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Opioids Buprenorphine for chronic pain

Man I feel you, I've put up with so much abuse and disrespect from doctors. I had lost all faith in the american healthcare system until I found my current pain clinic, which is like, the only pain clinic in California that doesn't treat you like a fucking drug addict, or turn me away for being young.

If I had a nickel for everytime I heard "You're way too young to be on this medication, You're way too young to be able to feel this much pain" When I'm in the office like crying about how I cant work anymore and had to drop out of college because I couldn't get my medication....

It is Unbelievable the abuse I've put up with over the years with doctors. But you've got to find that one who cares. It's like there is one doctor capable of compassion for every ten thousand who lack it, and for chronic pain patients this is a big deal and means a lot of pain and suffering until you find the right doctor. Just don't give up trying and resort to heroin or faking an addiction for methadone like I almost did.
 
tricomb said:
Man I feel you, I've put up with so much abuse and disrespect from doctors. I had lost all faith in the american healthcare system until I found my current pain clinic, which is like, the only pain clinic in California that doesn't treat you like a fucking drug addict, or turn me away for being young.

If I had a nickel for everytime I heard "You're way too young to be on this medication, You're way too young to be able to feel this much pain" When I'm in the office like crying about how I cant work anymore and had to drop out of college because I couldn't get my medication....

It is Unbelievable the abuse I've put up with over the years with doctors. But you've got to find that one who cares. It's like there is one doctor capable of compassion for every ten thousand who lack it, and for chronic pain patients this is a big deal and means a lot of pain and suffering until you find the right doctor. Just don't give up trying and resort to heroin or faking an addiction for methadone like I almost did.
Click to expand...

^^

Reading this tri, as someone who also in California, also "too young to be in this much pain" and "too young to be on this medication" Resorted to having to do so many things I morally or ethically would never ordinarily do, such as doctor shop or cop off the street. I've had my age and the fact that because I've had my spine fused multiple times on high strength narcotics that after one surgery the new pain doc I went to with my mom told us that "theres nothing I can do for you" and this was 2 WEEKS after my spine was fused. Like it was my fault!

I am so grateful for my present pain doc, he is without a doubt the most compassionate and seemingly interested of all my previous pain doctors. Its truly sad how the system has been corrupted by scheming and abusive patients and prick doctors who dont have an ounce of empathy in a medical specialty that along with oncology is almost ENTIRELY based on empathy and compassion.

My soul feels so much better not having to scheme to get adequate pain relief...
 
tricomb said:
If I had a nickel for everytime I heard "You're way too young to be on this medication, You're way too young to be able to feel this much pain" When I'm in the office like crying about how I cant work anymore and had to drop out of college because I couldn't get my medication....
Click to expand...

Totally. And what is this magical "age" that you can get the good shit at? 30? 50? i had to make several phone calls every day for nearly two weeks, just to get 2 weeks of oxycontin. Then when the doctor was finally writing the script, I get 4 days worth. It felt like they were playing a cruel joke on me. Oh, the joys of being 25 and having chronic pain.
 
If you have an opiate tolerance bupe will likely be useless as a pain med..being partial agonist.
 
Yeah, I have been, and sometimes, still am, forced to do things no chronic pain patient should have to do, like "supplement" your prescription with things that you don't have a prescription for, or fake an addiction to get methadone and pay in one day what you normally would for a whole months prescription of your normal pain medication.

It's sad that this is a harsh reality of the world we live in, even the OP is struggling with this in New Zealand so that tells me it's not just the USA. Also, considering the UK doesn't even hydrocodone, and it's the number one most prescribed drug in america, it really says alot.


Buprenorphine can be used for pain relief, yes it has a ceiling dose so it depends on your pain, but just because it's a partial agonist, doesn't mean it is to be dismissed IMO. As long as your taking the right doses for PAIN, between 0.2 and 0.4mg/dose it's pretty effective for mild-moderate chronic pain.
 
Swain said:
If you have an opiate tolerance bupe will likely be useless as a pain med..being partial agonist.
Click to expand...

Not necessarily true. I have a reasonable tolerance (would do 100 - 120mg of oxy in a shot pre-bupe) and I get decent pain relief from 24mg of bupe.
 
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I guess there are exceptions but you have to admit for someone who can do a 100mg shot of oxy, pain releif from bupe is a rarity.
 
Swain said:
I guess there are exceptions but you have to admit for someone who can do a 100mg shot of oxy, pain releif from bupe is a rarity.
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I'm not sure about that, I think people just hear 'partial-agonist' and then think 'it's not a real opiate so no way it'll do anything!'
 
^tricomb i knew i wasnt the only one going trough this but your post helped me alot being the way i have been treated made it seem like looking for another dr. would just be another reason for them too judge but thats what everyone has told me.. i also have lost my jobs and cant continue going to school because of the pain alone and then if my stomach acts up its a done deal ive almost died a couple times because of it.. but i really appreciate your post makes me want to keep trying
 
paper planes said:
^tricomb i knew i wasnt the only one going trough this but your post helped me alot being the way i have been treated made it seem like looking for another dr. would just be another reason for them too judge but thats what everyone has told me.. i also have lost my jobs and cant continue going to school because of the pain alone and then if my stomach acts up its a done deal ive almost died a couple times because of it.. but i really appreciate your post makes me want to keep trying
Click to expand...

Don't let doctors walk all over you, the way I see it is this is America, I'm supposed to have all these rights, and if your doctor doesn't respect you, then keep looking for another one who does. Nothing better than sitting anxiously in the exam room to meet a new doctor, then finally sitting down with him and realizing that there are people who do care, who are surprised other doctors have treated you the way they do.
 
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I hear what you guys are saying about dr's sucking and the american healthcare system sucking re: they are tightfisted with pain meds... but u know what..it's really the gubament. Dr's get their licenses from the gubament and the gubament can revoke it. If I spent 400K to become a dr I sure as hell woudlnt' want to jeapordize that, and the lives of my family, even if I cared a hell of a lot about my patients. My family comes first and I'm sure dr's families come first.

If you do your research you will discover that doctors were AGAINST the Harrison Drug Act in the 20's that was the first time in US history ANY drug became illegal. They testified before congress AGAINST it.

Same thing with Nixon's war on drugs.

Same thing with Steroids. They were AGAINST having them scheduled.

But dr's have the DEA breathing down their necks. And medical schools, like EVERY school in the entire country, is essentially controlled (to one degree or another) but the gubament. Try getting a license to practice medicine without going to a medical school that is not overseen by the government. Doesn't happen. Even private schools are regulated in some way by the gubament. Even home schooled kids, their teachers (usually the parents) have to answer to the gubament as to their curriculum or whatever.

So, what comes with that is the propaganda that the gubament wants to push. I remember having a convo with some kids in school becoming pharmacists back 25 years ago and how passionately they were arguing how only marinol was effective tx for aids wasting syndrome and for ppl dying of cancer with 2 months to live and being poisoned with chemo...and how only marinol was the only effective means of treating their nausea, never mj. This was when I was like 20yrs old and already an advocate for, and educated about, drug laws and gov't propaganda... this was in the day when NO ONE (actually 5 ppl in the entire country) were the only one's allowed to take pot medically. I used to get it for my dying grandmother. Her dr told her to get it and take it and used to let her smoke it in a private room in the hospital before her chemo tx's. She had no chance of cure, it was simply is she gonna live 2 months or 8 months.... so the wonderful gubament made me a criminal for procuring something for my grandmother her dr recommended and made my sick frail old lady grandmother a criminal.

So I think 'the culture' that a lot of dr's have is put on them by the gov't, through their schooling (they only get exposed to certain info), I doubt the stuff they are doing with heroin in Switzerland is at the forefront of the curriculum in any class in any medical school in the USA. Despite the effectiveness of the programs there in harm reduction and improving the lives of heroin addict patients, while at the same time improving the lives of other citizens who are less likely to be stolen from, and the families and friends of all those addicts.

If dr's didn't have the DEA breathing down their necks, and got to make their own rules, and the gov't got the hell out of the business of telling everyone what to do and not do and what to think and believe and not think and not believe I bet we would see pain meds flowing more freely. I'm sure it makes some dr's and nurses sick to their stomachs when they know they have terminal patients in pain but they have some regulatory body they have looking over their shoulders so they have to give less medicine than they think should be given and less medicine that a person in pain is asking for.

I'm not up to date on the specifics and am not a doctor but do know for sure the gubament plays a major role in this shiat.

It's similar with cops. They get brainwashed from day 1 about how drugs are evil and the drug war is doing 'God's work' or whatever. Starts in the acadamy. There is no discussion about weighing the costs against the potential benefits of arresting some drug seller. It doesn't even enter their minds. Run some operation that costs 500K when all is said and done (all the cops costs, court costs, lawyer costs, prison costs, etc) for $3,000 worth of crack or whatever, for example. And that doesn't even take into account all the other costs. The wives and children of the 'accused criminal', their future and their families futures now that the guy gets out of jail a convicted felon...good luck getting a 'good job'.

I know I got off track but my point is the gov't is at the root of this shit. It's evident when you look at how some other coutries deal with prescribing medicine, including heroin, like they do in Switzerland. So I assume in Switzerland (could be wrong but doubt it) they don't look down on ppl with pain issues who need pain meds if they are prescribing herion for people who need heroin 'because they need heroin' 'because they are addicted and request it', and that's it.

Ya dig?
 
Yeah there are two sides to every coin, and story ;) but still I've been treated very unfairly simply due to my age. But I understand WHY they aren't trigger happy with pain killers like they are with benzos.

It's like "Hmm, I don't want to prescribe you the dose of oxycodone you've been stabilized on for years, and you said you've just ended almost a decade of benzodiazepine dependency, but all I can offer you is some alprazolam?"

I've seriously had this happen to me multiple times, like doctors trying to put me back on benzos after my intense struggle to get off them, just to distract me from the opiates I need.
 
Yeah, i'm 23, I agree the age factor plays into it very heavily. I was even told "you're too young to be on opioids" - well, sure, i'd agree in an ideal world, where everyone is of comparable health at their respective age categories (20-29, 30-39, etc) and accidents don't happen, but that is a fantasy ideology. Fucks sake. It's pretty obvious this policy is going to cause unnecessary suffering.

When I get my pain clinic appointment i'll talk with them about supplementing the buprenorphine with tramadol, since y'all seem to think so highly of it (and there are pretty good reasons for thinking it might be so, too), if the buprenorphine proves to be almost but not quite good enough. Starting this Monday. Looking forward to knowing whether it will work - I haven't had any progress in anything related to my problems in a long time, or even reasons for thinking it might (actually, all its done is get worse!), so even a chance things might change is a great motivator.

Sorry to hear so many others have had comparable problems :( - this system is horrifically broken, and something needs to be done about it. Its terribly obvious the drug war has a LOT of casualties, including plenty of ones not even directly related to it - indeed, you could make a very strong case that this is PREDOMINANTLY so though the mechanisms of criminal (establishment and support of huge underground economy trading in human misery), socioeconomic (theft, joblessness, castes/classes, etc), and medical system toxicity (failure of adequate treatment). So much needless suffering by so many. It's obscene.

Oh yeah, just a question, when we're talking about bupe doses here, I see many people giving quantities (e.g. 1mg for pain) but not the ROA, not just in this thread but many others. Is it reasonable to assume they mean SL admin (unless explicitly stated to the contrary), or is everyone giving IV equiv (100% BA) figures and leaving the conversion up to the user? I think the latter is pretty unlikely but thought i'd ask.
 
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That's perfectly okay, it's a very pertinent topic for rants after all, i'm sure you agree ;)
 
I have results.

I took a 2mg Suboxone pill today (Buprenex or generic buprenorphine is unavailable here, sadly - they drank the Reckitt-Benckiser "naloxone prevents abuse" patent evergreening kool-aid), via SL route, around 2 hours ago. I fucked up taking it as I always do with SL ROA, finding it almost impossible to keep the pill underneath my tongue, not floating on a pool of saliva or migrating to my cheeks. My mouth was not salivating appreciably when I put the pill in, but it very enthusiastically produced it once I had, not really what I wanted. Due to the difficulties, I swished the liquid around in my mouth for around 3 minutes, then I accidentally swallowed it. Oops. Hopefully the 3 minutes of swishing was enough to get a decent amount of it SL + buccal. They have given me a 2mg take-home to have later if 2mg proves insufficient. I have to call them later to say whether 2mg or 4mg is more appropriate,and then i'll be given a script. I will have to dose it in the pharmacy where I pick up in future, which sucks, as I can see myself continuing to waste Suboxone (which was about twice as expensive as I thought it would be, incidentally, though it will be cheaper from the pharmacy where I will get it) by having to take it SL. I'd probably plug it if I had the option, since it's hard to mess up, and BA is similar, or better (50ish versus 30ish, right?) - I expect the half-life that way is broadly comparable to SL, too.

Anyway, despite not really knowing what effective dose I got, it seems to have worked okay.
Effects: (green = good, yellow=neutral, red=bad)
  • Analgesia (maybe 30-40% reduction)
  • Feeling of generalised well-being
  • Anxiety reduction
  • Warm feeling in face
  • Slight itching
  • Slightly reduced pupil diameter
  • Slight headache. It got better when I took 300mg aspirin/ASA

Maybe I should have the other 2mg. I was hoping for better analgesia. I may have just totally fucked up the dosing. Have to decide soon!
 
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I like the color coding!

Suggestions:

1) Use the rectal ROA, the BA is so much higher, meaning you save money and suboxone.

2) Use LOWER doses. Chronic pain doses are given in 0.2mg and 0.4mg, start lower. With suboxone less is more.

3) Continue to color code, I like it. I like the way you organized this thread very much even though this topic has been covered before, you're adding something to it. Continue to post your results too.
 
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