"I have had Hep C for 32 years."
Have you had a biopsy, do you know the current condition of your liver ?
The reason I am asking is
No dosage adjustment is recommended in patients with mild hepatic impairment [see Clinical Pharmacology (12.3)].
Nucynta® should be used with caution in patients with moderate hepatic impairment. Treatment in these patients should be initiated at 50 mg with the interval between doses no less than every 8 hours (maximum of three doses in 24 hours). Further treatment should reflect maintenance of analgesia with acceptable tolerability, to be achieved by either shortening or lengthening the dosing interval [see Clinical Pharmacology (12.3)].
Nucynta® has not been studied in patients with severe hepatic impairment and use in this population is not recommended [see Warnings and Precautions (5.10)].
It was a very long time ago that HCV was referred to Non A Non B Hepatitis. What is your genotype and what stage of fibrosis are you? Either way I am not sure about a narcotic for long-term pain management - on the other hand you have not really shared much about your overall health or anything else. It sounds like it might be time to follow through with a Hepatologist and see what options are available as far as pain management and your HCV.