Mixing Suboxone and Hydromorphone

[Thanksegon]

I have CF that led to chronic pancreatitis for a number of years; I finally had it removed in 2016 but I've suffered quite a bit of nerve damage and adhesions/scar tissue. My pain is chronic, but it is on and off. I have a script for #90 2 mg Hydromorphone every 2-weeks. Some days I don't need them, others I really, really do. Then there are the times I just like how they make me feel, but that's for another thread.

One of my many docs is suggesting I take Suboxone as my frontline pain med and only take Hydromorphone for break-through pain; he's philosophically opposed to opioids for chronic pain. His plan sounds fine until I start to think about the half-life of buprenorphine which is 3 to 5 days and its super strong affinity for the mu opioid receptor. It feels to me like I will have to take a lot more Hydromorphone to get the same pain relief. Also, he is suggesting Suboxone because it is easier to get insurance approval than buprenorphine.

Am I correct in my thinking that I would need 3 or 4 days of no Suboxone before I start to feel the effects of the hydromorphone?

 

[OpiateKiller]

Pretty terrible idea by your doctor In my opinion. Suboxone and full agonist opiates were never designed to be mixed due to the risk of precipitated withdrawal and taking hydro while on bupe will just waste the hydro. It will raise your tolerance and make hydromorphone less effective.

The only was this makes sense is if you were to completely switch to subs which I think you’d regret as hydromorphone is much more euphoric

 

[Julies1221]

I have CF that led to chronic pancreatitis for a number of years; I finally had it removed in 2016 but I've suffered quite a bit of nerve damage and adhesions/scar tissue. My pain is chronic, but it is on and off. I have a script for #90 2 mg Hydromorphone every 2-weeks. Some days I don't need them, others I really, really do. Then there are the times I just like how they make me feel, but that's for another thread.

One of my many docs is suggesting I take Suboxone as my frontline pain med and only take Hydromorphone for break-through pain; he's philosophically opposed to opioids for chronic pain. His plan sounds fine until I start to think about the half-life of buprenorphine which is 3 to 5 days and its super strong affinity for the mu opioid receptor. It feels to me like I will have to take a lot more Hydromorphone to get the same pain relief. Also, he is suggesting Suboxone because it is easier to get insurance approval than buprenorphine.

Am I correct in my thinking that I would need 3 or 4 days of no Suboxone before I start to feel the effects of the hydromorphone?

Unless you’re also an addict, you should never accept suboxone for pain! Suboxone will block any effect of opioid pain medication! Sorry but your doctor is a complete idiot unless you’re also an addict.

Does Suboxone help with pain?

Official answer: Suboxone is sometimes used “off-label” by doctors to help with acute or chronic pain in certain patients...

www.drugs.com

 

[Crowbone]

I have CF that led to chronic pancreatitis for a number of years; I finally had it removed in 2016 but I've suffered quite a bit of nerve damage and adhesions/scar tissue. My pain is chronic, but it is on and off. I have a script for #90 2 mg Hydromorphone every 2-weeks. Some days I don't need them, others I really, really do. Then there are the times I just like how they make me feel, but that's for another thread.

One of my many docs is suggesting I take Suboxone as my frontline pain med and only take Hydromorphone for break-through pain; he's philosophically opposed to opioids for chronic pain. His plan sounds fine until I start to think about the half-life of buprenorphine which is 3 to 5 days and its super strong affinity for the mu opioid receptor. It feels to me like I will have to take a lot more Hydromorphone to get the same pain relief. Also, he is suggesting Suboxone because it is easier to get insurance approval than buprenorphine.

Am I correct in my thinking that I would need 3 or 4 days of no Suboxone before I start to feel the effects of the hydromorphone?

Yea Suboxone isn't very good for pain. They are just train ing DR'S to push that instead of actual full agonist like Dilaudid. Tell him u don't want no part of that and also it would probably through you into precipitated withdrawals which u definitely don't want. He is right about insurance not wanting to pay for subtext though I dealt with the same problem recently