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Suggest Treatment For Severe Degenerative Spine Disease

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Posted on Tue, 6 Dec 2016
Question: I have been using butrams patch 10mcg for two month. Before that lortab 10mg every 6-8 hrs . I have severe degenerative spine disease had a fusion from T8 --S1 with fusion of si joint to iliac crest bilateral. I am trying to determine why my DR thinks this is a better way to go . It cost me with my ins 200$ mo and at this point I don't see better pain control.
doctor
Answered by Dr. Dr. Matt Wachsman (38 minutes later)
Brief Answer:
there might not be a good reason

Detailed Answer:
The butrans has been oversold by its developer as relatively less risky, less addictive, and able to block out taking other narcotics on top of it. This is totally wrong on all counts.

It is a narcotic that has limits on how much it can accomplish in terms of the amount of narcotic effect it can give. While other narcotics keep goiong up and up on the effect it can give, butrans patches have a maximal effect they can achieve and giving more than that doesn't give more pain relief. As such you won't see as much pain relief with butrans. But, It is a long acting narcotic and It does, however, last considerably longer than lortab. This is especially apparent with effects on sleep. Pills, like lortab, wear off by about 5 hrs after taking and so, might not cover all night.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (6 hours later)
Will takeing lortab for break through pain help?
doctor
Answered by Dr. Dr. Matt Wachsman (9 minutes later)
Brief Answer:
quite so

Detailed Answer:
The standard treatment everyone did used to be a long acting agent and then like a lortab for breakthrough. That resulted in a somewhat high dose of narcotics but it worked. Also people get used to the long acting drug and need to keep going up and up. Personally, I go with just the lortab in my patients, but many physicians use the butrans at a low dose and the lortab.
Pain management specialists or University centers might be more used to dosing narcotics.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Treatment For Severe Degenerative Spine Disease

Brief Answer: there might not be a good reason Detailed Answer: The butrans has been oversold by its developer as relatively less risky, less addictive, and able to block out taking other narcotics on top of it. This is totally wrong on all counts. It is a narcotic that has limits on how much it can accomplish in terms of the amount of narcotic effect it can give. While other narcotics keep goiong up and up on the effect it can give, butrans patches have a maximal effect they can achieve and giving more than that doesn't give more pain relief. As such you won't see as much pain relief with butrans. But, It is a long acting narcotic and It does, however, last considerably longer than lortab. This is especially apparent with effects on sleep. Pills, like lortab, wear off by about 5 hrs after taking and so, might not cover all night.