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Opioids HELP! Going from Suboxone to oxycodone due to upcoming surgery.

gwarguy66

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Richmond VA
I've been on Suboxone for just give days. I'm taking 4mg a day. NOW I have to have surgery on Friday. (2 days from now on June 23rd.) I'm gonna be back on pain meds. Oxycodone 30mg qid. My question is, how long should I wait to take the pain meds b/c I'm gonna be in pain. Like I said I've only been on the subs for 5 days at 4mg a day. My Doctor says since I've been on the subs for only five days, I should be ok. I say giving it 24 hours couldn't hurt. Your input is greatly appreciated.
 

losangeles1993

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if you've been on subs for months and at a high dose ill say 72 hours
if on a high dose for a few weeks ill say about 48 hours and if
you are taking a decent dose like 4mg for about 5 days to a week ill say 24-48 hours..
 

gwarguy66

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Richmond VA
Thank you. I'm worried about withdrawing from the Suboxe while waiting for the upcoming surgery. I don't wanna be in withdrawal and be sick before this surgery.
 

gwarguy66

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Richmond VA
Thank you for the very good info and link. Very helpful. Still worried, but I'm sure if I make it clear to the surgeon, he will adjust the oxycodone to a high enough dose that I'll achieve analgesia.
 

keeping

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you haven't been on long at all - i had been on subutex (no naloxone) 2mg a day for two weeks and i just didn;t take any 24 hours before my surgery and i had all the fent i wanted (still, fuck fent) with no dramas. but ofc ymmv.
 

gwarguy66

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I hate fent too. 100mcg patch. I hated it. They say it's so strong but it didn't do a thing for my sciatic pain, or pain in general. Just after being on it for a year. It didn't last either. Like I said above, I'm sure if I talk to the surgeon, he will adjust the oxycodone to a dose high enough to produce analgesia. The Suboxone seemed to help my pain better than anything else.
 

gwarguy66

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Richmond VA
Actually, I have been getting alot of headaches. It helps with the nerve pain more than anything else. People say it's REALLY powerful. For some reason, I don't know if I believe that. I've heard six mg of sub is equal to 300mg of oxy?! That seems crazy.
 

tacodude

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Jan 30, 2014
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Reduce your sub dose down to 1 mg if you can and you should be able to use the oxy no problem, but the effect will be diminished the first few hours so while you'll get pain relief it will not be the full oxy effect while taking more will only make you sick.

The more difficult issue is getting back on the subs after as pwd will be a concern, but going from subs to full antagonist is easy especially when you aren't worried that you only have one dose and if you screw up it will all be effort for nothing. If you take one early and it is not full effect it doesn't matter as each dose will be more noticeable as the bupe wears off before tolerance starts developing again.
 

gwarguy66

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Richmond VA
Thanks for that info. When the pain eases, I'm determined to get back on the suboxone. I'm not getting into that horrible lifestyle again. I took 2mg of suboxone today instead of 4. Tomorrow I'll take 1mg. My surgery is at 9:00am Friday, so I pray everything goes well and I'm not in a ton of pain or withdrawal. That's what worries me the most. Going into surgery or coming out of surgery with withdrawals. But I think I should be ok. I think the pain would be more of an issue than the withdrawals.
 

tacodude

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Honestly I found bupe for pain doses was much different than maintenence for habit mainly being dosing much lower doses 2x a day to 4x at most. Something like 250 or 500 ug (microgram=1/1000 mg) a dose or 1-2 mg one a day. I never found any real extra relief and sometimes it felt more uncomfortable for me although I really had trouble with the strips and letting them dissolve
 

Jabberwocky

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Whatever you do OP, just be clear with your doctor about issues you're concerned about and education yourself as much as possible so you are able to get an idea whether what your doctor suggests makes sense or not. Making sure to work closely with all those involved in the procedure will be important if your doctor/anesthesiologist/surgeon doesn't have a clear understanding of how to manage what and how much medication you are given.
 

gwarguy66

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Feb 1, 2017
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Richmond VA
Whatever you do OP, just be clear with your doctor about issues you're concerned about and education yourself as much as possible so you are able to get an idea whether what your doctor suggests makes sense or not. Making sure to work closely with all those involved in the procedure will be important if your doctor/anesthesiologist/surgeon doesn't have a clear understanding of how to manage what and how much medication you are given.
Basically, when I talked to the surgeon, he said "everything will be ok. We'll use fentanyl for after surgery pain and you'll be sent home with oxycodone 30mg to be used six times prn. I think that should be enough. I took 1 mg sub today.
After the pain subsides, I'll be weaned off the oxy and get back in the subs. On a side note, the surgeon said I could take 1 1/2 oxy if it doesn't control the pain, but I'm gonna try to stick to the plan of 30mg X 6 prn.
 

tacodude

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Tell them you lowered your dose of sub too as the fentanyl can break through, but needs higher doses for larger bupe amounts. You don't want them killing you with fent giving you an amount ment for someone on 4 mg of subs. If they ask why you reduced be honest and say when you expressed your concerns outside the office some suggested reducing the dose so the doctors don't have to struggle breaking through it as much.

Your doctors seem to know what they are doing
 

gwarguy66

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Feb 1, 2017
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Richmond VA
Yes. I only started the subs this past Saturday @ 2mg bid. Then cut it to 2mg yesterday and 1mg today. They know that I cut back so they can adjust the dosage of pain medication properly and will monitor my pain level, blood pressure and respiration after surgery and when I come to. My concern has been this; will the oxycodone work when I'm sent home? (The same day)
 

Jabberwocky

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It sounds like you've got this well under control OP. Are you planning to get back on buprenorphine after you've recovered from surgery?

It would be really great if you shared with us how it goes. We don't get to hear feedback from folks who go through what you are with buprenorphine and surgery.
 

gwarguy66

Greenlighter
Joined
Feb 1, 2017
Messages
22
Location
Richmond VA
It sounds like you've got this well under control OP. Are you planning to get back on buprenorphine after you've recovered from surgery?

It would be really great if you shared with us how it goes. We don't get to hear feedback from folks who go through what you are with buprenorphine and surgery.
I'll let everyone know when I get home on Friday and how things are going. I'll make sure I post my entire journey from the surgery to being on the meds, getting off the meds and back on Suboxone. If nothing, just to help someone or share my experience through this entire journey. I promise. I'm scared but I guess that's normal.
 
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