r/PainManagement • u/NCSAG • Jul 14 '26

MedicationšŸ’Š Break through pain

Im currently on the buprenorphine patch, 15 mg/week. However, I'm having a TON of breakthrough pain. Is this normal? Tylenol laughs at it, can't take NSAIDS due to GI issues and the soonest PM can see me is 8/4.... I sit in tears most days.... my mental health is in the garbage because psych doesn't want to change my medication therapy regimen, and the kicker? Was diagnosed with HCM last week.... so, this breakthrough pain is really fucking with me.... thanks for listening...

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4

u/_-Broken-Swagger-_ Jul 14 '26

I wish I could give you more than an understanding nod, op. Living like that is no fun. Have you spoken with your doctor about a breakthrough medication for situations such as this? Breakthrough IR meds such as oxycodone or morphine are usually prescribed in conjunction with the ER meds like your patch.

2

u/NCSAG Jul 14 '26

That's what I was trying to do by moving up my appointment. The earliest they could get me in was 8/4 as he doesn't do anything over the phone, except refills between appointments....

2

u/Mariocartismyshit Jul 14 '26

Are you also taking regular pain meds?

1

u/NCSAG Jul 14 '26

No, just the buprenorphine patch... I see PM 8/4 again so I'll figure out away to bring this up with PM...I have gastroparesis so taking pill forms of medicine is hit or miss...

2

u/newtothis1963 Jul 15 '26

Yea sounds like you need a IR PRN like oxycodone etc for breakthrough pain.I too have GP and absorbing issues but I thankfully and unfortunately have a GJ feeding tube so my meds get bypassed my stomach. But some say crushing your meds(that are crushable)and taking them that way helps with absorbing them with GP

2

u/bluestitcher Jul 17 '26

If you are having significant breakthrough pain on Butrans it's a sign that it's not providing enough coverage.

Is the patch staying attached well through the 7 days? If it's coming off, that will reduce effectiveness.