Greetings. I am a first time poster so bear with me. I have a conflict with pain managment treatment pathways (long term opiod user with chronic back pain since 2006). I am currently courting a respected anstiologist regarding raising my daily Oxy IR dose from 60mg/day to my old dose of 180mg/day (its looking like they will ok me as a patient within the next week). However, I started up a bupe (opiod cessation) program with another doctor as an alternate path if the new doctor declines treatment (first bupe dose today). My conflict is which treatment direction I should go if I do get approved for the oxy increase. All thought and opinions are welcome.
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OD Moderators: Keif’ Richards | negrogesic
Bupe Conflict with Buprenorphine
- Thread starter KeefR
- Start date
There are many alternatives to get what you need pain wise. Methadone is one route with pros and cons.
Pros: no precipitated withdrawal between your last dose of oxy or after (so if it doesn't do the trick, try alone, if pain is still there take both along side with oxy, (if dox lets you) or if you change your mind and say you'd rather be on oxy after you tried dones without extreme precipitated withdrawal.
Cons: it's the WORST to come off of. I spent 3 weeks in jail in solitary next to someone who dosed methadone before she was picked up and she WAILED in pain, wouldn't eat, diarrhea, sweats...she BEGGED God to help her or kill her to end the pain. I was so sad for her experience she was going thru and couldn't do anything. Had I known her before I'd tell her don't get on that, get on subtext. (WAY different from Suboxone because no naloxone-thats what mainly causes those excruciating precipitated wd)
Suboxone pros: can use sooner after last dose of oxy. Still wait 1-5 days depending on how long you've been one it/what mg daily. Moderately*** helps with pain. No narcan in it so if you say no, not for me, wait a day or 2 and get back on oxy.
Cons: withdrawals are not as bad as methadone but the mild wd lasts longer. Isn't noticeable til about 3-10 days, but can last a few weeks if going cold turkey using nothing.
Best option imo, look into new kratom concentrate chewable pills that are called something like
*7-hydroxy. (It's a long name but you'll find it if you Google that). They act the same as opiates latching to those receptors similar to morphine/oxy and are extremely fast acting. I take 2 pills at a time that are 15mg per tablet. I prefer the 7tabs brand or perks. The blue ones don't have caffeine. There are some with it if you prefer energy with it. There are stronger ones I've tried from green/red strand that I feel don't give the same pain relief unless taken with the tabz/perks brand...made me very shaky and hyper which cancels out my pain relief personally.
Cons: haven't found any currently. They get expensive if you take like 4 a day. About 20 bucks a 4 pack of you find a cool corner store or smoke shop. They're legal or you can order on elixyr.com I think.
If you can help it, don't let yourself be a slave to Big pharma. Not only do they f*** up our economy, morality, politics...the greed and carelessness for the consumer they take money from and they ruined those folks lives , and the docs that over prescribed. Jail time, PhD's going down the toilet, fake MRI scans, now we have to squat and cough to get health insurance because it's been made a joke of. I started with oxy, then banned those, put us on Dilaudid starting folks to use needles then took those away, flooded the market with heroin, cracked down on that but replaced it with fentanyl which killed me and my bf from an overdose. I have back pain and for me to get that relief again, get those 7ohms/7tabz/perks things. natural supplements but definitely don't hurt yourself. Go with your gut and I wish you the best! best!
Pros: no precipitated withdrawal between your last dose of oxy or after (so if it doesn't do the trick, try alone, if pain is still there take both along side with oxy, (if dox lets you) or if you change your mind and say you'd rather be on oxy after you tried dones without extreme precipitated withdrawal.
Cons: it's the WORST to come off of. I spent 3 weeks in jail in solitary next to someone who dosed methadone before she was picked up and she WAILED in pain, wouldn't eat, diarrhea, sweats...she BEGGED God to help her or kill her to end the pain. I was so sad for her experience she was going thru and couldn't do anything. Had I known her before I'd tell her don't get on that, get on subtext. (WAY different from Suboxone because no naloxone-thats what mainly causes those excruciating precipitated wd)
Suboxone pros: can use sooner after last dose of oxy. Still wait 1-5 days depending on how long you've been one it/what mg daily. Moderately*** helps with pain. No narcan in it so if you say no, not for me, wait a day or 2 and get back on oxy.
Cons: withdrawals are not as bad as methadone but the mild wd lasts longer. Isn't noticeable til about 3-10 days, but can last a few weeks if going cold turkey using nothing.
Best option imo, look into new kratom concentrate chewable pills that are called something like
*7-hydroxy. (It's a long name but you'll find it if you Google that). They act the same as opiates latching to those receptors similar to morphine/oxy and are extremely fast acting. I take 2 pills at a time that are 15mg per tablet. I prefer the 7tabs brand or perks. The blue ones don't have caffeine. There are some with it if you prefer energy with it. There are stronger ones I've tried from green/red strand that I feel don't give the same pain relief unless taken with the tabz/perks brand...made me very shaky and hyper which cancels out my pain relief personally.
Cons: haven't found any currently. They get expensive if you take like 4 a day. About 20 bucks a 4 pack of you find a cool corner store or smoke shop. They're legal or you can order on elixyr.com I think.
If you can help it, don't let yourself be a slave to Big pharma. Not only do they f*** up our economy, morality, politics...the greed and carelessness for the consumer they take money from and they ruined those folks lives , and the docs that over prescribed. Jail time, PhD's going down the toilet, fake MRI scans, now we have to squat and cough to get health insurance because it's been made a joke of. I started with oxy, then banned those, put us on Dilaudid starting folks to use needles then took those away, flooded the market with heroin, cracked down on that but replaced it with fentanyl which killed me and my bf from an overdose. I have back pain and for me to get that relief again, get those 7ohms/7tabz/perks things. natural supplements but definitely don't hurt yourself. Go with your gut and I wish you the best! best!
What is your goal here?
Are you thinking about starting bupe to get off of opioids, or to supplement with your oxy for pain needs?
Hey there and Welcome to blueworld
I have extensive knowledge or exp about all 3 meds @dabular mentioned but have to say i dont agree with everything he said but the most inportant q as @Quasimoto asked what are your goals, as we can give better advice if we know the answer to that q?
Suboxone does have naloxone in it, only subutex is pure buprenorphine @dabular and if on oxy you only need to wait like 24 hrs to switch over not 1-5 days.
With all said, please tell us what your goals so we can help further.
I have extensive knowledge or exp about all 3 meds @dabular mentioned but have to say i dont agree with everything he said but the most inportant q as @Quasimoto asked what are your goals, as we can give better advice if we know the answer to that q?
Suboxone does have naloxone in it, only subutex is pure buprenorphine @dabular and if on oxy you only need to wait like 24 hrs to switch over not 1-5 days.
With all said, please tell us what your goals so we can help further.
My goals are to get my pain controlled enough to return to the more productive life I was leading on my previous doseage. My meds were reduced last February from an MME of 285 to 120 for no medical reason (actually all patients meds were reduced at this particular clinic by the lead physican/owner due to his "issues" with governing agencies. Another story all together). Thus my life has been upended. I am now having to live more cautiously and select the tasks I can perform based on how much medication I have. If I have a big event (such as volunteering work last weekend) I take my old doseage to function but then, of course, I run short of my 30 day supply and struggle to get by for the remainder of the month. My spouse is very upset over the whole up/down situation and it is a strain on our relationship. I only sought out the bupe physican because I thought getting off the Oxy was my only path due to my medication decrease. It seems to be my only choice of treatment if the new anesthesiologist decides not to treat me (sorry for the long story).
FYI - I have tried most other Interventional treatments (pain pumps, surgery, countless injections of all types, RFA, spinal cord stimulators, many types of chiropractic, different posture therapies, yoga, PT, meditation, massage, exercise, acupuncture, even have had Maori women using hot stones after walking on my back. Unfortunately, the best therapy has been medication, exercise, coupled with posture therapy.
FYI - I have tried most other Interventional treatments (pain pumps, surgery, countless injections of all types, RFA, spinal cord stimulators, many types of chiropractic, different posture therapies, yoga, PT, meditation, massage, exercise, acupuncture, even have had Maori women using hot stones after walking on my back. Unfortunately, the best therapy has been medication, exercise, coupled with posture therapy.
As for the bupe program, i am taking a daily tapered, increasing dose of Suboxone (along with my pain meds) for 5 days then stopping all of my Oxy on Day 6 when my daily Sub doseage reaches 8mg (then is adjusted from there up to a daily max of 24 mg).
I say stick to both if you can..although for bupe you may get piss tested and same with the oxy doc sooo might lose both.
But if it works out to obtain both, bupe will be a great tool to have in med cabinet because eventually you will need it to get to your next oxy script.
I encourage you to save the first script (or 2) of both meds and wait it out for the next month/script THEN you won't have to worry about being short for pill count but the UA if there is one will be next to impossible to pass if you have both in your system
But if it works out to obtain both, bupe will be a great tool to have in med cabinet because eventually you will need it to get to your next oxy script.
I encourage you to save the first script (or 2) of both meds and wait it out for the next month/script THEN you won't have to worry about being short for pill count but the UA if there is one will be next to impossible to pass if you have both in your system
Like for me I try to steer clear from opioids I stay "clean" with bupe and not suffer from WD..but the bupe is built up in my system and need to take more oxy than usual to even feel it.
Also probably the reason I do not get precipitated wd because the bupe is already in my system...1mg to 2mg at most. Right now I'm down to .5. Trying to quit. That's another thing...being addicted to subs sucks and the kick takes awhile but makes life manageable if I need something on these receptors (lesser evil) in order to do day to day, but does not help with pain.
Also probably the reason I do not get precipitated wd because the bupe is already in my system...1mg to 2mg at most. Right now I'm down to .5. Trying to quit. That's another thing...being addicted to subs sucks and the kick takes awhile but makes life manageable if I need something on these receptors (lesser evil) in order to do day to day, but does not help with pain.
I definitely cannot be treated by both at the same time (I have an opiod contract with the bupe doctor and the new doc will want to enforce theirs if I accepted for treatment). I'm definitely fearing telling the anesthesiologist that I've started the bupe because they may decide not to treat me thus I would loose out on that resource.
I guess it call comes down to how effective the sub works on my pain. Hopefully I'll know the answer by the time the new doctor makes their decision. Does anyone know if one week is enough time to determine how effective the sub is on pain?
I guess it call comes down to how effective the sub works on my pain. Hopefully I'll know the answer by the time the new doctor makes their decision. Does anyone know if one week is enough time to determine how effective the sub is on pain?
stuckandfucked
Greenlighter
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Doesnt this cause precipitated withdrawal? Being on opiods and adding suboxone?
Heroes Inc.
Bluelighter
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- Jul 20, 2022
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I actually take both almost daily. I have never had PW.. for me personally, I can take about 2mg of bupe (straight sublingual bupe, btw, not suboxone) and then if I feel some pain later in the day, I have 10 mg oxy IR that I can take. Of course I won’t feel it as much because my receptors are saturated, but I definitely feel something.
I usually take the bupe every other day due to the long half life, and I just make sure I’m feeling slight signs of withdrawal from the fact acting oxy (yawning for me is the biggest tell tale sign I’m fine to take the bupe).
Disclaimer, the most oxy I’m taking per day is around 60 mg. And my metabolism is crazy fast. But personally for me, it works just fine. My doc was the one who told me about it.
I usually take the bupe every other day due to the long half life, and I just make sure I’m feeling slight signs of withdrawal from the fact acting oxy (yawning for me is the biggest tell tale sign I’m fine to take the bupe).
Disclaimer, the most oxy I’m taking per day is around 60 mg. And my metabolism is crazy fast. But personally for me, it works just fine. My doc was the one who told me about it.