I recently stopped using all opiods started using Suboxone for chronic pain management. I am in a good program (one on one and group therapies, medical oversight, etc.) but the physician is telling me that it can take weeks to months for the pain to decrease. Does anyone have any experience in using Suboxone for pain and the lenght of time it took? Thank you!
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OD Moderators: Keif’ Richards | negrogesic
Bupe Suboxone Efficacy for Chronic Pain
- Thread starter KeefR
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MedicinalUser247
Music Ambassador
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I would ask about Subutex because Suboxone can actually be more harmful.
I’m not sure on the reasoning behind this and not sure what he means by more harmful, but otherwise agree. Honestly subutex still didn’t really help pain much but it did give some relief where suboxone didn’t seem to give any.
Mine wasn’t prescribed so there wasn’t much of a choice, but whenever I could find subutex I took it every time over suboxone. It actually gave me a little bit of a high, whether I took it sublingual or sniffed it, and also actually helped with pain. Suboxone was just suboxone - randomly I’d feel kinda high/nod out but really only if I’d started drinking or took something like gabapentin before the dose kicked in. And it never once dulled my back pain, at least not that I noticed.
I see often people getting switched from potent, high dose pain med habits to suboxone and it doesn’t make sense to me. It is not an effective pain med, in my experience anyway, for even moderate pain. I really think it’s a doctors way to say you don’t need real painkillers anymore, here get “clean” without actually telling their patients they’re kicking them off their long term pain medication but don’t want to abruptly stop them as some doctors like to do. Suboxone is on label for “moderate to severe pain” iirc, and I think that’s just a marketing ploy lol. Ibuprofen gave me more relief than suboxone did tbh.
Thank you. That aligns with some of the information I been reading. From several reviews I've read, sub works about 50% of the time when used for pain control. (possibly due to the placebo effect?). The doctor did offer me straight bup (not sub) if I needed a dose higher than 24mg/day (which is where I'm at now).
For me it was worthless for chronic pain. Actually, worse than worthless because being on opioids long term makes you more sensitive to pain. At least with normal opiates you get relief after you dose, even if you feel more sensitive when it starts to leave your system. However with suboxone, I wouldn't even feel any pain relief after taking it and worse still it would block other opioids so I have a flare up in pain I couldn't even take another opioid to relieve it. I found kratom to be much more effective for pain than suboxone, although eventually it stopped working as well.
Hey @burn out 
I wish I had some better news for you. People with limited experience with Opioids can use Buprenorphine (Subutex) for pain relief. It seems to be just as effective as any other Opioid medication in this application. However, things are different for folks like you and me. Once you have had a heavy dependence to Opioids, it seems like some things change in a semi-permanent way.
Using Buprenorphine for pain-management warrants an entirely different approach if you're to be successful. Buprenorphine's complex pharmacology can make things extremely confusing. I will do my best to simplify while also giving you the information you need.
Buprenorphine is a partial agonist/antagonist. Most Opioids are full agonists while stuff like Naloxone, that reverses the effects of Opioids are known as antagonists.
What this means for you is that lower doses of the drug are going to be more effective at controlling your pain. Dosages for pain management are often in the tenths of a milligram, for instance 0.4mg Buprenorphine is the dose for a Buprenex injection.
You see, when the doses are lower, the desired receptor, the "Mu" is activated almost exclusively. As the dose increases, other receptors are engaged, receptors that you don't want. The really precipitous drop occurs right around doses of 2mg Buprenorphine.
If your doctor has you on maintenance doses of 8mg Buprenorphine or more, then it's highly unlikely that you will get the analgesia you actually need. Doctors are criminally under-educated regarding this stuff. Everything that I'm describing here? I've never met a doctor in person who knew any of this. I've met doctors who told me I was incorrect, Buprenorphine was not used for pain.
Basically, none of them know shit. My psychiatrist didn't know what the cytochrome p450 family was off the top of his head. He really did not know what I was talking about and it was frightening. It's such a simple concept. I learn this shit in my free time after working my regular job. If I know this stuff, how is it okay for a physician to write scripts for dangerous medications that they do not truly understand.
In closing, you want to keep your dose as low as possible. That is the only way you're going to get any kind of pain relief. Also, I would investigate other potential analgesics. Perhaps Gabapentinoids could be helpful. I know I've just typed a lot I'll let you read and digest. If you have any questions just ask buddy!
I wish I had some better news for you. People with limited experience with Opioids can use Buprenorphine (Subutex) for pain relief. It seems to be just as effective as any other Opioid medication in this application. However, things are different for folks like you and me. Once you have had a heavy dependence to Opioids, it seems like some things change in a semi-permanent way.
Using Buprenorphine for pain-management warrants an entirely different approach if you're to be successful. Buprenorphine's complex pharmacology can make things extremely confusing. I will do my best to simplify while also giving you the information you need.
Buprenorphine is a partial agonist/antagonist. Most Opioids are full agonists while stuff like Naloxone, that reverses the effects of Opioids are known as antagonists.
What this means for you is that lower doses of the drug are going to be more effective at controlling your pain. Dosages for pain management are often in the tenths of a milligram, for instance 0.4mg Buprenorphine is the dose for a Buprenex injection.
You see, when the doses are lower, the desired receptor, the "Mu" is activated almost exclusively. As the dose increases, other receptors are engaged, receptors that you don't want. The really precipitous drop occurs right around doses of 2mg Buprenorphine.
If your doctor has you on maintenance doses of 8mg Buprenorphine or more, then it's highly unlikely that you will get the analgesia you actually need. Doctors are criminally under-educated regarding this stuff. Everything that I'm describing here? I've never met a doctor in person who knew any of this. I've met doctors who told me I was incorrect, Buprenorphine was not used for pain.
Basically, none of them know shit. My psychiatrist didn't know what the cytochrome p450 family was off the top of his head. He really did not know what I was talking about and it was frightening. It's such a simple concept. I learn this shit in my free time after working my regular job. If I know this stuff, how is it okay for a physician to write scripts for dangerous medications that they do not truly understand.
In closing, you want to keep your dose as low as possible. That is the only way you're going to get any kind of pain relief. Also, I would investigate other potential analgesics. Perhaps Gabapentinoids could be helpful. I know I've just typed a lot I'll let you read and digest. If you have any questions just ask buddy!
LucidSDreamr
Bluelighter
It’s absolute shit for moderate to severe pain.
It’s ok for mild pain chronic pain.
The ratio of opiatation/analgesia is the WORST of any opioid I’ve ever done (which is all of them) ie you can literally be nodding off bupe and still not get good analgesia
There will be zero change to your pain beyond what you get after 2 or 3 weeks after you are done “withdrawing” from the full agonist opioids and settled onto suboxone which is a partial agonist. This does not take months. It takes weeks max.
It’s schedule 3 not schedule 2. Your doctor is just saving his ass from the DEA and doesn’t care about your pain
My advice if your pain is real severe. Hoard the suboxone. get clean piss with only suboxone and its metabolites in it. Freeze this piss. Warm and submit this piss to your doctor every time. Sell the subs and keep some as a back up. Get real opioids elsewhere if you have a safe source
It’s ok for mild pain chronic pain.
The ratio of opiatation/analgesia is the WORST of any opioid I’ve ever done (which is all of them) ie you can literally be nodding off bupe and still not get good analgesia
There will be zero change to your pain beyond what you get after 2 or 3 weeks after you are done “withdrawing” from the full agonist opioids and settled onto suboxone which is a partial agonist. This does not take months. It takes weeks max.
It’s schedule 3 not schedule 2. Your doctor is just saving his ass from the DEA and doesn’t care about your pain
My advice if your pain is real severe. Hoard the suboxone. get clean piss with only suboxone and its metabolites in it. Freeze this piss. Warm and submit this piss to your doctor every time. Sell the subs and keep some as a back up. Get real opioids elsewhere if you have a safe source
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Thanks for all the info everyone. I've been on sub for 2/12 weeks and gotten no analgesic effect from it (however it definitely helped with wd symptoms). Again, the dr. says it can take several weeks of even months and I don't understand the logic behind that. Perhaps it's a mental hurdle.
I am still meeting with an anesthesiologist later this week and will know then if they will treat me with the medication dosage I am requesting. I just dont want to quit the sub too early in the program.
I am still meeting with an anesthesiologist later this week and will know then if they will treat me with the medication dosage I am requesting. I just dont want to quit the sub too early in the program.
Painful One
Bluelighter
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Suboxone hasn’t helped me with pain at all.
I have really been suffering.
I have back and neck injury, chronic pain.
It absolutely sucks.
I used to have a doctor who gave me pain management control.
Now, I couldn’t find a doctor who would take over my care when my last physician retired.
I have been suffering badly for two years now.
I have really been suffering.
I have back and neck injury, chronic pain.
It absolutely sucks.
I used to have a doctor who gave me pain management control.
Now, I couldn’t find a doctor who would take over my care when my last physician retired.
I have been suffering badly for two years now.
There is no logic behind it. After months on suboxone you are just going to be dependent on suboxone and will barely feel any pain relief from it. Any relief you might get, even with a low dose (like the guy said above you need to take very low doses to get pain relief) will only last for a very brief time and wear off completely long before you're next dose.
Suboxone works for pain in opioid naive people but taking it long term following opiate dependence will not get pain relief.
I Will Always say that suboxone sucks. It's counter productive. having to chemicals basically fighting with each other, unless you on a high dose i feel is not where the pain relieve comes from.
I have been on pure bupre for years at a low dose of 500mcg-1mg and that was good enough for my pain up to a certain point but also felt it needed to build up in the system to reach stable plasma levels (this is my opinion not scientifically back up) but fuck it that is what work for me.
And also no need to go higher then 4mg with pure bupre. If i remember correctly that is the ceiling dose.
I have been on pure bupre for years at a low dose of 500mcg-1mg and that was good enough for my pain up to a certain point but also felt it needed to build up in the system to reach stable plasma levels (this is my opinion not scientifically back up) but fuck it that is what work for me.
And also no need to go higher then 4mg with pure bupre. If i remember correctly that is the ceiling dose.
Does the ceiling dose apply to analgesia too or is it just the bupe “high”(or lack there of)? I never really looked too far into it and kinda assumed it capped out fully at 4-8mg. I figured if the ceiling was 4(I always heard 4 but I’ve seen people on here say 8) the analgesic properties would stop there too, I’m not a chronic pain patient on paper, but do have daily pain from a back/neck injury, and never took my sub dose much past 4 because of the ceiling effect and when I did try it didn’t seem to help any so I went back down.
I’ve always wondered too if the effects stop at a certain dose what is the point of putting people on big doses(24, 32mg) that are extremely hard to come off of? I’m guessing tolerance to fent/H and high doses of other opiates require more bupe to supplement but at the same time if the ceiling dose is so low how does more bupe benefit, or ease WDs? I’ve always been a bit confused about it lol, maybe I’m taking the term ceiling dose too literally.
Hey @KeefR first of all, nice handle. I assume your choice is some form of hero-worship for yours truly. I appreciate that.
Regarding your comment on Burprenorphine (Suboxone) for chronic pain, I would have to say that the scenario described by your physician is not at all the norm for substances like Opioids. Yes, Buprenorphine does have some complex pharmacokinetics that make it a little different than your garden variety "Morphine", it still is utilized for analgesia in the same manner. It is supposed to work immediately, with the analgesia wearing off in time with the drug's metabolism.
It would be very unlikely, if it didn't work immediately, for it to suddenly begin working down the road. Opioids are actually some of the more simple drugs to track in term of tolerance, dependence and efficacy. What I'm saying is that the effects are essentially linear. They will be most potent at the onset of treatment, efficacy will wane as tolerance develops and eventually tolerance will render the drug largely ineffective.
Another very important point:
I don't want to overload you with information, so this will be simplified to some extent. Buprenorphine is more effective for pain in lower dosages. The dosages used for maintenance are in a completely different league than those used exclusively for pain.
For instance, there is a form of Buprenorphine called "Buprenex" that is an injection. The dosages for this go as low as 0.05mg - 0.4mg. Bear in mind that Buprenorphine is more potent by injection. With this in mind, we can essentially say that the dosing range for analgesia ends at ~1.6mg Buprenorphine per dose. This is in line with what I've read regarding the drug's usage for pain.
Here is a good starting reference for this:
I'd give this a read and then come back with whatever questions you have. As always, I would really recommend taking this data to your prescriber and hope that you can have an honest conversation about this. Make sure you tell him/her that the study is "peer-reviewed" whenever he starts to give you shit.
Regarding your comment on Burprenorphine (Suboxone) for chronic pain, I would have to say that the scenario described by your physician is not at all the norm for substances like Opioids. Yes, Buprenorphine does have some complex pharmacokinetics that make it a little different than your garden variety "Morphine", it still is utilized for analgesia in the same manner. It is supposed to work immediately, with the analgesia wearing off in time with the drug's metabolism.
It would be very unlikely, if it didn't work immediately, for it to suddenly begin working down the road. Opioids are actually some of the more simple drugs to track in term of tolerance, dependence and efficacy. What I'm saying is that the effects are essentially linear. They will be most potent at the onset of treatment, efficacy will wane as tolerance develops and eventually tolerance will render the drug largely ineffective.
Another very important point:
I don't want to overload you with information, so this will be simplified to some extent. Buprenorphine is more effective for pain in lower dosages. The dosages used for maintenance are in a completely different league than those used exclusively for pain.
For instance, there is a form of Buprenorphine called "Buprenex" that is an injection. The dosages for this go as low as 0.05mg - 0.4mg. Bear in mind that Buprenorphine is more potent by injection. With this in mind, we can essentially say that the dosing range for analgesia ends at ~1.6mg Buprenorphine per dose. This is in line with what I've read regarding the drug's usage for pain.
Here is a good starting reference for this:
I'd give this a read and then come back with whatever questions you have. As always, I would really recommend taking this data to your prescriber and hope that you can have an honest conversation about this. Make sure you tell him/her that the study is "peer-reviewed" whenever he starts to give you shit.
Ganja-Gremlin
Greenlighter
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- Mar 28, 2025
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This sucks… unfortunately suboxone isn’t for pain and I would recommend that you find another doctor immediately if you have not already, I am not sure why there is a trend for prescribers to lie to pain patients, it isn’t going to start working better after 6 weeks, that’s not how opiates worse. When I took it I got very sick 
Hope your okay…
Hope your okay…