Jiggered, if the BuTrans patch is causing constipation, try a regular daily dose of miralax. I have had problems with it all my life, (my earliest memories are of mom dosing me with Fletcher's Castoria) and resulting fissures, etc. but several years on miralax have done away with all my GI problems. I consider it a miracle. I am on low dose oxycodone along with my Gabapentin, but my problem far predates opiate usage.
So you find the Butrans effective? Does it have any other side effects? I am considering it for when my 325/5 once or twice a day are no longer effective for what I have to get done.