Bupe On suboxone but I need something for pain temporarily.....

[Sub_worthy]

I've been on suboxone for two years after 5-7 years of abusing vicodin, and oxy. The suboxone has done wonders, and I feel confident in my sobriety. However last week I broke my hand, and I have been in a significant amount of pain. I cannot have a cast placed on my hand or wear a splint for more than 50% of the day(long story). So being a good suboxone pt. I refused pain mess from the ER Dr., and ortho. I then went to my suboxone dr telling him that I needed pain relief for about 3-6(weeks according to the ortho), and my suboxone dr said I had two choices. #1 decrease my dose of suboxone from 8mg bid to 2mg qid, or #2 get off of the suboxone for a few days, then start taking 5mg of vicodin. I explained to my dr that the suboxone is not helping the pain, and he replied with well suboxone isn't approved for pain management but a lower dose might work. I also told him that since I have been taking 16mg of bupenorphine every day x two years that it is possible that my tolerance for opiates has increased and 5mg of vicodin probably would not work. He replied with "yes it would, I'm not giving you fentanyl or oxycontin." The weird thing is, I've never even taken or mentioned fentanyl to him, nor did I ask for oxy. I was thinking he might temporarily put me on subutex for a few weeks just for the pain seeing as that is kind of what I'm taking now(w/ narcan) then switch me back to suboxone. I've never snorted or injected and he knows that, so why would he not put me on subutex for 2-4wks??? Also, do y'all think that decreasing my suboxone by 50% will help with pain? And as far as the vicodin goes, I've heard multiple people say that after heavy/longterm suboxone use all of the vicodin in the world won't help you....... What should I do, I just want pain relief because I can't afford to miss work due to being in pain. Sorry for the long post, I'm just anxious please any input from knowledgable ppl is wanted.

 

[ReversiblePulpitis]

I responded to you in the other thread in which you posted this...

 

[morphonorconic]

Switching to Subutex will not change anything in terms of [temporarily] improving the efficacy of an Opioid pain medication. The Naloxone in Suboxone is not responsible for the blockade; the Buprenorphine itself blocks any subsequent full agonist. Good luck explaining that to your Sub doctor though...

Even if you drop from 16mg to 8mg per day as suggested, you can expect marginal to little or no pain relief from Vicodin taken on top of that. In terms of analgesia, eight milligrams of Bupe is much stronger than 5mg doses of Hydrocodone, no matter how many times a day you take it.

If the Buprenorphine alone doesn't provide adequate relief from your pain, and it sounds like it isn't, you honestly would need an appropriately guaged dose of a fairly potent Opioid in order to achieve the desired effects/relief.

 

[Sub_worthy]

My dr did not want to cut my suboxone by 50% and put me on vicodin. He said that I had two options, option 1= Start taking less suboxone than I do now. Option 2= Stop taking suboxone, wait three days, then start taking vicodin. I just thought that since subutex was used for pain, and I have pain, that I could switch to subutex without a waitting period of three days, and then switch back to suboxone after my hand was better..... I guess not. Does anyone think that subutex would be better or is it all just in my head? Lol

 

[HdoubleODeezy]

^ in your head.. suboxone and subutex are essentially the same since the naloxone is basically inert because the buprenorphine over powers it...


you can take tramadol with subs i have done so and when i was on subs i had a script from the same dr for both.

 

[Pegasus]

^Yeah, tramadol would be a decent idea.

morphonorconic summarized everything pretty well otherwise.

 

[Missykins]

I went through this when I had a tooth root abscess. I take more than 16 mg of suboxone (as prescribed by my doctor, not by myself) and vicodin didn't touch me. My sub doctor would not prescribe anything for me (which makes sense as he was not the dentist treating my condition), and the options presented to you (stop taking suboxone for several days, decrease dose, etc.) were the only options presented to me. Suboxone has a half-life of about 36 hrs, which meant that it would be about five days before enough suboxone had been eliminated from my body and the vicodin would have an affect.

I chose to just ride out the pain with naproxen and a lot of home care. It was pretty miserable. I didn't feel better until the abscess began to drain and the dentist performed the root canal. You might just try to ride it out with NSAIDS. If your broken hand still hurts, then the fixation may have not been done correctly.

 

[Fire&Water]

This is eventually going to turn into a vicious dilemma, with so many people being on daily subutex -
then needing strong pain meds' for (example) dental surgery,broken bones etc...low doses of hydro/oxycodone
is not going to work for Bupe' maintenance patients & most Docs' know this

 

[saturatedTHC]

I have a lot of experience with suboxone/ subutex, also Opana, and any other strong opiates/ opioids. suboxone works better for me when I take less than 1-2mg. Seriously I get a little buzzed when I take small amounts of suboxone, like .25mg-.75mg for long periods. But when I take 2mg or 4mg or 8mg or 16mg I can't get a "high". So when I get on subutex or suboxone I start off at like 4-8mg then work my way down to about .25mg up to 2-4 times a day and feel pretty damn good. Also taking the low doses makes me feel better, AND when i really need pain relief or to get high I can bust out 2mg line and be high for 8 hours.

My advice would to work your dose down to about 1-2mg a day total which is pretty easy to do. After a few weeks on very low doses the bupe starts to work better. With bupe, less is always more because once your tolerance is above the ceiling effect you can get any higher than what you are, and that is normal, not high.

-For me, less is more with bupe.
-The lower the dose of bupe you stay on the more room you have to get high when you need to.

For me on bupe, anymore then 2mg is a waist unless i am getting back on it again and actually need a ridiculously large dose (8mg, 16mg+) to feel stright. But after a week on high doses I take less untill I get under 2mg, and then I can get high by taking more. Someone who is on bupe for maintenance treatment would need the larger doses to keep cravings and shit away but I just cant break away from that wonder feeling that keeps me going day to day.


5mg hydrocodone would most likely to absolutely NOTHING with your bupe tolerance. If I was on 2mg bupe a day tolerance it would take me atleast 50mg hydro to even feel anything. bupe raises your tolerance insanely, or at least it dose to me.