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Suboxone for chronic pain?

Has anybody transitioned from high dosage oxycodone, 60mg er twice a day 10mg 4 times a day for breakthrough pain, same dosage for 5 years. Was 40mg twice a day the 5 years previous to this and 20mg twice a day previous to that. So 15+ years with titrated doses roughly every 5 years.  The physician is willing to try the switch and if it's not effective I can switch back. So has anybody here done this and did you have bad or good results. 

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Comments

  • I would look long and hard if you’re really thinking about switching to Suboxone. I went to a pain clinic for what was supposed to be just for IV Infusions (my pain clinic sent me to this other clinic for the Infusion bc mine doesn’t offer it). They tried to force me to switch to their clinic AND switch me to Suboxone, telling me I’m making myself worse by taking pain meds. Anyway, I found out that you have to pay a fee to the doctor every visit just to be prescribed Suboxone. AND either they sign something or you something (sorry, I can’t remember which one) that basically “ties” you to being an addict in your file. 

    NOW, I would like to say...this clinic was obviously shady as all get out and I ran out of there as fast as I could, so I can’t say that the information that I got from them was 100% correct. But I have seen similar claims like this since then. 

    So please just do your research before you try Suboxone. One thing I have heard from absolutely everyone is that the withdrawals are the worst. 

  • There are patches that contain the active ingredient in suboxone that are for treating pain. Suboxone contains naloxone, and if you are simply looking for pain relief, suboxone would be my last choice. I would try to bupe patches instead.

    Suboxone is intended to prevent drug abuse, and prevent relapse. The major problem I've read over and over is pain patients who go on suboxone strictly for pain often wind up at too high doses . When used for pain, the typical dose is 2 mg or less. Higher mg doses not provide better pain relief from my reading.

    Too often pain patients are put on 8 mg, 16, 24 mg doses unnecessarily.




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  • jm2323jjm2323 Posts: 1
    edited 05/05/2018 - 7:01 PM

    I'm well aware of the naloxone in suboxone, and that the narcotic is buprenorphine, I also know that they have medication that is buprenorphine only, subutex, and a few others. I'm not worried about being labled in my medical file. I've been with same physician for 20 years,  I also have very close relationships to other physician's, I will have zero problem obtaining my pain medication if I decide to switch back,  and suboxonxe or subutex usage in my file will not hinder me.  What I'm asking about is pain control? has anybody been on suboxone or buprenorphine and got adequate pain control from it. I also know that the withdrawal is lengthy on it,  I've done tons of research on buprenorphine. Ive seen conflicting research on its pain control ability, some have said it's great and others not so. So I was looking for fiest hand input of people who have tried it. 

  • That's one I haven't tried, like you, my 'knowledge' comes from researching others experiences.

    It's not so much your particular PM doc that could be a problem down the road, it's the insurance companies, and pharmacists, and requirement that suboxone/subutex isn't prescribed for pain management but addiction that causes the issues.




  • if you ever need surgery or have acute pain there may be an issue. Say you have surgery. If more pain relief is needed it may be hard to get. Being on suboxone causes a high tolerance to opiates. Your surgeon may not be willing to provide the amount of opiates needed 

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  • Yes the surgery aspect is a concern, Also a severe injury like a car wreck etc needing emergency pain control. From what I've read they have a process to breakthrough the buprenorphine using fentanyl/hydromorphone combo for emergency injurys, for a schduled sugery I'll just tapper down. I've been on an ultra fast tapper the last week from the oxycodone and will start the suboxone this week when withdrawals are high enough on sows scale. I'll post when stabilized on it and give a comparison of the pain control vs roughly 160mg oxycodone a day.  If this is inadequate my pm and I are going to try medication rotation every 6 months, Oxycodone for 6 months then Oxymorphone for 6 months etc. And possibly a slow tapper drug holiday every 24 months. He has seen recent studies on this that have shown promising results of keeping tolerance down.

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