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  • Starting Suboxone for pain Mngment!

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    Old 05-10-2007, 10:24 PM   #1
    shakorox
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    Starting Suboxone for pain Mngment!

    My previous post was Suspended from Work Because of Meds!

    Hello everyone,

    Because of all the issues with work, my doc does not feel comfortable perscribing narcotics to me anymore! So I did some research and found a doc who uses suboxone for pain managment. I have been in complete withdraw since taking my last narcotic on tuesday! However I started the suboxone today and so far I'm okay, I posted about it on the Addiciton/ Recovery board. I've taken 12mg so far today and if I wake tonight and cant get back to sleep the Doc told me to take another 4mg. Then I am supposed to call him in the morn.

    My back still hurts pretty bad but I think it might be left over withdrawl pain. I guess I'll find out in the morning! Suprisingly tylenol and ketaprophin work a lot better then they ever did when I was on the morphine. It's amazing how the suboxone made the withdrawls dissapear. I'm adjusting to the med hour by hour and as time goes on me head is getting clearer. Ealrier I was a little dazed after my first two doses but it;s getting better and my back pain is slowley subsiding! I didn't sleep last night because of withdrawls, so I;m gonna take a couple benedryl and have a siesta fiesta! I post how I feel tommorrow.

    Later,
    Derek

     
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    Old 05-10-2007, 11:07 PM   #2
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    Re: Starting Suboxone for pain Mngment!

    Hey Derek, You do understand that suboxone is an opiate, It's just a mixed opiate agonist/antagonist so there is little chance of producing a high because the antagonisstic action prevents it. Taking it while actively dependent or doing a cold switch from an opiate to suboxone will send most people into withdrawal. It's probably a good thing that you were able to detox a little rather tha having the Bup purge you instantly.

    If suboxone is to be used, IMO it should really be the first line in opiates rather than something you through in the middle. Because it's an opiae it is a pain killer, but as far as drug testing, each drug has it's own metabolite they have to specifically look for, Suboxonme is so new it's not likely many drug tests are able to detect it, but it's not like you would be returning to work opiate free and if your employer is dead against any type of opiate and knows enough about opiates, I'm not sure it's really going to be the answer your employer is looking for. If he's not well versed in Suboxones uses, he may simply come to the conclusion your taking it for addiction maint the way methadone is used for opiate addiction. I do hope it helps with the pain and should clear your head, but because it's only FDA aproved for detox, it's going to cary a stigma with some docs that still believe only addicts use methadone. I do hope all goes well and the withdrawal will deminsih pretty quickly from here on out.

    Good luck, Dave

     
    Old 05-11-2007, 12:23 AM   #3
    shakorox
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    Re: Starting Suboxone for pain Mngment!

    Thanks Dave,

    I'm having trouble sleeping but feel a lot better. My doc was trying to explain somthing I'm not sure I understand. He said he saw a presentation on it at a recent pain managment conference. He was explaining that when you are on particular opiates (his example was methadone) for an extended period of time your brain knows that somthing is still wrong with your body so it produces more opiate receptors. He said that because of the extra receptors there is more pain.

    He said there were some studies showing a pain patient on a low dose of Meth for an extended period of time who's pain was actually less when they were taken off the medication and adjusted. I don;t think I'm explaining this right, but his point was that he has patients who are on maintenence suboxone that are in less pain then when they were on full opiod antagonist. However he was adimit that this is just a theory because there are not enough studies done on suboxone for pain managment. So I guess we'll see.
    I have noticed that tylenol and nsaid's work a lot better while taking suboxone versus the morphine.

    Thanks,
    Derek

     
    Old 05-11-2007, 08:01 AM   #4
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    Re: Starting Suboxone for pain Mngment!

    Good Morning,

    I woke up this morning feeling pretty good. I had some insomnia last night but slept very well the few hours I did sleep and that in it's self is a great feat for be. I can't remember the last time I woke up in the same position I fell asleep in.

    I only had a few very minor W/D symtoms nothing worth complaining about. I called my doc and told him how I did last night and he said for me to take 8+8+4=20mg this morning and see if that holds me for the day. He said it will build in my system for a couple days before we find the right level to drop to for maint. He would rather people start on a higher dose than be uncomfortable, especially if they are a pain patient.

    Reguarding my pain, I actually feel great! My back hasn't felt this good in a looong while! I don't even feel the need to take a tylenol or motrin. Generally I would always awake rating my pain a 5-6 but this morning it's a 2-3. That a huge difference. I feel like going dancing but I'm not sure where to go dancing at 10:00am in the morning. So instead I'll just take it easy.

    I keep checking back,
    Derek

     
    Old 05-11-2007, 08:47 AM   #5
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    Re: Starting Suboxone for pain Mngment!

    Yep - my doc explained it also. You end up feeling more pain.

    He decreased my pain meds by a bit - not a lot and I've been better - at least till other nerves started hurting that hadn't before.

    Glad it's doing well for you...

     
    Old 05-12-2007, 08:09 PM   #6
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    Re: Starting Suboxone for pain Mngment!

    I've been doing very well today. No withdraw symptoms and I feel very clear headed. Not that I was high or anything on the Kadian but there is a sense of clarity and it's pleasent. Also my back is feeling very good. I don't know if it's cause of a new med, some kind of placebo effect or what, regardless I'll take what I can get! Today was very productive and I hope I have more days like it.

    Derek

     
    Old 05-20-2007, 01:29 AM   #7
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    Re: Starting Suboxone for pain Mngment!

    Derek,

    I recently went thru detox for Fentenal patches. When I was discharged, they prescribed me Subutex... which is the same stuff your taking currently. I took my last dose of Subutex on Mother's Day (Sunday May, 13th). I have not slept but 4 hours since. The withdrawl symptoms are tapering off now but Wednesday and Thursday were an incredible challenge! I was on pain meds for 3yrs 3months due to a severe auto accident. At my peak, I was using 100mg Fentenal paches and Lortab 7.5. I wish you the best off luck!

    Jason

     
    Old 05-20-2007, 02:05 AM   #8
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    Re: Starting Suboxone for pain Mngment!

    I hope you do well with this treatment derek. I hope you dont have any withdrawl symptoms and still get pain relief. There is a concern for lack of sleep with this treatment though and if it becomes a problem a simple sleep aid like ambien or lunesta should do the trick. You are doing a good thing starting this so you cn get back to work, some ppl just want to lay around stating the pain is too bad and take opiates forever and not work. you have my respect for doing what you did and hope you do well with both the treatment and work!


    Wvrecon432

     
    Old 05-23-2007, 09:20 AM   #9
    shakorox
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    Re: Starting Suboxone for pain Mngment!

    Thanks for the kind words. I have been finding it difficult to sleep. Within the last two weeks I went completly sleepless for two entire nights. I spoke to my doctor about this and he perscribed Trazadone 50-200mg nightly. Technicly it is an antidepressant, however it caused too much drowsiness as an adverse event, and noone adjusted to the drowsiness, so it's mainly used for off-label uses. Let me tell you, it works great! I've been sleeping like a baby. The first couple days I was hungover in the morning but that wore off and I'm not grogy when I sleep. My Doc was telling me how some of the most perscribed sleep aids interfere with the deep stages of sleep and they are critical. He said this med lets you get a full night and helps you get more REM sleep.

    I think I'm experiencing some of the antidepresent properties as well or maybe it's just the good sleep but I've been in a pretty good mood, better than usual, and I'm not as nervous. Who knows, it could just be some placebo effect but I'll take what I can get.

     
    Old 05-23-2007, 03:37 PM   #10
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    Re: Starting Suboxone for pain Mngment!

    Hello all,

    I believe, wholeheartedly, that the fewer opiates we need to take--the better off we will ALL be!

    Here's the "BUT..."

    I tend to get edgy, nervous, paranoid, etc., with this theory (AND I UNDERSTAND THAT IT'S A THEORY) concerning the development of more pain receptors over a period of time when a person is placed on potent opiates AND that we should be removed from these meds in order to receive less pain. The "theory" involves both parts of the sentence! I'm just extremely and overly sensitive.

    WHY?

    When my PM doc left the area, and my Internist (who took up the Rx'ing "duties" of this PM doc) retired in 2002--I was desperate to find a physician quickly. The first two I got appointments with told me practically the same thing. They said that I would "always" be in pain if I remained on the PM regimen (Duragesic, Actiq, Dilaudid). I had not been able to reasonably function until I was placed on these medications. FURTHERMORE, my dosages have been the same since 1998. I have not had to increase these opiates, for which I am thankful. However, I still get weary when I perceive that people are under the guise that these medications are the frequent root of the problem.

    AGAIN, PLEASE BE AWARE THAT I AM NOT SAYING THAT THIS IS THE "BELIEF SYSTEM" HERE. It's just that the ideas mentioned so far on this thread get really close to suggesting that some of these utterly life-saving opiates are the eventual cause(s) of our pain problems.

    Call me an absolute idiot. Call me an alarmist. Call me a moron. Call me all of them. Or, call me "Jon"--since that's my name.

    Truly, I don't mean to lose a grip (because it's obvious I don't have much of one left). I guess I'm just very protective of my relief that I've had to fight for. The reason I say this is that the whole idea of "doctor shopping" has been sickeningly amplified in our area. The few PM doctors in the area come across as wanting NSAID's placed into a controlled substance category. AND, certain pharmacy workers where I trade look like they want to call the police if you get more than two controlled substance Rx's on the same day. OK, this last sentence was just my sick manner of joking.

    I'll leave it at that. Please know that I am not usually so defensive, but I needed to vent. Thank you for giving me the psychiatric outlet (minus the possibly enjoyable Rx's) that I so blatantly needed.

    Sincerely,
    Jon (Conductor)

    P.S. Although I don't mean to be offensive, I somewhat expect to be "blasted" by some.

    Last edited by conductor; 05-23-2007 at 03:39 PM. Reason: Add P.S.

     
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