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Goodbye Oxycontin, Hello Suboxone!

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in Pain Medications
I was recently prescribed Suboxone by my Neurologist to Detox off of Oxycontin. I was taking 180 mg of Oxycontin daily and struggled with keeping a regulated amount constant throughout the day and many side effects from the Oxycontin as all of you who take it most likely do.

I recently found a Neurologist who would treat me on an outpatient basis to detox off of Oxycontin and prescribed me 8mg/2mg tablets.

Not only did it prescribe the Suboxone to detox but also wrote the prescription to full time, treat chronic pain that I deal with daily from damage to discs in my spine from T4 - T11 and L5-S1.

On Suboxone, my pain levels are very low (1-2), depression is minimal and the obvious, withdrawal symptoms from the Oxycontin were suppressed COMPLETELY 20 minutes after my initial dose approximately 16 hours after my last dose of Oxycontin.

In my opinion, Suboxone is an Excellent Drug for Pain Management and I have tried everything including Ibuprofen, Percocet, Morophine, Oxycontin, Soma and about 6 different muscle relaxers over the past 15 months.

This is my 2nd Detox from Oxycontin in the previous 60 days and I refuse to put another Oxycontin in my mouth again.

Anyone that struggles with pain should take a good look at Suboxone which is made up in part of Buprenorphine and is a great combined Pain and Opiate Dependence drug.

It is a partial agonist, and has a ceiling effect, so overdose is virtually impossible.

The elimination half-life of buprenorphine is 20–73 hours (mean 37).

I am having great success with Suboxone so far and if any of you have questions regarding my new pain management option let me know.

May all of your pain levels be low.... ;)



  • Hey Z !

    I tried to get ahold of you via email I will try again later today... Anyway congrats on the Detox or weaning off the oxy !!!! I will be right behind you ! I dont know if u got my last message ??? Anyway I think u mentioned in cooperation with Neuro. you were able to have program to come off the oxy with Suboxne... My question is was this with cooperation of P.M. doc ? You might have said so in previous post but in a hurry to get out the door and I would appreaciate if you could give me info regarding the P.M. part.

  • Believe it or not, my PM is not qualified to write a script for Suboxone. From what I have read, you have to have a certain prescriber's addition to write Suboxone, which includes some course and training in the use of the drug.

    My Neuro and my PM are not affiliated. I found this doctor using the physician referral tool at the maker of Suboxone's website which is VERY easy to find ( cant post it here ).

    I got a referral from my PCP to see this Neuro. I am now on day 4 of my Detox with Suboxone and things are going very smoothly. Its nice to have an MD that will take phone calls and answer any questions that I have or deal with issues with my medications promptly. ;)

    Like I said, my Neuro is going to put me on Suboxone full time to control pain. Over the last 4 days my pain levels have been no more than a 2.

    I have detoxed with and without Suboxone and would not recommend attempting it without.

    I wont take Oxycontin again. Even if I cant use Suboxone. I have had it with that pain medication.

  • I'm a bit confused; you say that because it has a 'ceiling effect', which means there is a limit to how much pain it can effectively control, that it is virtually impossible to overdose on; this is *absolutely untrue*. Just because a drug stops helping you with pain at a certain point doesn't mean it won't kill you. In mouse and rat tests the IV LD50 of suboxone is about 125mg per kilogram. The ld50, if you don't know, is the 'median lethal dose'. This has not been tested on humans, but nevertheless, ld50 numbers are considered quite official. It's lethal in high doses, yes. Claims such as yours are unsafe! Please research before someone gets hurt.

    For those considering the switch; wait until proper clinical trials have been done. Your PM would likely give you a very funny look if you ask for suboxone instead of Oxycontin, because to them you are basically saying 'I want off of pain meds for good'. Usually suboxone is used for a couple of weeks just to get someone through the detox/withdrawal period as painlessly as possible. If you have chronic pain, this won't help you.

    Being optimistic, it would be wonderful if this drug turns out to have the usefulness of a drug such a Methadone in chronic pain settings. However unless I missed the article, I don't believe it's the case. If it were, one of my latest issues of 'Practical Pain Management' (for doctors) would likely have ads galore in it for the new wonder drug Suboxone, but with a different, glamorous name. However, it does not. Rather, it has ads for Oxycontin and Opana.

    hmblpi, to answer your question while on long-term chronic pain maintenance with opiates/opiods, if you break your arm it will hurt like heck! Acute pain and chronic pain are two very different but equally wicked enemies of ours. For some or many people, becoming 'adjusted' to your level of say, 20mg oxycontin twice a day, can actually LOWER your pain threshold, making every day pain seem even more intense and unbearable, but this is not a solid rule. You definitely won't break your arm and just not know it however either =P
  • So glad that suboxone is helping some people on this board. My PM wanted me to try suboxone (turned out that my dose was too high and trying to get down to a dose that would allow me to try sub was just too painful. However, before I "went for it" --- i.e. tried to to an incredibly fast taper off a high level of meds to go on sub, I did a lot of research on sub/buprenorphine. [I sincerely apologize for not looking up the correct spelling of buprenephorine before writing this post]. For anyone who isn't familiar with bupeprenorphine - it's basically subutex [no added naloxone, which is mostly inert unless the suboxone is injected - naloxone has very poor oral bio-availability if I recall correctly].

    In response to JVM, First, it IS helping the the people on this thread who talked about the relief they are getting with suboxone. I know of other CP patients who do not get relief. But I am so happy it helps some pain patients.

    You urge people to be careful in the claims they make - First, there is some dispute about the ceiling -- there IS a ceiling on respiratory depression that does not exist for pure agonists. There is a limit to respiratory depression w/ buprenorphine - increasing the dose beyond a certain point does not increase respiratory depression. I have seen some European articles claim that while there is a limit to respiratory depression, there is no ceiling on the level of pain relief. I'm not a doctor, chemist, or neuroscientist so I am not in the best position to evaluate the claims made by the authors of the articles. I did not find the arguments persuasive but I can't fully understand how the they supported their claim.

    Bupeprenorphine [or subutex -- suboxone without the essentially inert naloxone unless injected] has been used in Europe for over 20 years for moderate to severe pain with considerable success. U.S. doctors tend to know little about the use of suboxone/bupe for pain. I believe a patch for of "bupe" for PM is currently wending it's way through the approval process in the U.S. Bupe has some very interesting properties that can make it a great medication for PM. As I mentioned, my PM suggested I try it - I couldn't because my dose of pain meds was too high - I have to work my way down to a dose that will allow a transfer to Sub.

    I think that there are some problems with using sub in the U.S. as a pain med right now - I don't think they have much to do with sub itself but with level of understanding about sub now. For example, if you wind up in the ER, the ER doctors are likely to think you're an addict and *might* deny you additional pain meds, which what you would need to handle acute pain. Any full agonist can be added on top of suboxone (going the other direction will kick off a a very nasty incident of precipitated withdrawal) So, once you're "on" sub, oxycontin, morphine, etc. can be added on top of it for added pain control. Fentanyl is often used because it is so potent. The reason you can go in one direction but not the other is buprenephorine's high affinity for the Mu receptors. If you give it to a patient on a full agonist without waiting long enough, or if the patient is on a dose that is too high, then you're going to knock the morphine or fentanyl off the mu receptors which can be risky in situations when someone is on a high dose of meds. If a person is on sub or bupe, some of the receptors will be unoccupied. The full agonists won't knock bupe off the mu rececptors, but they will attach to unoccuppied receptors. Unfortunately, few U.S. doctors and even fewer ER docs know anything about this. If I were taking sub for pain, I would want my primary care doc and/or the doc prescribing the sub to know how to treat acute pain in a patient on sub and to be willing to intervene aggressively in an ER situation. I would also want him/her to have enough 'stature' at the local hospitals so that an ER dr. would listen to him/her and follow his/her instructions about treating acute pain.Naturally, this does not help with pain in situations where you are far away from your doctor and an in an acute pain situation.

    It's helpful to read European pain management literature on buprenephrine because they have so much more experience with the medication than people/doctors in the US do.

    Bupe has been particularly effective with neuropathic pain and studies have shown that it raises the pain threshold while methadone, morphine, etc. have decreased the threshold for pain -- what JVM mentioned - a minor pain is amplified after you have taken full agonists - your pain threshold is lower. I may not be phrasing this correctly - If you compare patients on sub and methadone or morphine for example, the patients on methadone and morphine "react" to a painful stimulus much sooner than those on sub/bupe do. Unfortunately, this persists for quite a while (sorry to be so inexact) after a person stops taking pain medication. A study at Stanford found that the higher the dose of meds a person was taking before they "detoxed," the higher the level of pain that person experienced once he/she was off the meds. They had expected the opposite to be true. But this is getting off the suboxone discussion...I sincerely wish I had been offered the opportunity to try sub before my dose got so high that trying sub wasn't realistic until I go my dose down.

    The person who started this thread is getting great relief from suboxone as are other people. That is not to say that everyone will respond well to sub. Buprenephrine is in a class of it's own, much like fentanyl and methadone - it is not the same as other mixed agonist/antagonist meds either.

    I am not a medical professional and my understanding of the unique properties & the advantages and disadvantages of suboxone/buprenphorine comes from having reviewed 15-20 peer-reviewed studies of bupe in addition to looking at data that hasn't been reviewed. Some people who have been on full agonists and are no longer doing well on them (or they may tired of the restrictions of CII medications and not want to be dependent on meds that are so tightly controlled), may do great on suboxone. The doses that are given for detox now are much too high for PM.

    I think we will be in better shape once buprenephorine (again, I really should have looked up the spelling before writing this post!)is marketed as a pain medication in this country. At that point, hopefully, doctors won't associate the med with addiction since it will be marketed for pain, and maybe ER doctors will know how to treat someone in acute pain who is on bupe. The ER is a frightening place for any CP patient however, so it's hard to say how much difference this will make.

    Just my 45 cents :-) So happy it is working for some pain patients here - I suggest setting up a system/plan in the event that you are in a situation where you have acute pain and need care in the hospital. Your primary care dr. and the doctor prescribing the sub or you should have some kind of plan if you are in an accident or need relief from acute pain. You might talk to your primary care doctor about how your pain should be handled if you are in an accident and wind up in the ER -- you may want to get some abstracts from PubMed so that your primary care doctor (or your neurologist, if he is willing to be on call for that kind of situation) can tell doctors what to do if you are in acute pain [continue to take the sub and add agonists -- fentanyl is one of the best in this situation. I'm sorry I don't have a citation to give you rightn now. My computer is in the shop, and with it, all the articles I have downloaded on suboxone and buprephorine. I don't check my messages here often, but go ahead an PM me if you need some citations or the articles themselves. If they are still on my computer when it comes back to me, I will try to retrieve some for you.

    JWM, by your logic, we should be seeing ad for combining ultra low dose naltrexone or naloxone with morphine as a way to lower the dose since this has been very effective in bringing down tolerance (actually, I believe there is some dispute about how to see the the ability of ultra low dose (not the dose of naloxone used in sub or given to addicts -- the dose is tiny) in leading pain journals. I think the drug manufacturers have a lot more influence on what drugs appear in Ads than research does. Sub's market niche is addiction and getting off pain meds in the U.S. I'm repeating myself (sadly common these days), but in Europe, it's been a highly respected pain med for years....
  • Hi, Jessa - as you say, buprenorphine has indeed been used to treat pain for decades. It is only in the US that it is known almost exclusively as a drug for opioid dependence. Its use in treating chronic pain in Europe and other parts of the world (parts of Asia, Australia, etc.) is on the rise as doctors become more familiar with it. It is available as a sublingual tablet and as a slow-release patch, similar to the fentanyl patch. It is weight/weight some 30-60 times as potent as morphine (estimates differ depending on the source), but in effect seems about equivalent in analgesic effect to morphine and oxycodone (due to it having somewhat less intrinsic activity on the molecular level than the other strong opioids, apparently).

    As you pointed out, there have been a lot of misconceptions regarding buprenorphine due to its unique pharmacology, and its label as a 'partial agonist' or 'agonist/antagonist'. In analgesic doses, however, my understanding is that it behaves pretty much as a full mu-opioid receptor agonist, and it is perfectly safe to take along with other agonists, as long as it is in the standard therapeutic dose range. The usual starting range for pain relief is 0.2-0.4mg, with further titration as necessary to meet the ideal dose for a given patient. The dose range is quite flexible, but I agree, the doses used in opioid dependence treatment are generally much higher than necessary. Pain management doses are typically measured in micrograms, or in the lower milligrams, at most.

    I have been prescribed Temgesic (the sublingual formulation of buprenorphine for pain relief in the UK, Australia, Europe, and Asia) for many years for chronic neuropathic pain, and it works quite well for me. I find I usually need from 0.6-1mg in the morning, then another 0.2-0.6mg 6-8 hours later (it is longer acting than most opioid analgesics) as needed, usually three times a day. I'm also prescribed tramadol and diazepam as needed, and have had no problems taking these concurrently with buprenorphine. In the past I've also been prescribed dihydrocodeine and pethidine (Demerol) along with the Temgesic, and again, I've never had problems. The pain specialist explained that it has an additive effect when taken together with other mu agonists like codeine, morphine, oxycodone and hydromorphone, although he also pointed out that very high doses of buprenorphine - 16-32mg, for example, as is found in the high dose Suboxone/Subutex tablets in the States - can cause problems in people who are already taking another opioid, possibly leading to a dulling of the effect of the other opioid.

    As I understand it, buprenorphine has some advantages over other frequently prescribed opioid drugs: less constipation and pruritis, lower incidence of CNS effects, no significant adverse effects on the immune system, and its safety in patients with renal and cardiac problems. Although no ceiling effect on analgesia has yet been demonstrated in man (it has in animals), there is a definite ceiling effect on respiratory depression, which is further evidence of its safety.

    The above is based purely on my personal experience as a chronic pain patient taking sublingual buprenorphine for several years, and on the information given by the pain management specialists who have prescribed it to me. Thanks for posting the above - it is refreshing to see that there are people out there who do understand this drug, and whose chronic pain is being eased with it.

  • Hi Huggy,

    Just curious, where are you located? Personally, I'm kind of bummed that buprenorphine is going to be marketed as a patch in the U.S. - I would much prefer to try a sublingual version rather than a patch.

    You did a great job of laying out the basics of buprenorphine. I'm afraid I've come up with my toughest questions and am throwing them your direction or to anyone who knows the answers. I was wondering if you could help me to understand the lack of an analgesic ceiling. It's just hard for me to understand this since when the dose is increased to the level of 2mg + given as suboxone, it becomes a mixed agonist/antagonist. How is is possible to continue to raise the dose of buprenophrine?

    I want to double check on this question because I'm not sure if I'm right or not, and I'd rather not spread inaccurate information if at all possible. I know that bupe has a greater affinity to for the mu receptors and, the way it's used in the U.S. -- which is at the mixed agonist/antagonist dose, it knocks the full agonists off the mu receptors. I have also heard/understood that if you want to avoid putting someone into precipitated withdrawal, you should start with 1 or 2 mg (tho few doctors seems to be aware of this - they tend to dose very high instead) - though I believe that can put someone who is on very high dose into precipitated withdrawal.

    However, I think you suggested that when it is acting as a full mu agonist - possibly around 1 mg or lower, that it isn't going to have a negative effect on other agonists that may be present. In my post, I suggested that you could go one way but not the other -- i.e., that full agonists could easily be added on top of buprepnorphine, but that it was at least risky to go the opposite direction - to add buprenephorine to a high dose of oxycontin for example, b/c of the higher affinity of buprenorphine. I'd like to remove that if I'm wrong - I realize I may be. I know that agonists can be added on top of bupe but am confused about doing the reverse because of the problems with putting people into precipitated withdrawal (tho at much much higher doses of sub). I realize the usual dose is more in the .2 to .8 or 1 mg range (if I understand correctly this is pretty much the whole range for most dosing? It's interesting that your dose varies so much if most of temegesic/bupe doses are from .2 to 1 mg. Anyway, to sum up, the basic question is, if bupe is used in a dose under 1 mg, can it be added on top of a full agonist a person is already taking (it would be acting as a full agonist too) without causing any problems with precipitated withdrawal? In the situations you described, the tramadol and other meds were added on top of your bupe dose which would work fine according to what I read. Just not sure If you could take those meds and then add bupe on top of them. But, perhaps precipitated withdrawal is just an issue for suboxone where doses much higher than those given for PM are used? The affinity for the receptor must have something to do with it as well.

    I'm just wondering if you can shed some light on some of the mysteries that have continued to confuse me a bit - like the lack of an analgesic ceiling. . . I understand how you can have one ceiling for respiration and another for analgesia, but I how can you continue to increase the dose of buprenorphine when you bump into a limit around 1 mg/2 mg where it begins to act as a mixed agonist/antagonist. Obviously, with morphine you can give someone 1500 or 2000 mg or whatever their tolerance will handle -- there isn't a "ceiling" on increased analgesia - if you give them a higher dose, they should get more relief. If you can help me to understand how buprenorphine is similar/different, I would be grateful.

    Another question -- I realize you may not have answers to all these burning questions that arose when I was reading about sub, but I am curious about your opinion or what you do know. I'm happy to find someone who understands the med well (!) :-) -- I have to admit that I hope that it will work for me. Do you understand WHY they dose sub so high here? It must have something to do with using it for addiction/dependence since I am pretty sure that any pain benefit maxes out at around 8 mg? -- or might actually be better at the the dose ranges you were talking about. It would be nice if this turned into a thread that really clarified some of the different/interesting properties of sub/buprenorphine.

    I realize I have yet another question - last one -- what kind of cross tolerance have you seen with buprenorphine and full agonists? I've been told that it makes no difference what dose of an full agonist you were taking -- bupe will either work or it won't work for you -- I understand it is in a class of it's own like fentanyl and methadone, but there is still a lot of cross tolerance between the meds and the reason I didn't go on sub was because I was too far away from getting my dose down to a level where I could transfer over easily.

    Anyway, thanks for the information you shared Huggy. If you have thoughts about any of the questions I'm still trying to work through, I would love to hear your opinion. Thanks for your help!

  • Currently giving serious consideration to switching from oxycontin to sub. It is clear to me that I need to find a way to be in this world in the condition that my body is now in: FBSS, severe DDD, thoracic compression fracture. I have been offered a posterior/ anterior revision of the L4/5 fusion which scares the &^#@ out of me :SS . I have mental health issues which flared significantly after a recent lumbar medial branch ablation. I just don't think I'm strong enough emotionally to go through the revision. Will be talking with PCP this Friday about possibly switching meds. From what I have read here I seem to be lucky that after 2 year of severe constant pain my daily oxy dose is 60mg. On a side note, does anyone know what happens to a person on any of these meds, as far as dosages go, when we have an accute pain condition like say I break my arm...
  • Hi Jessa, sorry to be so late in responding to your post! I have been away for a few days, keeping my mother company in hospital (she's been having dental treatment and tests/physiotherapy for a broken hand).

    I live in Taiwan (though I'm originally from the UK), and over here buprenorphine is prescribed only in the form of sublingual Temgesic tablets. I've read that the patches are preferred these days for chronic pain, with the sublingual tablets being used more for breakthrough pain. I suspect one reason is the potential for abuse with the tablets (which are very easy to grind into a powder) and also because the patch formulation is considered more smooth and sustained by many doctors (apparently the tablets can cause more CNS effects, as they are absorbed faster).

    I don't know for sure about the analgesic ceiling effect. I have read in numerous studies that none has been demonstrated in humans, but I get the sense that it is a bit of a 'grey area'. One study I saw showed that at 16mg buprenorphine binds 80% of available mu-receptors, as opposed to about 40% at 2mg. That would seem to suggest to me (admittedly, a complete non-specialist!) that there may be little point in continuing to escalate the dose beyond a certain level.

    Likewise, I don't really know what the limits for safe, effective analgesic doses are. I know that the suggested analgesic dose is 0.2-0.4mg, but my pain management docs here in Taiwan and back 'home' in the UK confirmed that the dose range for pain relief is quite flexible, and they had no problem prescribing three of the 0.4 mg tablets for me to be taken three times a day. I would expect that the dose needed would vary from person to person, but I don't know for sure what the limits are in terms of safety with other opioids.

    According to the sources I've consulted (my doctors and various published studies) and the info that comes with my Temgesic prescription, it is safe to take buprenorphine in the therapeutic analgesic dose range at the same time as other opioid agonists, also in the analgesic dose range (for breakthrough pain, for example), and I've also read that the order of administration of the buprenorphine or the other opioid is irrelevant. That is my understanding, but I don't know at what point, if any, problems may be expected to arise, regarding the dosage of either opioid (or both). I do know that it is not recommended that a patient already dependent on high doses of another opioid add buprenorphine to the mix, as there is a possibility of dulling the effect of one of the opioids, or even of precipitating withdrawal. I think this is most likely to occur in people taking a lot of opioids and then adding a high dose of buprenorphine, but I don't know what doses, precisely, would be expected to cause such an interaction.

    I was prescribed Temgesic after trying dihydrocodeine and tramadol for several months (neither were effective on their own in controlling my pain), and I didn't have any problem switching from one to the other. I don't know if it would have been different if I'd been on higher doses for a longer period, or if I'd started off with a higher dose of buprenorphine. From what I've read, I'd guess that it could have been a problem if I'd been taking the kind of dose found in Suboxone or Subutex, but I can only speculate. Sorry to be so vague!

    Regarding the high doses used in Suboxone/Subutex, I honestly don't know - I know next to nothing about the role of buprenorphine in treating opioid dependence. The doses do seem very high to me, especially the higher range of 16mg to 32mg.

    Sorry I can't be of more help - I know everything I've posted here is pretty vague, but my own knowledge of buprenorphine (such as it is) is strictly limited to my own experience and I'd hate to give unfounded advice that may be harmful to someone else. Good luck!
  • I am almost suicidal with trigeminal neurlagia. I am going today to start on suboxone. I have to go to talk to a counsellor first who will explain how the drug works. I am so tired of taking pain pills, fighting physical addiction and withdrawals, upping my dosage, the whole mess. I am sick and tired of being sick and tired. If this suboxone doesnt' work I don't know what I will do. Your post are encouraging.
  • I had trigeminal neuralgia for several years due to a skiing accident and lyrica eliminated the shooting nerve pain up my 4front teeth every time I inhaled. Could not nose breath because it was broken and packed with gauze so every time I inhaled for weeks, I was in intense dental pain, kind of like super terrible root canal shooting pain in my teeth. Was on it for several years and it finally calmed down where I could get off the lyrica
  • I am not sure where the confusion is but suboxone is an excellent pain reliever and is often prescribed in an off label setting in this country specifically for pain relief, it is best used for moderate to severe chronic pain it has an efficacy of twenty times more powerful than morphine the area of confusion when a laymen makes the comparison is the suboxone allows for mental clarity up to the so called ceiling limit at which time you get so hammered you fall asleep below that point you have minimal to none of the intoxication feeling that many associate with pain relief and it's effectiveness on pain
    The two are really not associated the pain receptor site and the inebriation site are two different locations suboxone has simply found away to keep the chemical away from the inebriation site better than it's peers but once it attaches to the site which is normally volume significant based the inebriation is significant ,normally your typical pain dose even for severe pain is well below the inebriation threshold .I wish all well and please if you suffer from chronic pain as well as the negative loss of clarity from narcotics find a pain doctor and get on the film you deserve the opportunity to have your life back.
    Thank you I hope this helps
    I am not a medical doctor this information is easily extracted from science based reference data
  • I have been in suboxone for over 5 years, and it has been wonderful for me. Before the suboxone I was on over 6 different narcotics at once, all prescribed by the same doc. I think the beginning of the end for me was at 22 I started fentanyl patches, and over the next six years vicoden, dilaudid, and quite a few others were added and before I knew it I was taking over 6 narcotics at the same time and I was still in a ton of pain and extremely foggy headed,and most of all I had had a child and was missing out on her childhood, I was 28 and felt like I had no life ahead of me, I was physically dependant on the meds even though I took them as prescbed, finally I went looking for an alternative. I found a wonderful pm doc that was taking part in a study to include cronic pain management as a labelled use for suboxone in conjunction with the drug company and the FDA . I was apprehensive at first but after finding out that I would be hospitalized the first week of the change over and would be using subutex at first in case it didn't work. The worst part of that week was the taste of the subutex, my pain was well controlled, any symptoms of detox were controlled with other meds, and the staff was compassionate and never treated me like I was an addict. After being on it for several months I began to see the real affects of it , less pain and pain I did have was better tolerated, and I was clear minded for the first time in years. I now have been on it for the last 5 years and have only had to up my dose once. Some days I can take 4mg but I'm allowed up to 24mg a day. One thing no one has brought up is that suboxone is not a preventative it only works if you are in pain it won't work to prevent pain. The worst part is how ER docs and docs that are use to prescribing narcotics treat you, they either treat you like a second class citizen or their answer is to offer you narcotics, most docs besides my pain doc are flabberghasted that I will not take other narcotics, even my pain med doc says there are some times I will have to temporarily stop suboxone ( I.e. going under general anasthisa ) I was concerned about the withdrawals but my doc said that I would have to be on some sort of pain med my whole life and it was the lesser of evils. My insurance company fights me every 6 months about the prior authorization but my doctor helps me fight this battle. I look back on my years on narcotics and I am saddened by what I went through and what I missed but I can now look forward to the closest thing to a normal life as possible, sure I still have some physical limitations but just having the mental clarity to be a better mom is so sweet and I owe it all to my wonderful pm doc and suboxone!
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