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Bupe Subutex for Pain?

King J

Bluelighter
Joined
Jul 4, 2010
Messages
133
Is Subutex good for pain? I have 3 fractures in my back and I got kicked out of Pain Management for being honest with them after they changed me from OxyContin 60mg to MS Contin 30mg that it didn't work and they kicked me out. I'm tired of trying to find a doctor when all I have is Medicaid..nobody wants me.

Is Subutex good for pain since it doesn't have the blocker like suboxone does?
 
The naloxone in suboxone isn't really active since the buprenorphine in it out-competes the naloxone in binding to the opiate receptors.

As for using either subutex or suboxone for pain, I won't comment on that since I don't have experience using them for pain management, but I know that it is prescribed off label for the treatment of pain.

A lot of sub doctors only accept cash though, so that is something that you need to figure out since it may be more expensive for you to see a doctor for subutex or suboxone than it may be for you to find pain management doctors that you are happy with.
 
say you are on a dosage of 2mg, once per day. How long could you stay at that dose before you need to raise it due to tolerance? A month? two? more?
 
Suboxone/Subutex can be very helpful for pain but I personally think that it has to be taken properly to be able to get its best pain killing properties.

Taking Subs like one would take them for ORT I have found does not treat pain very well. That is once a day large dosing seems to only keep one from feeling withdrawals and does not provide much pain relief.

I have found that small doses of less than 2mg spread through out the day bring out buprenorphines real pain killing properties. For me it literally turns it into a different drug, very close in the way it feel and works on pain to a full agonist.

I would be happy to go into this more if you are interested.
 
^ I am. What would you say it is similar to on a mg for mg scale? I mean technically if you're dosing it throughout the day what ir opiate would you put it on parr with?
 
It is really hard to compare it to any of the IR full agonists as it does not have the heavily pronounced narcotic effects that most full agonists have. IE, I never find myself nodding or getting droopy eyes. There is almost no euphoria, however there is a mild feeling of well being for an hour or so after it has kicked in.

I think pain control wise it could be compared to being on a stable long term dose of most of the mid range full agonists. You do not get the ups and downs of something like a large dose of IR oxy. Although I have never been on a long term regiment of Oxycontin I would assume that it would be very similar to what one would feel if they were taking OC at an appropriate stabilized dose just enough handle the pain with out getting the strong narcotic side effects. The main draw back I have found with Sub for pain is that it is not the best at handling break through pain. It keeps the normal consistent pain I have at bay but when I get spikes in my pain level taking a little more sub only slightly helps as the spike in pain usually subsides before the sub really even has a chance to kick in.

Overall though, especially for someone that may have issues controlling their use of strong full agonists Sub is great.
 
would you recommend twice or thrice daily dosing? also, how many total mg woudl be good for pain a day?
 
Ah I see. I feel no euphoria from my pain meds anyway, they don't even halve my pain so no worries there. Thanks for the answer though, I am looking at my options for a new medication regime, as I have been awake for days and today I have been so bad I can't even use meditation to keep the tears at bay. I shall now try and do some other research into this when my mental capacity isn't so diminished :S
 
Please keep in mind this thread is about Subutex and not Suboxone because of the naltrexone in suboxone.
 
Is Subutex good for pain? I have 3 fractures in my back and I got kicked out of Pain Management for being honest with them after they changed me from OxyContin 60mg to MS Contin 30mg that it didn't work and they kicked me out. I'm tired of trying to find a doctor when all I have is Medicaid..nobody wants me.

Is Subutex good for pain since it doesn't have the blocker like suboxone does?

Honesty is rarely the best policy when it comes to pain management. The doctors have too much to lose, so they under treat pain to cover their asses. Sadly this is the reality all over the world. I live in SE Asia and witness how terminal cancer patient are given NAIDS in their final hours. The med change in your case is a huge slap in the face. I'm a math retard, however the change from Oxycontin (roughly 10x stronger than morphine) to morphine is drastic. Then to cut the dosage by 30 mg........I truly feel your pain. Well at least the doctor can brag about how responsible he or she was, and rest comfortably knowing their license is safe.
 
To King J, for all practical purposes Subutex and Suboxone are the same thing. Due to the fact that the Buprenorphine out competes the naloxone in the Suboxone they can literally be used interchangeably. If you are interested there is a good amount of information here on bluelight to back this up.

Dcraver877, I find that dosing 3-4 times a day to be the best for controlling my pain. I take 2mg first thing in the am, then about 1mg at noon, another 2mg around 5 and finally 1mg at bedtime. By dosing this way I find that the Sub works more like short acting full agonist.

I have done once daily dosing at higher doses and it does keep the withdrawals at bay I find that it only mildly helps my pain for the first few hours after dosing.

Maybe there is some science behind the results I get from spreading small doses out through the day. Anyone?
 
Buprenorphine can be used for pain, yes.

Yep, up to the doses where the mu agonism plateaus (typically 2-4mg SL), it's effects are essentially indistinguishable from typical full agonists used for pain. Larger doses will produce a more substantial and longer-lasting blockade effect without producing superior analgesia (or recreational effects) however.

say you are on a dosage of 2mg, once per day. How long could you stay at that dose before you need to raise it due to tolerance? A month? two? more?

As is the case with any opioid used appropriately for pain, if you take stable doses, tolerance to the analgesic effects builds at a crawl and typically patients can maintain stable doses indefinitely, often even for years. It's when people want to get the other effects and keep chasing that high by raising their doses regularly that you build tolerance to the analgesic effects quickly.

Suboxone/Subutex can be very helpful for pain but I personally think that it has to be taken properly to be able to get its best pain killing properties.

Taking Subs like one would take them for ORT I have found does not treat pain very well. That is once a day large dosing seems to only keep one from feeling withdrawals and does not provide much pain relief.

I have found that small doses of less than 2mg spread through out the day bring out buprenorphines real pain killing properties. For me it literally turns it into a different drug, very close in the way it feel and works on pain to a full agonist.

I would be happy to go into this more if you are interested.

This is an interesting point to consider. The fact that clinicians are moving towards using the Butrans 7-day patch that slowly releases smaller amounts of burprenorphine more regularly rather than high-dose, once-daily sublingual preparations supports this. Your physicians may be more amenable to prescribing something like this over more abusable full agonists.

Please keep in mind this thread is about Subutex and not Suboxone because of the naltrexone in suboxone.

Put it in bold all you want, in practice they are the exact same because burprenorphine has a higher binding affinity for the applicable receptors so the NALOXONE Not naltrexone, another antagonist) is in effect inactive. ONandOFF nailed it.
 
Buprenorphine is a very decent pain relieving drug; it's still very potent though, and you still can increase regular full agonist opiate tolerance using buprenorphine. Try to keep this in mind.
 
Subutex was completely useless for pain for me. I was always in pain regardless of the subs. There was no difference when I got off them. I was taking 8mg daily.

I've had doctors tell me it's a bad painkiller as well. In my opinion methadone is much MUCH better.
 
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