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  • Suboxone and other opiods

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    Old 11-01-2017, 02:15 AM   #1
    elteec
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    Suboxone and other opiods

    I've had 8 rods placed in my low back along with otherlow back injuries repaired. Injured combat Vet. Docs currently have me on 90 mg Morphine sulfate daily plus six 10mg Oxycodone pils. I recently had a Spinal Cord Stimulator implanted. Also have DDD, stenosis, spondylitis. Doc wants to bring me down on my pain meds and states I'll need pain meds for the rest of my life. Is sending to Suboxone doc to get me weaned down on my regular meds. How can I use sub to lower amounts of opiods if you can't take both simultaneously? I have been on opiods since 1999 after retiring from military.

     
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    Old 11-02-2017, 05:49 AM   #2
    tortoisegirl
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    Re: Suboxone and other opiods

    Welcome! I expect that they will switch you directly over to Suboxone. This can only been done safely when you are in moderate withdrawal from the other opioids (otherwise it can cause severe precipitated withdrawal). You would likely abstain from all opioids for a period of time (such as 24-36 hours) or until you hit a certain severity of withdrawal symptoms, then start on Suboxone (and possibly taper down on that). Be aware that it only treats pain for some people, less than traditional opioids. There are a significant number of people that just don't respond to it, at any dose.

    My doctor had me do this a few years ago. I had difficulty however as I was on Methadone, which is super long lasting, and a very high dose, so any dose of Suboxone wouldn't keep me out of withdrawal. You are on a lower dose of shorter acting meds than I was though, so I wouldn't expect that issue. Suboxone didn't work for my pain so I ended up back on Methadone, however, at 1/3 the previous dose. All the withdrawal I went through lowered my tolerance, plus my doctor just wasn't willing to prescribe my old dose any more. It feels like a waiting game lately as to whether I will get completely get cut off.

    Questions I'd ask the Suboxone doctor:

    What is the end game with the Suboxone? ie. will you stay on the dose you start at, or taper down?

    How will you transition me to Suboxone? If they tell you to start taking it right away with no time in between, that is a red flag.

    Can you prescribe anything to help the withdrawal symptoms during the switch? There are meds that can be used to help withdrawal, such as for nausea, insomnia, agitation and intestinal cramping.

    Are you reachable after hours if I have an issue?

    What could be used to treat any acute pain issues I may have in the future (such as with an accident or after a surgery) while on Suboxone? (as it blocks other opioids)

    How soon after the switch will my follow up appointment be? You ideally want the doctor to be available by phone if you have issues, or at least be seen within a few days.

    Note that for insurance to cover the Suboxone script they will have to say it is for "opioid dependence", as it is not FDA approved for pain. However, note that dependence is not addiction (it only means that you will have withdrawal if you stop opioids).

    I wish you luck with this. Its unfortunate that the pain management climate is going anti opioids, even for folks who have done well on them long term and have failed everything else. The doctors are just getting so much pressure not to have folks on them long term, especially at high doses. Hang in there! Best wishes.
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    Old 11-02-2017, 11:35 AM   #3
    elteec
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    Re: Suboxone and other opiods

    Kate, Thank you for all the info. I retired from the Navy in 1998 after 20 years. I originally broke my back in a bad jump in the Gulf War. But had a job to get done so I did. When I got back onboard a ship, I couldn't stand straight. No one would believe something was wrong. Even though the Master Chief with me heard my back crack. They gave Vitiman M (Motrin). Able to walk ok so continued until after retirement and running became too painful. After 16 years like this after so many VA docs, a civilian doc said surgery. 3 hour surgery lasted 8.5 hours. Surgeon couldn't understand why I wasn't paralyzed. And, so the story continues. Pain is worst after surgery in 2007 than before. Sorry to bore with details. I really do thank you much for the help. Dave

     
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