| Re: post surgery pain and buprenorphine or suboxone
Bup and Suboxone are combination opiate agonsist and antagonsits, Meaning they both bind to opiate receptors and block other opiate receptors. The antagonsit action "blocking receptors" of either med can send a chronic pain patient that's physically dependent on opiates into withdrawal.
Mixed opiate agonsist /anatagonsit like Bup, Sub, TalwynNX, Stadol, Nubain are all limited in there ablity to offer pain relief due to there opiate receptor blocking activity. They are usually preffered meds for people that have had compliance problems or abuse problems with other opiates.
The receptor blocking action prevents abuse for the high, limits the meds ability to manage severe pain but can be a good first line choice before putting people on meds that do cause physical dependence. He's working backwards as far as going from the strongest pure opiates to combination mixed opiates.
I understand wanting to help your son and gather info on these meds, But gathering info on his condition and treatment options may be more effective. IF his condition is progressive or permanent, learning to accept that he may not be able to return to his old life will help more than finding the full prescribing info on each med.
He can certainly make a new life but understanding the goal of pain management is not to relieve someone of all their pain. It's to improve function. Once the meds are hindering his ability to function the line gets crossed from a med being helpful to the med hindering his ability to function.
If he's looking for a magic pill to take all the pain away and allow all his former activities, expectations of the meds and pain management are much too high. If a doc would flat out say our goal is 50% reduction, comeing to terms with his new limits will occur much faster.
The idea that if X amount relieves half his pain than twice as much will relieve all pain isn't how Pain manangement works and will likely just leave him doped up and still complaining. If he increases doasgaes on his own, he will end up without a doc at all and 0 pain relief.
I know it's harder for younger people to except they can't go mountain biking or sking or whatever the old favoriter pass times were, but that's where the phsychology of pain management comes in. He can have a fulfilling life with 50% of his pain relieved.
He won't be doing any bull riding or water sking but he has to have reasonabale expectations and except that often this is as good as it may get.
He's tried all the LA meds for pain. If he's looking for complete pain relief that won't interfere with what he wants to do or his friends want to do, His expectations are not realistic.
If he wants meds increased and increased thinking more will allow him to function, I'm sure you have seen just the opposite effect. To much and you become a nodding out couch potatoe. The idea is to find a medium where he can function as much as possible given his condition and not have the meds impaire him even more.
Knowing what the problem is may open a few doors and looking into non opiate methods may offer something opiates can't.
Good luck, Dave
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post surgery pain and buprenorphine or suboxone 
