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jayboy557 04-12-2006 10:23 AM

Switching to SUBOXONE Monday for Pain Management
Any idea what to expect in the docs office. He told me I wouldn't have to come in and be in withdrawal. I have heard that when you detox that they want you in withdrawal. What about starting sub for pain management.

Anyone care to share how sub is working for their pain. Jayboy

ARANGER 04-12-2006 12:06 PM

Re: Switching to SUBOXONE Monday for Pain Management
Hey Jayboy,

Are you going to a PM and suppose to go on Sub for Pain Management or to get you off opioids? The reason I ask is because Suboxone is currently approved to treat opioid dependence and help you get off. It is not approved at this time for pain management.

The reason a Dr wants you to be in partial WD is because, if you start taking Sub while on a full agonist like Oxycodone, the two drugs will compete and Suboxone (Buprenorphine/naloxone) will take over and make you sick (go into WD's)

I think I read about someone else saying thier Dr was going to use Sub for PM. Maybe the Dr's are using it off label, however it is only approved for opioid dependence and specifically says it it not to be used for PM. Actually a Dr has to be certified to prescribe this particular med.

Anyway, keep us posted on what the Dr does. I'd be interested to know if Sub is being used for PM off label.

Good luck at the Dr's office. Take Care.

slipperyslope 04-12-2006 03:00 PM

Re: Switching to SUBOXONE Monday for Pain Management
Jayboy I think you should post this over on the addiction board, there are many folks over there who are on Suboxone and will be able to answer all your questions and concerns regarding this medication you can also do a search on sub on the addiction board and find a ton of info that way. I don't no of many people who take SUB to treat pain, its mostly for addicts who want to come clean and don't wanto go through the W/D'S.

From what I gather from your previous post, you do have chronic pain issue's but also you abuse the percocet have you spoekn to your Dr about this what do they suggest you do? . since you do have ligitimate pain issues and addiction now I still think the methadone is a beter choice for you as it treats both problems you can either go to the meth clinic or get the pills from your Dr I know the meth clinic does not treat you with meth for Pain only for addiction so a Dr might be a better choice for you. I have heard people say that Sub doesn't do that great for chronic pain patients so than how will you survive being on constant pain, are you sure you want to do the sub?.... good luck to you though.

tina76 04-14-2006 09:26 AM

Re: Switching to SUBOXONE Monday for Pain Management
Hey Jay - I have been a chronic pain patient for the past seven years. For about two years up until about 5 months ago now (or so I think) I was having trouble taking my vicodin as prescribed. Major trouble. I finally came clean with my doctor's about it and because I cannot go OFF opiates due to my pain condition they referred me to a PM doctor that put me on methadone. I too thought sub was only for addiction and was also not meant for long-term use? I might be wrong on that.

Anyway, the methadone has worked wonders for me. I started at 30mg and was up to 50mg (back to 40 now but that is a different story in a different thread) and that was working really well for me. It works better for my pain than ANY other drug I have used in the past seven years, and I am pretty sure I have tried almost all of them. I know it is different for everyone but I have several friends on the boards here that use methadone for pain with great success.

The methadone also does NOT get me high so I have no desire to abuse it in any way. It's like I take it and I still feel completely "normal" (he he he, normal for me that is...) but my pain goes away. It's great. No buzzy head feeling, no nothing. It's liek I didn't take anything at all and the pain just started fading. It has also completely nixed my desire for the buzz I used to get from other opiates. I don't even THINK abou the vicodin or oxycodone, etc.... Also when I had some major torn ligaments and had to be hospitalized it was great because they were able to give me IV morphine and did NOT get buzzed off of it because of the methadone. I was really worried about getting that "good" old feeling back and having cravings kick back in. Well it didn't happen at all. I got out of the hosptial and went right back to my normal methadone routine with no added cravings or anything. It has been great. I feel like I have at least somewhat of a normal life back. The pain is never 100% gone but it is the best it's ever been. And I don't have to feel like I am in a coma half the time due to my meds being so heavy.

Did you talk to your doctor at all about methadone? I'm just curious because everyone seems to be saying that sub is ONLY used for addcition. I'm concerned that your doctor is going to put you on the sub and then try to wean you off completely and then you will be left at square one with no more addiction but still a ton of pain? It just seems weird that they are using this for addiction/chronic pain long-term.... My doctors told me that methadone was teh best drug for that sort of double edged problem. Granted I'm sure each doc has their own opinion. Just reading all the other posts I'm concerned that maybe they are really just trying to get you off everything. And that won't work if you have CP? One of my doc's tried to do that with me originally putting me on 10mg of methadone. Which is a "nothing" dose according to my current PM doctor. He said he was treating my pain but really he was trying to get me off opiates period. I was naive and had no idea until I complained to my OTHER doctor because the 10mg was doing nothing for my pain. She freaked that my dosage was so low and that is when I got in with my current PM doctor who told me that the "normal" starting dose of methadone is no lower than 30mg normally. Adn I completely trusted that previous doctor. Until it showed up in his notes that he ws trying to get me off teh opiates all together. My gyno was none to happy due to the fact that she is the one who has diagnosed my chronic pain and knows the details of it etc.... The other doc was primary though and handled my pain meds. So I went about 2 months like that in pain thinking something was wrong with ME because I thought methadone was supposed to work well according to the doctor.

I'm not saying your doctor is lying to you. I'm just saying that sometims they try to do what they think is "best" for us and are not always up front about it. I have had it happen to me several times over the past sseven years with all my different doctors. If everyone is saying that Sub is only used to treat addiction and that it is only APPROVED to be used to treat addiction and is not recommended to use long term for chronic pain then I think you need to talk to your doctor rigth away about what their plan actually is for you. LONG TERM. That was the mistake I made. I just put my trust in them completely. NOW I have a long term plan. The methadone for the next five years, then surgery. Has your doctor given you anything like that? If not, you need them to sit down with you and go over what their plan is. I would just hate to see you end up surprised like I did when all of a sudden they keep DROPPING your dosage on you and you are in more and more pain.

Let me know what happens of if you have already discussed long term plans etc.... As a fellow patient who has had both addiction/chronic pain problems I am interested in what is happenign with your treatment.

Tina :)

jayboy557 04-21-2006 04:42 PM

Re: Switching to SUBOXONE Monday for Pain Management
strictly for pain management. I couldn't stand taking hydro's all the time for pain. suboxone is amazing for my pain. I feel like a brand new person and don't have to pop extra pills just to ease the pain.

This is for pain management only. It did however cut the craving. I had no withdrawal at all. What a drug. Not many doctors are prescribing it for pain but they should be. it's amazing. jayboy

jayboy557 04-21-2006 04:47 PM

Re: Switching to SUBOXONE Monday for Pain Management
If you haven't tried suboxone for pain management how can you say that methadone is better for pain. I have tried both. Suboxone makes me feel much more normal without any highs or side effects. Yes, i did take more percs than i should have but it was mostly because of tolerance and pain. thats why i switched to a different drug and one with less side effects.

mark my words. suboxone will be used for pain management all over the us in a few years. Great painkiller with little or no chance of abuse.

mpvt 04-22-2006 01:59 PM

Re: Switching to SUBOXONE Monday for Pain Management
Buprenorphene has been used for years as a pain killer....Dave

slipperyslope 04-23-2006 06:55 AM

Re: Switching to SUBOXONE Monday for Pain Management
sorry jayboy, I only remember you asking several times about methadone, you got lots of answers but we never heard back from you as to whether you were going to try it sorry I had no idea you have tried mathadone I must have missed that post. did you have side effect from it? so glad the SUB is working for you. that is great news.

jayboy557 04-23-2006 08:52 AM

Re: Switching to SUBOXONE Monday for Pain Management
sorry for the delay. methadone caused the worst constipation out of all the painkillers. Sub isn't near as bad for me. most docs won't prescribe sub for pain down in houston so i was happy to find a doctor with so much confidence. Feeling normal and not having the euphoric feeling and then coming down from it was tough. Hopefully we have cleared the air. thanks

slipperyslope 04-23-2006 11:52 AM

Re: Switching to SUBOXONE Monday for Pain Management
Jayboy being constipated is no fun AT ALL, the worst pain med for me is tramadol it plugged me up like a cork. I don't have those problems at all with oxy of vicadin but tramadol is horrible for me. anyhow keep us posted that is wonderful its helping you SO much!

sparky06516 10-05-2009 09:51 AM

Re: Switching to SUBOXONE Monday for Pain Management
Just went to my PM doc on friday, have been on Methodone for some time for pain, yes it works great, but he did mention that he was try the suboxone for pain and has had great success with some patients. You do, however, have to be off Meth for about 2 days for it to work.

mark76 10-05-2009 04:11 PM

Re: Switching to SUBOXONE Monday for Pain Management
Suboxone isn't approved for pain in the US, though that doesn't actually mean anything (ex., Lyrica isn't approved for most nerve pain, trazodone isn't approved for insomnia, etc...). However, in the rest of the world, bupe is frequently used for pain with much success. I don't think doctors in the US actually require any special license to prescribe bupe for pain so I'm surprised it hasn't caught on more (especially amongst primary care doctors).

Jema X 10-06-2009 07:45 AM

Re: Switching to SUBOXONE Monday for Pain Management
In Australia Bupe comes in a patch or sublingual tabs for pain management. I was taking OC and decided that I'd like to try a patch so that I didn't have to take tablets all the time (I have a superfast metabolism and have to take OC up to 5 times a day).

There is one problem with bupe - it has a ceiling effect - meaning that it only treats pain to a certain level. For some people this is fine but when I had flare ups, it didn't matter how much I took, it didn't work and I ended up in hospital. The docs there (and later my PM) explained that bupe isn't a good choice for those that have severe flare ups of pain because of it's ceiling effect. I went back on OC and oxy for BT and was much better for it. The patches are being used quite commonly in Aus for moderate pain that doesn't tend to have bad flare ups - arthritis in the sedentry etc.

I'm sure it's a good drug but even at the highest dose it did touch my pain and I was going into chest spasms all the time. Also the patch here is quite abraisive - leaves an itchy red mark that hangs around for months. I swapped to the sublingual tabs but you have to take them every 3 hours or so which is a pain. I personally didn't find it a good drug for pain but that's just me. The Aus version doesn't have naloxone in it.

I'm glad it's working for you. Thankfully I don't have cravings but I understand that it must be very difficult for those that do. I don't get any buzzy sort of feeling from my OC at all. We're all different I guess.

Good luck with it.

mark76 10-06-2009 12:42 PM

Re: Switching to SUBOXONE Monday for Pain Management
Jema X that's a very good point. The ceiling effect means that bupe will only work for people who only require a relatively low level of pain relief, and do not have flares of pain that require more than the ceiling effect.

sparky06516 10-06-2009 02:06 PM

Re: Switching to SUBOXONE Monday for Pain Management
Mark 76, sorry but I must disagree with you about sub. it is approved in the us for pain management but the doc's have to have some kind of certification to administer it. This is what my PM doc told me the other day.

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