Pain Management Patient, Clean, Scared, and Suboxone

[Maangchi]

Hey everyone. After a brutally botched operation years ago, I was left in intense chronic pain (Pancreatitis and Biliary Tree damage.) I had been in pain management for a long time and it had got to the point where nothing was working anymore and the government was making my life harder than anything. I got new doctors and did a hospital rehab and am 100% clean of opioids. I never did them illegally and don't have that mental addiction, however, I haven't slept in a long time. I am up all night with my Chronic Pain returning. They are putting me on Suboxone today. Is there anything I should expect. The Detox was the worst thing I have ever experienced in my life.

 

[T. Calderone]

That's an awful situation and I am sorry about your botched operation and rehab, Maangchi. Suboxone will help a person from being sick but in my experience, didn't do much for opiate cravings. I have a couple questions: Is it a rehab doctor who suggested that you start suboxone upon your return home? What dose do they have you at and have they a plan in place as to how long you will be on this medication?

 

[Pickledlemons]

Suboxone should help a lot. My advice.. dont let them put you a stupid high dose. The least amount that makes you feel better is the best amount to take. You might find as little as 1 or 2mg makes you feel better. You might need 4 - 8mg. But you shouldn't have to go any higher than that.

Congrats on your detox! Good luck!

 

[Maangchi]

That's an awful situation and I am sorry about your botched operation and rehab, Maangchi. Suboxone will help a person from being sick but in my experience, didn't do much for opiate cravings. I have a couple questions: Is it a rehab doctor who suggested that you start suboxone upon your return home? What dose do they have you at and have they a plan in place as to how long you will be on this medication?

I saw one of the best Pain Management doctors in the country and they admitted me to the hospital so that they could do a slow detox while ensuring that I do not have any major side effects from the actual underlying cause of everything (that of the damaged organs). I came home and went two days without anything and honestly had no cravings for drugs just pain relief. The last two nights were like hell as I flipped and flopped in bed in agony pouring sweat in pain. My Pain Management doctor who was supervising the entire protocol sent me to a specialist who can actually give the Suboxone script. She started me on a small dose half a strip (4MG), once a day, or night whichever helps me get the relief I need at my peak pain time (9PM - 2PM). The plan after this is intensive therapy both physical therapy and all the mental stuff. I was up for anything I just want to be able to better manage my pain without all the medication. I have been a prisoner in pain and blanketed by opioids for years now and all I wanted was to get off them. I am scared though. My normal pain level is 7 and at night it gets into 9's, sweat pouring, night terrors, screaming, type pain. So whatever therapy these doctors think I need whether I think I need it or not I am playing ball. They are treating me great and they keep reminding me I am not an addict, I have a physical disease that is slowly killing me, and I am looking for relief, not a fix. It's an amazing support staff and these doctors are heroes to me, especially after all these horrible doctors before them, one of them the Pain Management doctor who almost killed me.

Suboxone should help a lot. My advice.. dont let them put you a stupid high dose. The least amount that makes you feel better is the best amount to take. You might find as little as 1 or 2mg makes you feel better. You might need 4 - 8mg. But you shouldn't have to go any higher than that.

Congrats on your detox! Good luck!

I took my first Suboxone today at 11:00AM and its 11:00PM which is my prime time pain time and I am doing well. I felt like the Suboxone worked right away and I actually liked the way it worked better than the Opana + Fentanyl mix I was on before. I feel as though the Suboxone kicks in smooth and is very stable. The Fentanyl patches I felt were too up or down and Opana was like shoving a rocket up your ass and then crashing to earth.

 

[Deemgd]

The suboxone will definitley help your pain levels. I agree with the previous poster, don't let them raise your dose super high, or the day will come when you will be going through suboxone withdrawals- which is something you don't want to do. Take the lowest therapeutic dose possible.

 

[Maangchi]

So far things are going well. I am pretty pain free and amazed. Its the first time in years I have been pain free without being zonked out. FYI, I am being used in a two-part research project by a major research hospital monitoring my underlying illness and the second on suboxone and pain management with that underlying issue so things with me are a little different.

 

[stockhunter]

I have been on a buprenorphine type medication for the last 8 years straight. 4mg is still a large dose. Try to start at 1mg or less before your body is dependent on 4mg. See what minimum dosage works for the pain. As there is a full saturation dose of bupe on the receptors
.

 

[Keif' Richards]

Hey there OP, can I ask, are you getting the desired analgesia from the Buprenorphine? That would obviously be the best possible scenario, but I don't want to see you becoming dependent upon Buprenorphine or entering any kind of maintenance program unless you totally believe it's right for you based upon your own research. You're still at a point where you can back out and use the drugs to withdraw.

I'm just saying, make sure this is what you want. Maintenance is easier than addiction, sure, but it can be demanding and there are no "non-junkies" in maintenance according to the overriding philosophy of addiction and dependence in this country. Personally, I would not recommend maintenance for someone like you. You should be on regular Opioid analgesics. I feel that you're being forced into a bad situation, but if it's the best bone they're throwing at you for your pain, I don't know.

 

[CfZrx]

I took my first Suboxone today at 11:00AM and its 11:00PM which is my prime time pain time and I am doing well. I felt like the Suboxone worked right away and I actually liked the way it worked better than the Opana + Fentanyl mix I was on before. I feel as though the Suboxone kicks in smooth and is very stable.

How are you doing Maangchi? Are those subs all they seemed at first?

 

[Maangchi]

Old thread but thought I'd check-in. I've been on 8MG now solid for about 8-months now. I self taper towards the end of the month though to keep my tolerance low. I take half in the morning and a half at night for 20 days and then half at night for 20 days. It seems to be a good balance of keeping my pain managed and not getting the dose higher. They wanted to kick me up to 12MG and I refused. I actually told the doctor I wanted off the Suboxone but there has been a lot of pushback from the doctors. The hardest part has been I have some undesirable side effects. It makes me a total slug and some days I spend the entire day in bed. Even worse I have had Night Terrors my entire life and with Suboxone I have them 4-5 times a week. I have the worst nightmares and I wake up screaming a few times a night. My wife sometimes has to leave the room and sleep in the other room its so bad. Also, I am in and out of the hospital when I have flare-ups, and I was in the hospital last month and was treated terribly. It was shocking to me because its my normal hospital but I saw another doctor. They withheld pain medication from me for 36 hours (in the middle of a massive Pancreatic flare) it was so bad I was literally sobbing and asking my wife to kill me. They finally came in and gave me... .25MG of Dilaudid. They essentially treated me like a drug addict. I had no relief the 9 days I was there. The only relief I had was during my stay I had an operation to clean some nerves up. The Anesthesiologist saw how much Dilaudid they were giving me and she was upset. She said it was torture to not give me pain relief. She gave me 1MG every 3 hours for the 9 hours I was in recovery and it was the first time I had relief the entire time. They then took me into my room unplugged me and sent me home, literally kicked me out. It was not a good situation and every time I told the doctor I was in pain they brought up the damn Suboxone. I talked to my doctor this week (who is their boss) and he said he talked with them and he was apologising but it just makes me want to get off this crap even more. I feel like if I was told the truth and told everything I know now then, I would had NEVER started taking Suboxone. I went from one hole to another.

 

[Maangchi]

BTW, is it better to take the strips Buccal or Subling? I usually put them under my tongue until the burning and taste goes away (1 hour). How can I maximize it so I can take less?

 

[Painful One]

Wow Maangchi, that is just horrible and I am so sorry that the doctors left you without pain control. That is torture!
This “opiate epidemic” has gone too far! Leaving people who just had surgery and who have diagnosed problems without proper pain control is not humane and is terrifying. I am terrified to be living in severe chronic pain in this day and age.

It sure doesn’t sound like the suboxone is cutting it for you and now the doctors have just gotten you into a worse situation.

I completely agree with what Keif Richards said above.
(Looks like it is too late for that)

Thank you for reporting this information.

You will be in my thoughts and prayers. I sure would try to find a doctor that can and will treat you with the medication that helps the most.

 

[Speed King]

This is minority off topic, but applies here. Does your hospital have Ketamine infusions. I had over 15. I can tell you for me the pain relief is long lasting and I had no desire for pills. Ketamine actually helps reset your pain receptors. YMMV, but it is something to think about.

 

[FutureReference]

Ugh. Your story eerily resembles mine. Botched labrum surgery led to a winged scapula and a list of permanent issues. I was on Suboxone for 5 years and it did little to nothing for pain. High doses are beneficial for addicts, which you are not. 8MG is a lot.

The only aspect of the Suboxone that can help with pain is norbuprenorphine. Taking 8MG a day floods your opiod receptors. For me, and I know we are all different, 1MG in the morning and .5MG at night brought my pain from a 10 to an 8 which was the best relief I found. Recently I asked to be moved from Suboxone to Oxy which helps slightly more but with the new laws the dosage is very low. But there is a reason that ALL formulations of Bupe that are designed for pain and not addiction are significantly lower than most Suboxone doses. Most are less than 1MG.

I suggest lowering your dosage to 2MG or less a day for pain relief. If your insurance covers it, you can ask about Butrans. It is Buprenorphine and designed for pain, not to just drown your opioid receptors. I am wishing you luck and if you get no relief on lower doses of Suboxone I would talk to your doctor about getting on a different medication to help with pain.

 

[Zonxx]

me

Ugh. Your story eerily resembles mine. Botched labrum surgery led to a winged scapula and a list of permanent issues. I was on Suboxone for 5 years and it did little to nothing for pain. High doses are beneficial for addicts, which you are not. 8MG is a lot.

The only aspect of the Suboxone that can help with pain is norbuprenorphine. Taking 8MG a day floods your opiod receptors. For me, and I know we are all different, 1MG in the morning and .5MG at night brought my pain from a 10 to an 8 which was the best relief I found. Recently I asked to be moved from Suboxone to Oxy which helps slightly more but with the new laws the dosage is very low. But there is a reason that ALL formulations of Bupe that are designed for pain and not addiction are significantly lower than most Suboxone doses. Most are less than 1MG.

I suggest lowering your dosage to 2MG or less a day for pain relief. If your insurance covers it, you can ask about Butrans. It is Buprenorphine and designed for pain, not to just drown your opioid receptors. I am wishing you luck and if you get no relief on lower doses of Suboxone I would talk to your doctor about getting on a different medication to help with pain.

Will this butrans work for someone taking 400mg of morphine + other break through meds if they werre to lose their doctor because mine said he's retiring and " no one will give me what I'm on which leaves me deathly afraid of wding from my stuff

 

[FutureReference]

Will this butrans work for someone taking 400mg of morphine + other break through meds if they werre to lose their doctor because mine said he's retiring and " no one will give me what I'm on which leaves me deathly afraid of wding from my stuff

Are you located in the US? 400mg of Morphine is a lot, most doctors here claim "we can only prescribe MME 90mg" (either 90mg of Morphine or the equivalent, like 60mg of Oxycodone) Also, which breakthru medications are you taking?

As a near lifetime opioid user, I will be brutally honest with you brother. Suboxone is a way to override our receptors so we can not feel "high". Now, Butrans is a funny version of Bupe. It is a transdermal formulation that, even in its highest dose, does not fully block full opioids. It manages pain exceptionally well, but it will not replicate the euphoria or immediate relief of your Morphine. Unfortunately these patches are also 7-day patches so applying more than 1 will leave you in awful WD toward the end of the month.

Are you trying to infer if the Butrans will work well with your current meds, or if it will be a suitable replacement once your doctor retires? Butrans and Oxycodone was my absolute favorite combination. The norbuprenorphine levels remain pretty high so you are able to get both pain relief and the euphoria associated with opioids. Combining the Butrans with your Morphine will do the same thing. I liked it better than Fentanyl! Bupe is a very good painkiller in small doses and doesn't oversaturate our receptors like the insane dosages doctors love to prescribe of Suboxone.

I am praying that you are able to find a replacement doctor once your PM doctor retires that will understand and treat your pain properly. As a replacement for the Morphine alone, you may find the Butrans lacking in its' painkilling and analgesic properties unfortunately. I would suggest lowering your dose and then starting Butrans. Again, praying for you brother. I know how unfair this epidemic is for genuine pain patients

 

[Zonxx]

Are you located in the US? 400mg of Morphine is a lot, most doctors here claim "we can only prescribe MME 90mg" (either 90mg of Morphine or the equivalent, like 60mg of Oxycodone) Also, which breakthru medications are you taking?

As a near lifetime opioid user, I will be brutally honest with you brother. Suboxone is a way to override our receptors so we can not feel "high". Now, Butrans is a funny version of Bupe. It is a transdermal formulation that, even in its highest dose, does not fully block full opioids. It manages pain exceptionally well, but it will not replicate the euphoria or immediate relief of your Morphine. Unfortunately these patches are also 7-day patches so applying more than 1 will leave you in awful WD toward the end of the month.

Are you trying to infer if the Butrans will work well with your current meds, or if it will be a suitable replacement once your doctor retires? Butrans and Oxycodone was my absolute favorite combination. The norbuprenorphine levels remain pretty high so you are able to get both pain relief and the euphoria associated with opioids. Combining the Butrans with your Morphine will do the same thing. I liked it better than Fentanyl! Bupe is a very good painkiller in small doses and doesn't oversaturate our receptors like the insane dosages doctors love to prescribe of Suboxone.

I am praying that you are able to find a replacement doctor once your PM doctor retires that will understand and treat your pain properly. As a replacement for the Morphine alone, you may find the Butrans lacking in its' painkilling and analgesic properties unfortunately. I would suggest lowering your dose and then starting Butrans. Again, praying for you brother. I know how unfair this epidemic is for genuine pain patients

We too have a 90mg limit in Canada BUT my doctor explained " New regulations from the college of physicians are more like guidelines" meaning it's up to the treating doctor to go higher but if I were to overdose and die, he would be liable which is what doctors are afraid of
And yes I was asking if it would replace my current meds
But yeah this epidemic... it's really craps, I've got severe scoliosis where surgery isn't an option Because a good risk is being a vegetable and I'm not keen with the idea not to mention its more than 1 surgery and that's even more off putting
But my doctor patient relationship is amazing, he knows I smoke crack among whatever else but I do smoke it cause it helps my pain,so the trust is very high, but I've known him for so long that he knows I'm not a fool - I even halve my opiate doses when I'm on coke to avoid adverse reactions I.e smoking more than I can handle ( because all these lower my HR making it easy for me to smoke n smoke n smoke but that's dangerous)
But in the beginning I was told " I'm going to treat you, but don't expect this treatment from other doctors, he then walked to his office, came back an hour later ( was in the waiting room) and explained how we'd start and higher my doses for my pain I know it's going to be a hassle, I have a pill doctors number but.. $300 to walk in, $300 per RX, 50$ for a signature, literally insane. and then one of my friends who referred me has to go every single month, started every 2 weeks... cash cow basically

 

[CfZrx]

But my doctor patient relationship is amazing, he knows I smoke crack among whatever else but I do smoke it cause it helps my pain,so the trust is very high

My doctor would shit a tyrannosaurus egg if I said I was smoking crack, lol!