Transitioning from Opioids to Buprenorphine Patches: A Personal Experience

Transitioning from opioids to a buprenorphine patch can be a complex and sometimes challenging process. As a former registered nurse, I have firsthand experience with this transition, including its challenges and benefits.

Introduction to Buprenorphine Patches

After experiencing tolerance to my sublingual buprenorphine, I was advised by my pain specialist to switch to a buprenorphine patch. Initially, I was prescribed a 10 mcg patch for a two-week trial period. My experience with this switch, however, was not without complications.

Urinary Retention and Hospitalization

During the patch trial period, I encountered urinary retention, a common side effect, which necessitated hospitalization. Unfortunately, my pediatrician, without consulting my pain specialist, forcibly removed my patch, leading to flu-like withdrawal symptoms during hospitalization. This highlights the importance of communication between healthcare providers during medication changes.

Transition from Lortabs to Buprenorphine Patch

My next outpatient visit involved a refill of Lortabs (7.5 mg every four hours as needed), and I was surprised to receive a prescription for a buprenorphine patch instead. Due to the complexity of the transition, no clear instructions were provided online, and thus, I had to devise my own method.

To transition from Lortabs to the buprenorphine patch, I followed a gradual tapering process. Starting the first day with four Lortabs, I applied the 10 mcg buprenorphine patch at night. The next day, I reduced the Lortabs to three, followed by two, then one, and finally none. This method proved effective, with the patch providing excellent pain relief despite the initial concerns about efficacy.

Pain Management and Side Effects

With the buprenorphine patch, I experienced significant relief from my chronic pain conditions, including knee MRI issues, lumbar and sacral spine issues, adult-onset scoliosis, Ehlers-Danlos syndrome, and muscle spasms. However, the medication management was not without complications.

I encountered respiratory issues during the transition, which worsened to a point where I could not obtain a pulse-ox reading. Emergency care was sought, and the oxygen level was forced to 91, leading to respiratory distress. After receiving steroids, antibiotics, and an inhaler, my pulse-ox returned to 99.

Another adjustment was made later, switching to a 7.5 mcg patch, which provided only a fraction of the pain relief compared to the 10 mcg patch. My pulse ox level also dropped to 95, prompting a request to return to Lortabs. A gradual up-titration of Lortabs, following the opposite tapering process, resolved the issue without complications.

Conclusion

The transition from opioids to a buprenorphine patch requires careful management and close communication between the patient and healthcare providers. The experience underscores the importance of considering individual patient needs and closely monitoring for side effects and adjustments as needed.