Dakota,

You are right and I was speaking of the patch too...not the pill. The way it was explained to me is that it would be a steady and consistent dose without the peaks and valleys from taking other forms of opoids. AND...I was told IF there was breakthrough pain I could still take a Vicodin. The dose my PM prescribed was 12mcg...a newer patch...not the standard 25mcg. Not only that but there are so many different forms of neuropathic pain that one type of med may or may not work or even touch the pain. I know Neurontin did nothing for my cervicogenic headaches and actually made me worse along with increasing burning sensations. If I can help it at all, I will NEVER go back to Neurontin or Lyrica. I went that route for 3 years and it was awful!
I can't tolerate the AD's either...been there and done that too. So, when my spinal PM mentioned the Duragesic patch, I am willing to give it a try. I just want to wait until the cooler months when I do. But as far as I understand it, you have to be opoid tolerant. I questioned this because I do NOT take more than one Vicodin a day...sometimes maybe two when the pain is bad. But my PM assured me that I have been on it long enough even though I don't take a lot. And the nice thing about the patch is that it goes directly into the bloodstream and bypasses the liver. It would be really nice if this worked for me and I could pitch the Vicodin and eventually taper off the Klonopin. I have talked with a lot of people at the other "site" and from what they have said...the patch gave them a great deal of relief. But again, it remains to be seen.