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Bupe Suboxone for Pain Management?

Jktm

Bluelighter
Joined
May 19, 2012
Messages
1,920
A Little Background First:

So I signed up for what I thought was a psych unit that specialized in pain management on the side, which is kinda true, but pain management is all they focus on and it has a rehab-esque attitude towards the program which really kind of aggravated me (It basically said that all people that had been Rx'ed opioids long-term for pain were addicts and didn't distinguish psychological dependence (or addiction) from physiological dependence at all; they even considered cancer patients on painkillers to be addicts :|). The doctor, regardless of your medical history puts you on a buprenorphine titration that takes you from taking 2 doses of 2mg a day to a final regimen of 8mg in the morning, 4mg at 2pm, and 4mg at 8pm, so all patients are on a total of 16mg, or, 2 Suboxone/Subutex tablets per day.


What I'm Getting At:

I feel as though this amount is too much and that I may be dosing too many times throughout the day. My pain still isn't being controlled by the buprenorphine, but I know there's a ceiling dose for pain that's much lower than the ceiling dose for effectiveness at stopping w/d's and minimizing cravings.

My Questions

1. What is the ceiling dose for PAIN RELIEF of buprenorphine (I realize this is a controversy among BL'ers, so I guess I should expect differing answers on this)?

2. How long do the pain killing effects last, and how often should I be dosing this?

3. Is the ceiling dose for pain relief for a 24 hour period or just for the length of time it actually helps with pain relief?

Examples of What I Would be Looking For in an Answer

The ceiling dose is 4mg and that is for the period of time it helps with pain relief, which is 8 hours so it should be taken 4mg q8h.

or

The ceiling dose is 8mg and that is for the whole day, and the pain killing effects last 6 hours, so it should be taken 2mg q4-6h.

Just something like that...if you would like to add some insight as well, feel free, just trying to let you know exactly the type of answer I'm looking for. Plz don't troll this thread either, because I'm wanting to taper down to something that will provide the same amount of pain relief I currently have until I can get into a doctor that won't treat me like a junkie and give me something that will sufficiently control my pain. I'm not used to this amount of bupe and it makes me really tired with all the other meds I was sent home from the institution with, so, like I said, please don't fuck with me in this thread. Anything constructive will be appreciated.
 
Well the ceiling dose is 32mg i believe but for pain relief i would stay under 4-6mg I would shoot for around 2-4mg though as at lower doses i feel more analgesia. If under a certain amount I believe norbuprenorphine fills up more receptors and its a full agonist therefore giving more full agonist effects. Suboxone should last you ATLEAST 24 hours I know it keeps me well for about 40 hours, for pain killing effects I would assume their prevalent for about 20-24 hours. IMO though, I would split your dose in half, say you were taking 4mg a day I would take 1 when you wake up i.e. 7am and another before dinner i.e. 6pm. I did a little research and saw that some people who use bupe for pain relief like to split their doses into two.

Maybe someone smarter can chime in but im giving you my personal experience
 
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He's not my current doctor...he was just the doctor at the inpatient facility I went to...
 
Depends on the degree of pain, route of administration, and tolerance to other analgesics if applicable.

For me, I was using 0.25mg IV for severe pain, several times a day, which is many more times what I would use now, and about 6 times as much as I was using immediately before the severe pain.
 
I wasn't inpatient for opioid addiction...I went in for pain management...all I was Rx'ed was 3 tramadol a day at that time (been Rx'ed more in the past) and hadn't even developed dependence yet (if you can get dependent to 150mg of tramadol/day lmfao)...good pain killing dose for me is 90-120mg of MS-Contin at once...I'm thinking of going 4mg BID
 
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