Help with suboxone

[Shelly320]

Ok I've posted a few times before about my situation but I am currently on suboxone therapy ( it has been AMAZING for me) I know that's a whole different topic BUT I take very small amounts 2 or 3 times a day for me it works great I've been "clean" for over 2 years (I say it that way because I'm a realistic person and I KNOW I'm not cured and I'm always 1 step away from where I was) anyways I am going to need surgery again BACK STORY is I got addicted from having numerous health issues I lost my health insurance and the doctors didn't care so I went to the streets and it took me down a very dark road I almost lost EVERTHING but my amazing support lifted me from hell and suboxone really helps me it helps the pain and all! BUT now I have new insurance and there is a chance I can live pain free ( or closer to it) but I don't want to go into a new doctor with the stamp ADDICT because that's what will happen SO I was gonna try to be on a low enough dose that I never have to tell them then when it's time for whatever I can easily get a script ( I have a true medical issue) and I'll switch over question will this work?? All the research I've done says it will but I'm scared

 

[roxi2873]

When you say small doses how small are you talking about? Some people consider 2mg a small dose but in reality jumping off 2mg of Suboxone will still cause extreme withdrawal and a full agonist opioid will still be blocked by the bupe. Now if you are taking in the microdose range like 0.5 mg then you could likely stop for a few days and then be able to feel the effects of oxycodone or other full agonist opioids. Also where I live in Ohio my sub doctor checks my name in a database every appointment and will know if I am prescribed any other narcotic and I will be kicked out of the program. I think you should talk to your sub doctor about your situation first and ask him about having surgery. I would never want to have a surgery on sub maintenance because I take about 4mg a day and it would block any morphine or any other opiate besides maybe fentanyl and I would feel all the pain of the operation. Now, the doctor can basically shoot through the buprenorine blockade with high doses of morphine or Dilaudid etc and actually give you pain relief if he knows your on sub maintenance but I would want to talk with them before hand about that and make sure the doc would actually do that for you if you had the surgery. Basically, even though you're at risk of being labeled a junkie, you should still be honest with your doctors. They can find out anyway if they look up your script history.

 

[jamesBrown]

Ok I've posted a few times before about my situation but I am currently on suboxone therapy ( it has been AMAZING for me) I know that's a whole different topic BUT I take very small amounts 2 or 3 times a day for me it works great I've been "clean" for over 2 years (I say it that way because I'm a realistic person and I KNOW I'm not cured and I'm always 1 step away from where I was) anyways I am going to need surgery again BACK STORY is I got addicted from having numerous health issues I lost my health insurance and the doctors didn't care so I went to the streets and it took me down a very dark road I almost lost EVERTHING but my amazing support lifted me from hell and suboxone really helps me it helps the pain and all! BUT now I have new insurance and there is a chance I can live pain free ( or closer to it) but I don't want to go into a new doctor with the stamp ADDICT because that's what will happen SO I was gonna try to be on a low enough dose that I never have to tell them then when it's time for whatever I can easily get a script ( I have a true medical issue) and I'll switch over question will this work?? All the research I've done says it will but I'm scared

I'm sorry for your situation. I truly empathize....but I do not believe it is a good idea, nor will it work.

For starters, as roxi already stated, the doctors can(and WILL) check your prescribing history. So right away you will be caught lying to or keeping something from them.

Also, suboxone has a very long half life. It could easily still be acting as a full agonist blocker during your surgery...you DO NOT want that.

And just in general, when it comes to medical treatment, especially surgery, it is not a good idea to lie to or keep things from your doctors, whether or not they can find out on their own.

 

[roxi2873]

I agree. Just because someone is an addict doesn't mean they shouldn't be allowed to have a surgery that can improve your quality of life. The fact that the OP has been clean on sub maintenance for quite a while may help a doctor's decision. Ideally though, you would want to be off Suboxone long enough so it's completely out of your system and you are stable without it... Like a month at least I'd say. This will basically reset your opioid receptors to the point where IV Dilaudid or morphine would be effective for the pain and opioids prescribed for the recovery process would actually relieve pain. Then after that you could go back on your sub maintenance if you need to or you could try just staying clean without anything. I agree this is a difficult subject to figure out. I'm on sub maintenance and am paranoid about accidentally breaking my leg or a car crash knowing the buprenorine will block any pain relief available. Your only hope is you get an ER doctor who knows about buprenorine and would be willing to basically shoot through the blockade in high doses until it worked. I just hope nothing like that happens.

 

[Shelly320]

Roxy thank you so much this is so hard I really don't know what to do literally I'm in tears. I have been sick for so long and I KNOW I need to go get help but I feel like I'm being punished for doing the right thing, my back story is a little crazy I have to start at the beginning to make any sense 19 years ago I had a gastic bypass I was 19 years old ( shows my age lol) and I weighed 503 well it was the original one and a very long recovery but I had no issue stopping any meds back then all I did was smoke weed and that was ALL I was in the hospital for 2 weeks and went home with a morphine drip but never had an issue when I stopped them life continued and 3 years later I met back up with an old friend and instantly clicked I also has a tummy tuck that year ( I had lost over 250 lbs and had the skin removed) again no issue with the meds at all and I was on some heavy ones anyways that old friend was my true soul mate ( now I call him hubby) we got married the next year and had our daughter the next year life was awesome and things were great, but I ended up needed another surgery that year after I had a chance section I got an infection I swear I barley even took the meds they gave me at that time I had no drug issues and only took whathe I absolutely needed...back then anyways I was feeling good and we moved to hell oops sorry I mean florida and I got pregnant with our son and developed a hergnia (sp) so I had another c section and 3 months later a repair surgery AGAIN no issue life went on but a year later I started school went back for medical assisting we moved "home" to Connecticut and I tried cocaine for the first time and my addictive personality showed up in full force i went full force and thankfully my hubby saw and lifted me out of the situation ( I'd say a few months) and we moved back to hell dang I mean florida and we'll shit went south I ended up landing a great job I was working a few months and I was taking tramadol ( perscribed) and I had a grand Mal seizure and they didn't know why so they started loading me up on a steady stream of benzos now this is florida circa 2006 in the pill prime I was clueless! 3 months later I found out I was pregnant AGAIN but guess what TWINS of course I stopped all meds and no issues well when I was pregnant I started feeling so sick when I ate I assumed it was 2 babies moving around I ended up in the hospital on 9 weeks bed rest and I was being given 10 mg percocet 3 times a day due to severe dental pain from a rotten tooth the pain was so extreme it was giving me contractions and one twin was a placenta previa and I was in danger of losing them anyways they were born healthy and they were negative for all substances at birth they were perfect and almost 6 lbs apiece!! I however didn't do to well I needed a blood transfusion and got an infection but we made it through after I had them I was constantly being perscribed meds I believe my body was clearly addicted but my mind took a while to catch up, I went home with a script and a few weeks later I was still feeling terrible and vomiting it felt like I was digesting glass I went to the emergency room and long story short I ended up diagnosed as a gastro gastric fistula ( hole in my new stomach leading to my old stomach) basically my old stomach needs to come out and the hole repaired the nigjt before surgery they call and say your insurance has denied the claim it's pre-existing WTF mind you I had been in pain management for the 6 months prior on oxicontin 40 mg 3x a day percocet 10mg 3x a day for breakthrough pain and klonpin for whatever idk again now its 2007 in the pill mill capital! So I stayed in pm for like 3 more months then I lost my insurance and turned to people I knew bad people to say the least I was sick and I didn't even know what dope sick ment! Anyways shit got ugly fast and to say the very least it landed me in prision all the while I've been honestly getting sicker and sicker anyways obviously still in severe pain when I came home from prision side note my husband does nothing not even smoke cigarettes anymore and had been my rock and true GODSEND he never did drugs just smoked weed in the past I am a blessed woman, anyway I had no insurance at the time and turned to old ways thankfully he saw it and helped me find a sub doctor it has truly changed my life back to normal I can not even begin to tell you how AMAZING things are now don't get wrong my life is NOT roses BUT I am happy I work alot I have money my relationship is amazing with my husband and my parents we talk about everything and all I do is smoke weed and take my subs....but I'm sick all the time I never eat and it's really starting to affect my health and appearance I've lost too much weight and I'm tired all the time!! I really hurt so bad all the time now as of 1/1/17 I have new insurance under my husband who works for the hospital and I really wanna start fresh this time with knowledge I want HELP but honestly I'm scared if they want to do a procedure I'm gonna have to tell them and with all my surgeries in the past I HAVE to tell them I am perscribed 16 mg 8 am 8 pm a day but I've been taking 4 mgs 2 am 2 pm for a while now sometimes I would take a boost 1 or 2 mg in the afternoon, I was afraid I was not going to be able to get them due to insurance issues ( because that happened several times) so I like to have back up and I never told him I tapered anyways lately I've lowered even more and I've been cutting more carefully so I can safely say I'm rapidly tapering and feel like shit! For the last 3 days I've been taking 1mg am and 1 mg pm I also have cloniodine. 5 if I need it but I'm ok right now I have plenty and a script but I'm so confused with what to do so I try to just taper and jump start fresh and hope I don't have issues?? Or stay where I'm at and be honest?? My sub doctor knows the whole story BUT I'm in his "clinic" aka legal drug dealer I pay him 100 a month to listen to my heart and say here is your script BUT see I'm different I've been going faithfully for almost 2 years never failed a drug test ( they are 100% ok with weed actually told me with my stomach issues I should be smoking) I'm around people who use at work all the time but I don't hang out with them I go home my life is so full and busy!! I have no desire BUT I realize that could be the suboxone talking??? I feel like my life is so different actually it's my old life that was on hold and I feel like the old me!! BUT I'm getting sicker and I have to do something soon, sorry so long my head is insane right now

 

[roxi2873]

Ok, with Obamacare now they're not supposed to deny anything for a pre existing condition. From what I've gathered though, now you could actually have your surgery but the Suboxone is the problem now. Btw, I always took way less of my Suboxone than I was ever prescribed too. It's a smart thing to do if you don't get tested for levels of buprenorine Incase you suddenly can't go to your doc anymore at least you have some back up. In my opinion you're tapering too fast. The half life of buprenorine is something like 36 hours and it wears off very slowly. If you say you're comfortable now on 2 mg twice a day then I would stay on 2mg 2x a day for 2 weeks. Then cut down to 1.5 2x a day for 2 weeks, then 1mg 2x a day for 2 weeks, then after that try going to 1mg just once a day and just keep taking smaller and smaller does as long as you're stable on it. If you feel a little crappy when you lower your dose that's normal. If you're definitely dope sick then wait a while longer until you feel like trying it again. Measuring very small doses with a full 8mg strip can be hard but there are ways to do it accurately. This is what I do. Get an oral syringe with CC's on it. Or a regular syringe with out the needle. Take an 8mg strip and cut it exactly in half so it's 4mg. Put the 4mg piece in a shot glass. Measure 40cc's of warm water into your oral syringe and put it into the shot glass. Use a toothpick to stir it up until the orange is completely dissolved in the water. You now have a solution of 1mg buprenorine per 10cc's of liquid. 5cc's is 0.5mg etc. I usually plug mine (squirt it up your butt, no I'm not gay just an addict lol). Sometimes I kinda slowly squirt the solution down my nose like snorting it. Just do a little bit at a time so it absorb into your sinuses and doesn't just run down your throat. You can also just take drops of it under the tounge but that's kinda difficult. Plugging is the easiest way to go and it's better bioavailability than sublingual. As long as you don't have to take a shit your bowel soaks in all the bupe fast and effectively.
As far as your dillema with doctors... Maybe you should get an appointment with the GI specialist first and tell him how your on maintaince and everything and ask him if you would need to stop the subs completely or just get down to a low dose like 0.5 so the pain medication can overpower the bupe or what they want you to do. Be assertive that you really need this surgery because it's making you miserable and whatnot but be polite and respectful too. Doctors like to think they're smarter than you so just let them think that. Just don't hear no and not try to make a case for yourself. Good luck and report back if you can. If you have any questions about Suboxone I can help you out. I've been through just about everything with that crap you can think of.

 

[Shelly320]

Roxi I had one mess up on the subs last summer I was taking about 4 mg am and 4 mg pm at the time and I didn't take it in the am and got some pills ( I was an iv user, lmao about the I'm not gay comment I NEVER judge anyways I know I'm one step from nurse to junkie) I got high as shit that night nothing was blocked but I was so scared to go back on subs cuz of precipitated wd and I could tell my hubby or family I ended up on a 3 day bender I was able to tell my hubby and he never judged he just said ok we can fix this...and he helped me reinduce after I faked the flu and wd for 12 hours anyways I NEVER want to do that again I realized and remembered how horrible that life is it was 3 days of hell!! I had to lie and shit and I depleated my account ( thank God for my hubby) anyways now I'm thinking if I can level at 1 mg a day total then I can just jump 12 hours before and procedure and be fine but then WHAT? Isort it possible that I can then switch to narcotics and carefully come off those never telling the doctor?? Please understand I HATE doctors and hospitals I used to LOVE going there to get meds now I'd much rather chill with a blunt and deal with the pain but I really can't do that anymore I'm so scared to lie to the doctor but more scared to tell the truth and be judged...

 

[roxi2873]

Everyone is different, I had tried to relapse before when I was on subs and even after 8 days not taking my subs it still blocked out oxycodone 30s. I couldn't believe it. It took a full month off subs before I could actually get high again. It's possible that what you suggested could work but unfortunately they can and will find out you're lying. Another option would be to taper off your subs and hold yourself stable on other opiates until your surgery, but that's inviting a full blown relapse. I still think the best option is to tell the truth

 

[YMI_BISHoP]

Suboxone was very helpful for me when using H but a miracle with pills

 

[chelle216]

You're likely going to need the help of a sub dr to get adequate pain relief meds for the surgery. I've been through this scenerio with a loved one and at least three Drs including the surgeon refused to handle the post op pain relief prescription if it needed to be anything over 10mg percs. These Drs all attributed it to a lack of knowledge involving how to manage the care of a patient on suboxone, it was not because they didn't want to get involved in giving an addictive personality opiates. Basically what ended up happening was a patient-Doctor agreement in which patient was to discontinue subs 72-48 hrs before surgery. They then got a prescription for 15mg oxycodone IR 4x a day to be taken for a day before and a few days following surgery. The following week patient had to see dr in office and reinduct on subs.

I would caution against not disclosing your medical history involving suboxone to your surgeon. The surgeon was especially cautious in going forward with a surgery until we secured an outside source with better knowledge in managing care for a patient on sub maintenance. IIRC, the surgeon was especially concerned with the possibility of withdrawal occurring and causing complications that could lead to death during the operation if suboxone wasn't stopped a few days prior so that a full agonist could be given adequately while in the OR.
Seriously, I wouldn't risk it.

 

[roxi2873]

You're likely going to need the help of a sub dr to get adequate pain relief meds for the surgery. I've been through this scenerio with a loved one and at least three Drs including the surgeon refused to handle the post op pain relief prescription if it needed to be anything over 10mg percs. These Drs all attributed it to a lack of knowledge involving how to manage the care of a patient on suboxone, it was not because they didn't want to get involved in giving an addictive personality opiates. Basically what ended up happening was a patient-Doctor agreement in which patient was to discontinue subs 72-48 hrs before surgery. They then got a prescription for 15mg oxycodone IR 4x a day to be taken for a day before and a few days following surgery. The following week patient had to see dr in office and reinduct on subs.

I would caution against not disclosing your medical history involving suboxone to your surgeon. The surgeon was especially cautious in going forward with a surgery until we secured an outside source with better knowledge in managing care for a patient on sub maintenance. IIRC, the surgeon was especially concerned with the possibility of withdrawal occurring and causing complications that could lead to death during the operation if suboxone wasn't stopped a few days prior so that a full agonist could be given adequately while in the OR.
Seriously, I wouldn't risk it.

Yes, I would do exactly this in your situation. Lying about this kind of stuff comes natural to addicts, but in this situation you need to be truthful and try to get both doctors to work together.