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Suboxone for Pain Mgmt

AnonymousUserAAnonymousUser Posts: 51,465
edited 06/11/2012 - 8:23 AM in Pain Medications
Anyone else taking Suboxone for pain?

My Pain Mgmt Dr. just started me on Suboxone on Monday afternoon for pain relief from DDD, Stenosis and sciatic flareup.

Is anyone else currently prescribed Suboxone for their pain? I was curious as to the level of pain relief you are having and also what if any side effects are troublesome?

At first I had some dizziness and general feeling of being "Out of it". Hard to focus. That is getting better each day. However, I still have a feeling of being high. Pain relief is very good....better than Vicodin.

Richard J.
Chicago
_____________

DDD; Lumbar spinal stenosis; Osteoarthritis. Fusion of L4L5S1 in Feb 2005 titanium rods and screws. Current bulging/ protruding disc at L3L4 with compressed nerves resulting in foot drop in left foot; numbness tingling both legs neuropathy
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Comments

  • :) i have only known of the medication to be used to combat withdrawal symptoms from opiates. ~X( talk to your doctor about this! :-C Jenny :)
  • of Suboxone being used for pain. I have often wondered why it is not used more often instead of opiates since there should be no withdrawals from it. Maybe it is not safe long term?
  • Is it narcotic? I am glad to hear that you are receiving relief from it though. I wish I could find something to take that wasnt so strong for my back pain and was non-narcotic...still looking :?
  • Oh there are most definately withdrawals from it they are just more subtle than with straight opiates. Alot of people at my rehab had trouble with getting off suboxone with no opiates being taken for months. For me yes it did help a bit with pain but I was going through hellish opiate withdrawals which is what its made to combat. Honestly though yes im sure it helps with pain maybe on the level of tramadol
  • chgorich said:
    Anyone else taking Suboxone for pain?

    My Pain Mgmt Dr. just started me on Suboxone on Monday afternoon for pain relief from DDD, Stenosis and sciatic flareup.

    Is anyone else currently prescribed Suboxone for their pain? I was curious as to the level of pain relief you are having and also what if any side effects are troublesome?

    At first I had some dizziness and general feeling of being "Out of it". Hard to focus. That is getting better each day. However, I still have a feeling of being high. Pain relief is very good....better than Vicodin.

    Richard J.
    Chicago
    _____________

    DDD; Lumbar spinal stenosis; Osteoarthritis. Fusion of L4L5S1 in Feb 2005 titanium rods and screws. Current bulging/ protruding disc at L3L4 with compressed nerves resulting in foot drop in left foot; numbness tingling both legs neuropathy

    I was also just put on suboxone for pain management yesterday. The doc talked about it's how well it handles pain, did not say anything about it's use for withdrawls, didn't know about that till I got home. I was shocked and wondered if he put me on it thinking I have an aditicion or really for pain. The first night with it was horrible, my pain was a mess, spiking constantly and I did take my normal ambien cr, which would usually give me 8 hrs. I was previously on oxycotin 30mg 3x day and diladid for breakthrough, i hadn't really had crazy pain problems until 3 weeks ago when they changed my to diladid from percocet for the break throughs. I went into ER on Wend night because i could not get it under control and was very rudely treated by the Er Doc. he just left me in the room at a level 10 wouldn't even give me an exam, just a lecture on doc shopping. i had already called my pm and set an apt for the next morning, this doc would not believe me until finally i got him to call my doc who then permited him to treat me. the next am at the PM he changed me to this suboxone. I am hoping this works and am going to give it the weekend, it is friday now and i know if i call the pm they will say it takes a few days for a new med to get into your system, went through that speech when they changed me to diladid. if anyone else has taken this for real pain management i would love to hear from you, right now i am confused.
  • Read here what some people who take suboxone are commenting about this drug.

    http://www.drugs.com/comments/buprenorphine-naloxone/suboxone-for-opiate-dependence.html


    Good luck to you :)
  • Rockabilly Chick

    I'm sorry that you had to go through that, the way pain management patients are treated in this country is "criminal".
    I have done a great deal of research on subs, though accurate Western literature is hard to find. Suboxone was introduced in the US as a "opiate blocker" to help people addicted to opiates to get off of them. This is because it didn't make sense (money wise) to introduce a new pain pill into an already billion dollar industry (Oxycontin alone made 1.2 billion in 2007) of pain medication when there was only methadone to compete with in this market. However, suboxone was originally introduced as a pain medication in Europe and has been used for severe cancer, neuropathic, etc. pain (even for post op pain) for more than 10 years there and is available in a pain patch in every country but the US. I have been on suboxone for 10 months for pain management (it is used in the US (more rarely) as a secondary indication for pain) and it works better for me than the dilaudid & Fentaynl patch I was taking previously (for severe sciatica, related problems, & ovarian cancer with complications). I have had 2 instances of severe breakthrough pain in 10 months, and had a shot of morphine and a shot of Stadol (for the back). The biggest problem that I have encountered has been within the medical profession/pharmacists thinking I have drug addiction issues rather than pain management issues, and the treatment of pain, especially when they aren't familiar with my medical background, due to the aforementioned being introduced in the US as "opiate blocker". Suboxone is a powerful narcotic, it is a derivative thebaine, which is the same derivative of oxycontin, and sub. is approximately 25 to 40 times as strong as morphine, much stronger than the pain relief of tramadol. I believe the reason it works so well for me is that traditional opiates deplete the dopamine (natural painkiller) in the brain, thereby actually increasing pain perception over time, where suboxone heals the receptors damaged by long term opiate use ( I have been in & out of pain management with cancer & back problems since 2000) and restores natural dopamine levels. It also has antidepressant properties in some people, and for me it has worked in this capacity where no other antidepressant worked, possibly because my depression was related to the pain (?). The most important thing to know when taking suboxone is that if you do receive a shot of morphine at the hospital for severe breakthrough pain (or take any other opiate, although only morphine, dilaudid, & Fentanyl will work while on suboxone) is that if you don't wait a sufficient amount of time before taking suboxone again, you will suffer severe and irreversible "precipitated withdrawals" which I am told are horrible, but if you are careful and aware of how the medication works, this can easily be avoided without much discomfort. The other drawback is that the formulations of the drug suboxone in the US aren't designed for pain management, which makes dealing with breakthrough pain tricky. I hope this helps somewhat and I hope that suboxone works as well for you as it has for me, but if not, even taking it for a short while has some benefits. Best of Luck to you! peace&love J
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,794
    My pm Doc. and pain Phych. wanted me to give it a try because most meds work differently for me than other people. And I have bad side effects with most meds.
    When posting a question on suboxone on the old forum. I got nothing positive and everything negative about it. Also I need more surgery And if I chose to get it. I was afraid of complications. So we opted for methadone instead. With a special hydrocodone compound for break through pain. And it is less than satisfactory for me.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,794
    I should have been more clear. My doc. wanted me to try the suboxone for pain management. Not to withdraw from opiates.He believes that there are pain management qualities not advertised with suboxone.
    Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • There are MANY people who take suboxone for pain management.It was first introduced as a way to wean abusers and addicts,but is also used to treat pain.

    Just like methadone you will hear stories and there might be a 'stigma' involved,as with anything we have to learn to rise above the ignorance out there.

    It's whatever works.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,794
    The more I read about them the more confused I get. My eyes are tired!
    Jayleigh seems to know more about them than my pm doc.
    I did see buprenorphine patches. But I don't know if they are available in the USA.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Like most everyone here I have had lower back issues from an injury for several years now, I have also gone through the "courteous treatment" from emergency room doctors and on occasion regular doctors. Actually several "fired" me as a patient as they claimed I was just drug seeking. I finally found a wonderful pain specialist who listened and we tried a couple of different things including methadone. The methadone did not give me any relief and in fact made things worse as I had more issues from the side effects than pain relief... Honestly it seriously disgusts me how people with chronic pain issues are treated in this country. We are told that we are either drug seeking or that its all in our head etc. The other issue I have run into is not having health insurance and was initially injured while at work where the employer refused to do anything about it and did not have worker's compensation insurance. So for a good portion of time my only treatment options was the emergency room when my pain levels got to the 10 range on the scale. After about 2 years of this I finally found the pain specialist I see, (he was partially responsible for the national pain foundation set up so he knows his stuff) after the bad experience with the methadone he decided to try the suboxone. He was up front with me and told me what it is used for in this country which is the narcotic addiction, he also took a good amount of time to explain to me that in no way was he using it for that intended purpose. He also works closely with the pharmaceutical company and since I have no health insurance helped me to get into their low income program, so they send the medication to his office and it costs me nothing.
    Personally I have had amazing relief with the suboxone as my main pain medication. Previously taking all of the other various narcotics after a while it would require higher doses to achieve the same partial relief. My quality of life was so bad I had finally gotten to the stage of depression of feeling suicidal. (At the time I was trying to take care of my family which included a 10 year old daughter and non supportive spouse) I was constantly "out of it" and had about the mental acuity of a zombie. After trying the suboxone the relief was fairly quick without all of the other various issues with the other narcotics, sleepiness, that disconnected feeling and the "high" that I hated the sensation of. I have been taking the suboxone now for a few years and it is still just as effective, in fact I had to decrease my initial dosage after the first few months instead of increasing it as I had previously needed to do with the "regular narcotics". Granted when I had to have a major surgery recently the hospital did not know how to work with the suboxone so I had to stop taking it prior to the surgery so their "regular pain medications" could have their full effectiveness, but as soon as that was done I was back to my usual suboxone dosage.
    The first time I ended up in the emergency room for a bad breakthrough issue after starting the suboxone they contacted my PM doc and he handled the "its used for narcotic addiction" issue I was running into very well and on my follow up visit with him told me to use this and he would back it if there was ever a question to any doctor that contacted him about it. That advice was telling the emergency room doctor or any other doctor's that questioned the suboxone and its "intended purpose" that this is part of a study to alter its "label" to include pain management as part of its US profile. I am amazed at the number of doctors who have never even heard of suboxone and as soon as they look it up and see that is to treat addiction they suddenly treat those of us taking it as if we are beneath them. Telling them that my doctor uses it off label as a pain management medication and in conjunction with the manufacturer seems to do wonders for their attitude. You would have to have a fairly good close relationship with your PM doc for this but if you run into those problems maybe give it a try...
    Honestly I can not praise the suboxone as a pain relief medication enough. Yes because my initial back disk issues were not treated in a timely manner I also have permanent damage to the sciatic nerve bundle in the lower back so I have a good combination of medications I take but the suboxone is the top of the list for helpfulness... recently my doc added lyrica and I take a muscle relaxant specific to spinal injuries called zanaflex. We had topamax in the mix for awhile but then I unexpectedly turned up pregnant and had to change several of the medications. But a good PM doc who listens and understands and doesn't treat us ike its in our head or that we are just addicts looking for a fix, that treats us with respect and understands that it is our body and we are the ones who live inside it is a wonderful godsend that I hope everyone with a chronic pain issue finds no matter what medication that ends up helping. I am proud of the fact that the suboxone is so helpful for me and will argue with any doctor that says addiction treatment is all it is for.

    "Knowledge is power
  • I have been prescribed Temgesic sublingual tablets for many years to treat my chronic pain, and I find it works pretty well, especially in combination with a muscle relaxant. I'm prescribed twelve tablets a day, but I can often get by on seven or eight a day, if I don't overdo things. One of the things I'm most happy about with Temgesic is that my tolerance has not changed at all in over ten years. This has never been the case for me with the other opioid painkillers I've been prescribed in the past, and it's a relief to get decent analgesia without having to up the dose all the time.

    I'm glad to hear that others here are using buprenorphine successfully for pain relief. It is used in both sublingual (under the tongue) and transdermal forms, with the transdermal patches being more popular today for chronic pain (sometimes the patches are prescribed for long-acting relief, with the sublingual tablets used for breakthrough pain).

    Buprenorphine (the analgesic ingredient in Temgesic, Transtec, Butrans, Buprenex, Subutex, Suboxone, etc.) has been used for pain management for around 25 years in the UK and some other European and Asian countries. Its use is on the rise now, as more doctors become more familiar with it and some of the old misconceptions are dispelled (overdose can be reversed with naloxone, for example).

    While it has in recent years been used successfully to treat opioid dependence, it is, first and foremost, a painkiller, and a powerful one at that. It is estimated as being (depending on the source) between 30-60 times as potent as morphine (weight/weight), but in effect it produces analgesia that is about equivalent to morphine and oxycodone. This is because it is a partial mu-receptor agonist, and as such has less intrinsic activity on the opioid receptors than full agonists like morphine and fentanyl. It was actually available as a painkiller in the USA before it became widely used to treat opioid dependence, but only in an injectable from (Buprenex).

    It has certain advantages to the full agonists in that it causes less respiratory depression (there is in fact a ceiling effect on this, which makes it safer in this regard than other opioids), and has an all-round favourable safety profile (less pronounced CNS effects, no effect on immune or endocrine system, safety in renal impairment, etc.). It is safe for long-term use, according to all the studies I have read, and according to my pain management doctors both here in Taiwan and back 'home' in the UK. It also causes less dependence and is supposed to have gentler withdrawal symptoms, but it is still an opioid, and a very strong one, and as such there will probably be some degree of withdrawal syndrome, so this is still something a patient should be aware of when taking buprenorphine.

    One thing that is important to take into account when talking of buprenorphine for pain relief is the dosage. Doses for pain relief are much, much lower than doses used in opioid dependence/withdrawal treatment. The average starting dose for pain relief is 0.2 - 0.4mg every 6-8 hours. The dose can then be titrated to suit the individual patient (I usually need between 0.4 - 0.8mg - sometimes a little more or a little less than that). Suboxone/Subutex tablets often contain anything from 8 to 32mg of buprenorphine - a huge difference. While there is a danger of buprenorphine blocking the effects of other opioids when taken concurrently, this doesn't occur when the usual therapeutic analgesic doses are used (in the analgesic dose range it works as a pure mu OR agonist). It is usually only an issue if large doses are taken by someone already dependent on another opioid. A 2mg dose of buprenorphine occupies around 40% of available mu opioid receptors, while at 16mg the number increases to 80%.

    A lot of the confusion that I've seen take place whenever buprenorphine is discussed on message boards is the result of misconceptions regarding the nature of the drug itself (it is unique among the opioids), and also the fact that in many cases what is being discussed is essentially two separate formulations of the same drug, used for different purposes: one (lower dosage) to treat pain, the other (higher dosage) to treat dependence/withdrawal.


  • I just spent the past night awake coping with dizziness and nausea from my first trial with Suboxone for pain management. I only took 0.5 mg, i.e. a fourth of a 2 mg tablet. Many people are taking eight to 16 mg. I won't be touching this drug again. I have had bad experiences with opiates generally -- the side effects are just too severe. Keep in mind that the drug manufacturer says Suboxone is NOT indicated for pain management. That doesn't mean it won't work for some people, especially those who are hooked on older opiates. But that's the point: this drug is designed for people who already have a high tolerance for opiates/opioids and presumably won't have to bother with the side effects. It's a drug meant for an elephant, and I'm just a little mouse.
    I'm back to Tylenol for now.
    -P
    (2-level ALIF with posterior instrumentation L4-S1 plus laminectomy L4-L5 Oct. 2008 and Jan. 2009)
  • that a doctor is prescribing suboxone for someone who was taking vicoden . I am not pro -suboxone for pain management in cases where there is not a history of addiction, and one of the big reasons why is that it is being used in cases where someone is taking vicoden and then their doctor is making a huge jump to something like suboxone, when there doesn't appear to be a history of trying the other , standard pain medications but just putting a patient on sub????
    Even the manufacturer says that it is not indicated for pain management here. Too many doctors prescribing it, without knowing what they are doing, at too high of a dosage, and without telling their patients that after being on it for a while, there is a difficult withdrawal ahead of them.
    Suboxone definately has it's place when there is a history of addiction and there is a need for pain management as well, or as a treatment to get someone off opiates, but in most of the chronic pain scenarios, I can't see where it should be used to get someone off narcotics without a history of addiction in the pain management atmosphere, or as a pain medication when the standard pain medications haven't even been given a chance to see if they would work, instead of a huge jump to something like suboxone.

    I just went to the suboxone.com website and this is what it says about using suboxone in pain management scenarios--
    "SUBOXONE is not indicated for pain management. Patients with a clinical need for pain management should not be transferred to a SUBOXONE regimen, even if they are physically dependent on opioids".
  • Suboxone may not be intended for use in pain management, but buprenorphine tablets and patches (Temgesic, Transtec, Butrans, etc.) in the appropriate dose range are. This is a drug that has been used safely and successfully to treat pain for many years, long before it was ever used for dependence/withdrawal treatment. Please note what I said before about how the dose range differs according to indication. There's a world of difference between the small doses used to treat pain and the very high doses typically used to treat dependence. I agree that it seems irresponsible to switch a patient on to high doses of Suboxone for pain relief; it's definitely a case of less being more effective, in this case. It's all a matter of using the drug (or one of them, given that Suboxone also contains naloxone) appropriately, in my opinion. Doctors need to keep in mind that 0.3mg of buprenorphine is roughly equivalent to 10mg of morphine. The usual starting dose is 0.2-0.4mg. I think they should also take into account the possible complications in switching someone who is already dependent on another opioid to a high dose of buprenorphine.
  • If you've had bad side effects from other opioids, it's not surprising that you'd have them after taking buprenorphine, especially if you start at higher than the usual starting dose. Some patients have trouble with nausea and dizziness when they first start on the drug - they are the most common side effects, but they usually wear off after a while, as with other opioids. I was lucky in this regard - I didn't feel any bad side effects (I started with 0.2mg and gradually increased to 0.4mg after a few weeks). I can only imagine how sick a person might feel if given 8mg or 16mg (roughly equivalent to 240mg and 480mg or morphine, respectively!) as a starting dose for pain relief. Even the smallest dose Suboxone tablets available (2mg) is about 5-10 times the recommended starting dose of Temgesic.

    I should point out that prior to being prescribed buprenorphine for chronic pain, I'd never been dependent or had any addiction problems whatsoever. I'd been on dihydrocodeine for a few weeks, then tramadol for a few weeks, and after they didn't help relieve my pain, my doctor then switched me to Temgesic. I realise that in the States the formulations used (Suboxone/Subutex) are made specifically for opioid addiction treatment, but this isn't the case in many other countries, and being an addict is emphatically not a prerequisite for taking buprenorphine for pain relief! It's a matter of the drug being prescribed appropriately, and of individual reaction, as with any other pain medication. I suspect fewer people in the US would have bad experiences with it if the low dose tablets/patches were available for pain relief, as they are elsewhere.
  • Thanks Huggy for your insights. I realized after taking what seemed like a tiny dose (a quarter of a 2 mg tablet) that it was actually quite high for someone who's really never taken opiates before, except for right after surgery. Interestingly I did not feel dizzy or nauseated after taking hydrocodone (Norco) 10/325 after my operation.
    Because this drug is intended for addicts with a long history of opioid use and a high tolerance, it is formulated at a very high dose. Perhaps you can tell me how you manage to cut the 2 mg pill down to 0.2 mg. I ended up with powder.
    My pain management doctor said I should try it again in his office in about a week. I'll be there for a while and they'll give me a patch to counter the nausea. Not really looking forward to it. I'm still wary of any opiates.
  • I agree, for pain management they should really use tablets of a smaller dosage. I can understand the problems you must be having, trying to get the right dose from a tablet that isn't designed to be chopped into ten pieces!

    The Temgesic brand tablets that I'm prescribed are 0.2mg, a tenth of what's in one Suboxone 2mg tablet (it's the same thing that's in Suboxone, minus the naloxone). Temgesic is used in many countries specifically for pain relief, so there is no hassle - if you need just 0.2mg, you can dissolve one tablet under the tongue; if you need 0.4mg, you take two... and so on. I need around 0.8mg in the morning (when my pain is very bad) but it's pretty difficult to keep four tablets under your tongue at the same time, so I have to take them in stages, usually two as soon as I get up and then another two about 10-15 minutes later. They used to have 0.4mg tablets until a few years ago, when they stopped prescribing them for some reason. The good thing is they are relatively fast-acting, and pain relief generally lasts anything from 5-8 hours (usually 5-6 hours for me).

    The nausea and dizziness are quite common side effects of opioids, especially the stronger ones. I've never had hydrocodone before, but in the past, whenever I've started taking any of the milder opioids like codeine, propoxyphene or dihydrocodeine, I've never experienced nausea or even queasiness - just a mild lightheadedness. I have heard that the incidence of nausea is somewhat higher for people starting buprenorphine, especially if they aren't used to opioids. For many people the nausea wears off as they become accustomed to the drug, but some people have stopped treatment because of it, so obviously it can be a persisting problem in some cases. If the 0.2mg tablets (or patches) were available in the States, I would think that these problems could probably be avoided, or at least reduced. I never had any nausea at all, but I started with the lowest dose and then gradually increased over a period of weeks until I found the dose I needed to give me relief. Then again, I've always tolerated pain meds pretty well - the only time I felt queasy on opioids was the day after my lumbar laminectomy (I was on epidural diamorphine at the time, and tried to walk to the bathroom on my own - bad idea!).

    Is there any way to cut these Suboxone tablets cleanly, say with a pill cutter? I imagine it must be difficult - the Temgesic tablets I take are tiny, definitely the smallest tablet I've ever had. They are easy to crush (I've squashed them by accident before, while still in the foil strips they come in), so I can imagine you having trouble trying to break little bits off a 2mg pill. I hope you and your doctor can find a way to get the right dose, and hope the side effects you get from them decrease. If you can get rid off these, it can be a very effective and very safe pain reliever. Good luck!

  • Thank you Huggy for your thoughts on Suboxone. I'm scheduled to give it a second try on Friday -- this time at my doctor's office, where he can monitor me while I writhe in agony from nausea and dizziness. Supposedly he has an anti-nausea patch for me. I don't know... I think it may not be such a bad thing to have a sensitivity to opoids. Look at all the problems they cause.
    But if there's an opoid I might take, I guess it would be Suboxone. Just wish I were in your country where I could get it at a reasonable dose ;-)

    Best regards,
    P
  • Didn't you say that you really had not been on opiates other than right after surgery? And this doctor is going to treat you/is treating you with suboxone?
    I'm sorry, but I would be running far and fast from some doctor who wanted to put me on a drug like suboxone , especially when I had no previous experiences on opiates.....
    I truly hope that you have done far more research on using suboxone for pain management, and it's withdrawal in long term use * longer than 21 days*, before you decide to take any more of it.
    He is going to give you a patch to manage the side effects of nausea and vomiting so that you can continue to take a drug that you have no tolerance for?
    There are many other pain medications that you could try instead of using this, which you already said makes you sick .
    I realize that reading a post by someone who takes a medication or who makes it sound like some miracle drug ( no offense Huggy- I'm glad that it works for you, but it is not the same drug- you are taking what would be called subutex here in the States), we don't have the minute dosages here in the States that you have in Europe, so it is guess work by the doctor and the patient. I might feel a lot different about it if it was used by doctors who know what the heck they are doing, but here, it is the newest drug on the market and will supposedly prevent "abuse" of opiates, so the doctors are gung ho to start prescribing it, not knowing what they are doing.....
    sigh
    I hope, Watch , that you change your mind about using this drug.....I truly do. But if not, I hope that you don't experience the problems that I have read far too often about.
    Sandi
  • No offense taken, Sandi. I hope I haven't made it sound too much like a 'miracle drug' - it's simply what I've been prescribed for my chronic pain, and I've found it helpful. I realise not everyone will have the same experience with it, especially since in the States it doesn't come in the lower dose tablets and patches that are designed for pain relief. To be honest, I share your concern about Suboxone being prescribed for pain relief - if they are going to use buprenorphine for pain relief, they should use the low dose formulations that we have over here, not the whopping doses that you find in Suboxone, with naloxone thrown in to boot. Even then, buprenorphine isn't the kind of thing you prescribe to someone who hasn't already tried other, milder opioid drugs.

    When I was first prescribed Temgesic, my doctor told me openly that she was wary about prescribing morphine, not because my condition didn't warrant it, but because of my age (I noticed several of the doctors I saw shared this attitude). Of the stronger opioids (I'd already tried various mild-moderate strength ones, such as codeine, dihydrocodeine, etc.), she was only comfortable prescribing Temgesic for chronic pain to someone my age.

    It's the same here in Taiwan: the doctors realise I need a strong pain reliever, but full agonists like morphine and fentanyl (which are really the only two available here - there is no oxycodone, hydromorphone, oxymorphone or even hydrocodone) are reserved almost exclusively for cancer pain. My pain management doctor is willing to prescribe Temgesic and tramadol because he sees them as having less potential for dependence than morphine (though obviously they can still cause dependence), and because they are Schedule 3 and 4 here, respectively, and therefore easier to prescribe. If I lived in the US, I'd probably be on OxyContin or MS Contin or something similar.

    Watch, I hope you find something that works for your pain, whatever it is. If buprenorphine doesn't work, there are several other drugs the doctor could prescribe for you. Whatever it is, I hope that it works for you and doesn't make you feel nauseous all the time. Good luck!
  • Thank you for understanding where I am coming from and my concerns regarding using Suboxone here. You are absolutely right, we don't have the micro doses here and that in my opinion leaves patients to use a pill splitter or some device that is similar to try to "guesstimate" the "right " dosage if they are going to try a smaller dose, which creates yet another concern, one that the patient is taking a small dose one day, but might split the pill wrong the next and take a bigger dose...inconsistent dosing is what I was trying to get at.
    I have read too many stories from someone in pain, using suboxone who is treated like a drug addict by their pharmacists, other doctors, hospitals and all because they are taking suboxone. That's not to say that it doesn't happen with other opiates since we all know that it does. Then comes the issue of break through pain, and emergency room treatment, where if the doctor is unfamiliar with suboxone, he may throw someone into some serious withdrawal by giving them the wrong med.
    Anyway, I am sure that you are well aware of all of the problems with it here, so I will stop my ranting.
    Thank you for being understanding of my concerns.
    Sandi
  • All I will say is Suboxone is so misunderstood in the US (I've lived in the US all my life) its pathetic.
  • chgorich said:
    Anyone else taking Suboxone for pain?

    My Pain Mgmt Dr. just started me on Suboxone on Monday afternoon for pain relief from DDD, Stenosis and sciatic flareup.
    Is anyone else currently prescribed Suboxone for their pain? I was curious as to the level of pain relief you are having and also what if any side effects are troublesome?

    At first I had some dizziness and general feeling of being "Out of it". Hard to focus. That is getting better each day. However, I still have a feeling of being high. Pain relief is very good....better than Vicodin.

    Richard J.
    Chicago
    _____________

    DDD; Lumbar spinal stenosis; Osteoarthritis. Fusion of L4L5S1 in Feb 2005 titanium rods and screws. Current bulging/ protruding disc at L3L4 with compressed nerves resulting in foot drop in left foot; numbness tingling both legs neuropathy
    I am taking suboxone 8mg twice a day for pain management. I was having really bad chronic pain in my lower back due to scoliosis and chronic pain in my left lower leg and left foot due to nerve damage. Since being put on Suboxone, I have found great relief in pain. Suboxone is the first drug I have taken that has actually helped with my pain. I have been on many other pain medicines and have tried many other means to stop my pain. Such as, exercise, rehabilitation, portable TENSE UNITS, back braces, epidural, and steroid injections in my spine. Some have shown signs of relief but not long lasting relief. Suboxone has changed my life. I can now feel normal again. When I first started Suboxone I too was feeling a little out of it, but after using Suboxone for awhile those feeling have subsided and now I can function normally on a daily basis. There is no cure for pain and no matter what you take you will still have feelings of pain. I just know that before suboxone I had way more bad days than I did good and now I actually look forward to waking up each morning.

    *This is my opinion and based solely on experience with this medication. This does not make up for asking or seeking medical advice from a well qualified person or persons.*





  • My son did not have pain problems he is a recovery addict from oipades to herion , they put him on sub everytime for with drwasl at rehab when he OD and died , they were able to revieve they put him on it he has been on it for 3 yrs he now is doing 100 percent better turned his whole life around any way my point after rambling is i knwo you are not an addict , he is have a horrible time getting off it he a ttapered to almost nothing. his withdrwal is depression severe and pain he said he would rather withdrwal from herion.. just our opion good luck and talk to your dr .. get all the info u can for long term use and its effects
  • I am in the recovery process from a TKR aND HAVE EXPERIENCED COMPLICATIONS in healing, original surgery was May17, Manipulation was June 27, I was taken off oxicodone and put on 4mg dilaudid every 4 hrs., Today is my last dose of hydromorphone and the dr switched me over to suboxone, I have heard that its being used for cronic pain but at this point Im just so frustrated with taking my pain meds I want to get off., I have had experience in using suboxone to curb vicodin withdrawal in the past and If i remember correctly I was able to work 8hrs a day on my feet , so i think it must have masked the pain.(Just for a point of information Suboxone is very habit forming and you will experince withdrawal) from experince, no sleep, anxiety.,severe sweats and lack of energy., And one for the books for me was i developed IBS, that flooredme,(spasms in the abdomen and very loose bowels) I plan to do this for no more than a week or two., my mistake was getting comfortable and stayin on it for 2 yrs....I will be back to see everyones experience and let you guys know how i progess(tomorrow morning is my first dose, Im going to try to hold out as nlong as I can because the dr did say that if you take it to soon it will put you into acute withdrawal, None of us need that, Theres alot drs dont know about suboxone and only by sharing our experience do they learn more about the effects and if it works for pain..Looking forward to learning more about my condition
  • day 3 swiched from dilaudid 4mg every 4 hrs to 4mg suboxone, waited 14hrs to take first dose, had no withdrawal symptoms...(from past experience when taking suboxone to soon, put into acute withdrawal, vomiting, stomach spasims etc)Its day 3 Feel Great, alittle shakiness but slept great...3 days no opiate.,
  • Suboxone is safer than other pain medications, and in fact, buprenorphine (a component of Suboxone) is more often used by Veterinarians because it won't over-sedate the animals. The reason it isn't used more is that there are DEA restrictions on who can prescribe this medication. It requires special training, and there are strict laws in the US regarding medications used for opioid addiction. Good question!
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