Dispatchick17
Bluelighter
- Joined
- Nov 16, 2018
- Messages
- 61
Hey there to everyone, and esp to all of our BL pharmacists and big brained pharmaceutical experts... I need a little hope (and maybe someone who's been through this).
I'll explain the whole backstory someday if anyone wants it, but here's the short version.
I'm currently waiting on cervical spine adjustment/revision surgery and am on the cancelation list because it honestly can't come soon enough.
I have two herniated discs compressing my spinal cord, severe nerve impingement on both sides, the disc above my previous fusion has essentially degenerated to bone-on-bone, and to add insult to injury, I've also developed multiple bone spurs. Because who doesn't love added content, right?
Pain level? 10/10. Would not recommend.
Years ago I had an ACDF (Anterior Cervical Discectomy and Fusion) at C3 - C5. Since then I've been through just about everything on the menu for pain: opioids, non-opioids, injections, procedures, products, physical therapy, etc.
The medication that actually seemed to help me the most was buprenorphine. It controlled my pain better than anything else I'd tried, and coming from the a medical profession that saw addiction at its absolute worst, I also appreciated that it felt like a safer option for me than traditional opioids.
Most recently I was taking:
• Suboxone 24 mg/day (for pain)
• Lyrica 600 mg/day
• Celebrex 400 mg/day
• Topamax 75 mg/day
Because I'm preparing for surgery, my longtime pain management provider switched me from Suboxone to Subutex so the naloxone wouldn't complicate perioperative pain management.
For two weeks I took:
• Subutex 32 mg/day (4 × 8 mg)
• Same doses of the other medications.
Did it completely control my pain? No. But it definitely helped.
Then four days ago everything changed.
We have a new physician who took over the practice. He wasn't comfortable continuing the Subutex, despite my regular provider managing my case from the beginning still recommending it. Instead, he stopped it and switched me to:
• Percocet 5/325 mg three times a day.
Three days later he increased it to:
• Percocet 7.5/325 mg three times a day.
Here's my problem...
I'm not in precipitated withdrawal. I'm not sick. But my pain has become even more unbearable, and now it hurts in my lower back and further down my spine.
This isn't my "normal" chronic pain. This is a whole different beast. The only way I know how to describe it is, "slap my own deceased mother" level pain. (Obviously kidding *Rest in Peace, Mama*... but you get the point.)
The Percocet honestly feels like it's doing absolutely nothing.
I've read a lot about buprenorphine's incredibly high receptor affinity, how long it occupies the opioid receptors, and why full agonists sometimes don't work well until enough of the buprenorphine had been evicted.
So here's my question...
Am I wrong in thinking the Percocet may simply not be able to do much yet because the bupe is still occupying those receptors?
If that's the case, how long does that usually last after stopping high-dose buprenorphine? When should I realistically expect the Percocet to start providing meaningful pain relief?
Is there anything that can safely speed up that process, or is it simply a matter of waiting?
I'm frustrated because I feel like I voiced these concerns before the switch, and they were largely dismissed.
I'm looking for experiences, education, and maybe just a little hope that this won't be forever.
Thank you all so much.
Edit to add: My last dose of Subutex (32 mg) was the evening of July 22. Since then I've only been taking the Percocet (along with my Lyrica, Celebrex, and Topamax). I'm currently about three days out from my last buprenorphine dose.
I'll explain the whole backstory someday if anyone wants it, but here's the short version.
I'm currently waiting on cervical spine adjustment/revision surgery and am on the cancelation list because it honestly can't come soon enough.
I have two herniated discs compressing my spinal cord, severe nerve impingement on both sides, the disc above my previous fusion has essentially degenerated to bone-on-bone, and to add insult to injury, I've also developed multiple bone spurs. Because who doesn't love added content, right?
Pain level? 10/10. Would not recommend.
Years ago I had an ACDF (Anterior Cervical Discectomy and Fusion) at C3 - C5. Since then I've been through just about everything on the menu for pain: opioids, non-opioids, injections, procedures, products, physical therapy, etc.
The medication that actually seemed to help me the most was buprenorphine. It controlled my pain better than anything else I'd tried, and coming from the a medical profession that saw addiction at its absolute worst, I also appreciated that it felt like a safer option for me than traditional opioids.
Most recently I was taking:
• Suboxone 24 mg/day (for pain)
• Lyrica 600 mg/day
• Celebrex 400 mg/day
• Topamax 75 mg/day
Because I'm preparing for surgery, my longtime pain management provider switched me from Suboxone to Subutex so the naloxone wouldn't complicate perioperative pain management.
For two weeks I took:
• Subutex 32 mg/day (4 × 8 mg)
• Same doses of the other medications.
Did it completely control my pain? No. But it definitely helped.
Then four days ago everything changed.
We have a new physician who took over the practice. He wasn't comfortable continuing the Subutex, despite my regular provider managing my case from the beginning still recommending it. Instead, he stopped it and switched me to:
• Percocet 5/325 mg three times a day.
Three days later he increased it to:
• Percocet 7.5/325 mg three times a day.
Here's my problem...
I'm not in precipitated withdrawal. I'm not sick. But my pain has become even more unbearable, and now it hurts in my lower back and further down my spine.
This isn't my "normal" chronic pain. This is a whole different beast. The only way I know how to describe it is, "slap my own deceased mother" level pain. (Obviously kidding *Rest in Peace, Mama*... but you get the point.)
The Percocet honestly feels like it's doing absolutely nothing.
I've read a lot about buprenorphine's incredibly high receptor affinity, how long it occupies the opioid receptors, and why full agonists sometimes don't work well until enough of the buprenorphine had been evicted.
So here's my question...
Am I wrong in thinking the Percocet may simply not be able to do much yet because the bupe is still occupying those receptors?
If that's the case, how long does that usually last after stopping high-dose buprenorphine? When should I realistically expect the Percocet to start providing meaningful pain relief?
Is there anything that can safely speed up that process, or is it simply a matter of waiting?
I'm frustrated because I feel like I voiced these concerns before the switch, and they were largely dismissed.
I'm looking for experiences, education, and maybe just a little hope that this won't be forever.
Thank you all so much.
Edit to add: My last dose of Subutex (32 mg) was the evening of July 22. Since then I've only been taking the Percocet (along with my Lyrica, Celebrex, and Topamax). I'm currently about three days out from my last buprenorphine dose.
