Lumbar fusion 2001, foramenotomy and laminectomy Dec 2013, spondylosis, stenosis
I'm a 60-year old male.
After many years of oxycontin therapy before and after my 2001 fusion surgery, the pain clinic rushed me through a weaning period (2 months from 4 80mg oxys daily) and I was still totally sick with withdrawal. My family doc was sympathetic, tried easing the symptoms with vicodon, etc...all the time I was missing work, basically a sick zombie. Finally gave up and checked myself into the methadone clinic. Two years there, up to 165 mg daily. I wanted out desperately, but I get so violently ill with withdrawals I was trapped.
Finally checked into an inpatient rehab and was inducted onto Suboxone - left there with a scrip for 4 8mg tabs per day. Great drug, no more withdrawal, functioning well, and my life was putting itself back together. The fusion surgery took care of most of the lumbar pain for 2-3 years, but it came back - epidurals, etc. to control it. Still on Suboxone. In the last 3 years, stenosis has started taking its toll, and I live in level 2-3 pain with flares up to 4-5.
MY problem with Suboxone is the way I'm treated by anybody in the medical field. Example: I fell and broke 4 toes on my right foot - went to the ER - not much they could do other than a special shoe, but when I asked the nurse for some pain meds, I heard her ask the doc and heard him say "he's on Suboxone - he's an addict - don't give him anything" - told me to take Tylenol and sent me packing.
Same story any time I have to list my meds - all of a sudden I'm a pariah and am profiled as a drug seeking wack job. Three years ago I'd had enough of this kind of treatment, I tapered myself to 4 mg per day, and at the same time discovered another doc in the same clinic as my family doctor 2 miles from my house had the Suboxone license, so I changed to him to help me with the last bit of weaning to nothing. Granted my pain levels were increasing, but I wanted off the Suboxone just to be treated like a regular patient once again.
His comment at my first appointment was "OK, but what are you going to do for pain control?" I said "I don't know" and then and there he talked me into going back up to 24 mg per day of Suboxone. I am almost positive my health insurance won't pay for Suboxone for pain control, but they've been paying for it for 3 years because the doc uses his DEA number. I'm actually on Suboxone for pain, but as far as the insurance (and anyone else in the medical field) knows, I'm on it for drug addiction. I hate that - I have NEVER abused any of my scrips. I really dislike this Suboxone doc - he knows so little about the drug, even tried to tell me it was easy to come off from - "You'll feel like you have the flu for a couple days, then you'll be fine". I know better.
Anyway, fast forward to today. I just want to be back on traditional pain meds - It's only a matter of time before my insurance catches on and I'll be out in the cold because there's no way I can afford $800 a month for Suboxone. So I asked my long time family doc (I trust him implicitly, we've got a great long-time relationship, and he's a personal friend) if he would put me on Duragesic to replace the Suboxone. I was on Duragesic for a couple years between surgeries and did well on it other than the patches falling off all the time.He was fine with that - did the equivalency calculations, and it looks like a 75 mcg patch will cover the pain. But...I'm having second throughts now - I'm currently weaning the Suboxone to be at 4 mg or less for my July 8 apt, and will stop completely 2 days before. Just spoke with my doc in the phone and he's concerned that the Fentanyl will take at least a week to overcome any Suboxone left in my system, leaving me both in withdrawal sickness and lots of pain.. Am I going down a dead end street here?
I read all kinds of posts on using Suboxone to stop taking Duragesic, but what I am planning is the opposite. I really need some advice - I am sick and fed up with the stigma of being on Suboxone, really tired of the way Suboxone docs know so little about what they're prescribing, sick of being labeled an addict when all I am is a chronic pain patient. My family doc knows me and treats me fine, he's great to work with. Can I make this transition and end up with adequate pain control without going through weeks of hell? I realize Fentanyl is a powerful drug, but I'm just not an abuser, and with all the spinal ailments I have I'm going to have to be on something for the rest of my life. There's more surgery in my future, and after 7 days of hell after my neck surgery with nothing but Toradol for post surgical pain meds, I just don't want to be on Suboxone any more.
I have a few days to decide, but I really really need some advice and some idea what to expect if I make the switch. Please help.