then called the pain clinic AGAIN and explained my fears and was told not to worry that this 20mgs/hr will not cause w drawals?I am in constant pain and heard this will take care of it once its allowed to work but starting off being horribly sick is not anything i am willing to do....HELP!

[godhlpme]

gabapentin -best for opiad wd symptoms-never felt the come down

[godhlpme]

gabapentin -best for opiad wd symptoms-never felt the come down

[weaver71]

I think you are making a good decision. There are warnings about butran patches causing prec. withdrawal. I would not worry as much if you where on a fast acting full agonist. Methadone has a 36 hr half life. If you where on a sustained dose of 30mg for 10-14 days and wait 48 hrs, you should be fine. I would still wait until you are in mild withdrawal after the last oxy, based on your plan. I'm with you, I would rather err in excess caution than go into prec. withdrawal. Good luck and keep us posted.

[kidscharityguru23]

Thanks Vicki...the butrans patch (20mcg/hr) is suppose to be very powerful and has warnings all over about possible death blah blah! I was more worried because I know that bupe beats off other opiates and once on the receptors stays on them for a long time making themeither totally ineffective or if not barely so. My wife and I met as counselors on the treatment floor of the dept of corrections and saw the induction of suboxone into many patients and got to know quite a bit about it through talking with the docs and staff for years. I am not familiar with bupe alone w out the nalaxone but was told the naloxone in subox is not what causes the withdrawals but the bupe only being a half agonist and beating off the full ones a patients body is use to. Now im scared that it will do the same to me. I last took 30mgs of methadone 24 hrs ago and am planning to use my short lasting pain meds to get by for at least another day...I am home from my job as a program director for a childrens sharity and have been since my accident in April so I do have time to spend resting.

[vicki595]

Hi- I don't know if I can offer much more info than what you know but I think the difference in the precip.withdrawl is in this form of delivery.
Once you're off the methadone for any length of time, when you begin the patch the delivered dose is so small that by the time it's full effect is reached in 3 days, the methadone has left the active system.  That's the theory anyway.

I understand your fear but I would tend to lean with the pharmacist on this one. When did you last take any methadone? Have you spoken with your doctor?  

This should help your pain once you get going with it!