I have severe arthritis, bone spurs in my shoulders and hips, and a total right knee replacement. He first put me on nucynta, which I had severe side effects on and couldn't tolerate. Now he's put me on Butrans 5mcg patches with lortab 7.5x2 for breakthrough pain. The patches provide only the barest of relief and seem to wear off completely after the 4th day. My Dr says that he doesn't believe in narcotics for my kind of pain, which is confusing since the patches are narcotic. I've had these problems for years and have a fairly high tolerance to medications. I tried to avoid pm for a long time, but have finally given in to the need. Does anyone have suggestions on how to deal with the Dr so he looks at me like a person in pain and not a junkie?