This disabled female pt reached out to me about a week ago and her doc had just abruptly cut her oral opioids she had been taking for ~ 10yr from 90 MME/day to 30 MME/day and put a Buprenorphine patch on her the next day. This is just starting to evolve but I am going to leave this post at the top of the first page and update as things happen – STAY TUNE
A day or two after she put the buprenorphine patch on she was scheduled to have a treadmill cardiac stress test. Before the test, they took her blood pressure and it was 240/120 – what the American heart Association claims is a hypertensive crisis level. This test was done in part of a hospital system. Of course the stress test was cancelled, and the staff just SENT HER HOME. Before she had the patch on, her blood pressure was more normalish. Here is the American Heart Association on its definition of blood pressure. You may have to click on the graphic TWICE to make it enlarge and more readable
Filed under: General Problems
Buprenorphine seems to be getting a bad rap when it comes to chronic pain patients. I agree that the oral film you put in on the inside of your mouth is bad and should be pulled from market. My question…does the patch, when used specifically for pain , do anything for chronic pain. Especially when there are different levels of chronic pain. Some patients may have severe chronic pain like can’t get out of bed pain. Or some patients have moderate or mild chronic pain that is irritating but they can function in most settings such as go to work, do grocery shopping. Thanks for letting me reply…
90mme to 30mme. That’s below most documentation I’ve seen mandating specific levels. I believe that 50mme was the bottom that the updated 2022 CDC Guidelines and CARA 2016 promoted. Regardless, that’s not in anyway condoning this draconian reduction and I thank you for sharing her story.
Dr. Steve, That ought to be a very interesting case! I’m looking forward to reading about it with my coffee to see how it unfolds and what happened to the poor lady
❤️