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PostPosted: Wed May 06, 2009 10:40 pm 
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Since I've been abusing narcotics for years, and on Sub for about 4 months, I am very familiar with the constipation issue. However, last week I sepnt 2 days in the hospital diagnosed with a narcotic ileus that the doctor was 100% positive was caused by the sub. Essentially, your colon becomes paralyzed, and well then it doesnt work and that can be painful, as well as a very dangerous problem. In all my research i had never heard of this. Anyone else ever had it?

It was also intersting that nobody in the ER knew about sub. They wanted to give me a narcotic pain killer, and I had to explain in great detail about the Narcan etc. I was surprised by this. But again, when the surgen looked at me and my cat scan, he knew right away what it was, how Sub caused it and how to treat it.


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PostPosted: Thu May 07, 2009 11:47 pm 
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Yeah I was in the ER once and they had no idea what Suboxone was.. But then again there are 1000's of drugs.

How did they end up treating the condition? Did you have to terminate suboxone therapy or did they do something else?


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PostPosted: Fri May 08, 2009 12:52 am 
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The condition isn't unique to buprenorphine/Suboxone-- all opiates cause an ileus, and it is a major reason for delayed discharge after surgery. So I'm a bit skeptical that a surgeon would be able to identify that it is from 'Suboxone'-- I would imagine that an ileus from Suboxone would be uncommon enough that a person could write up and publish a case report about it.

My trip to DC a month ago was, in fact, a meeting with a pharmaceutical company over this topic. Wyeth has a new med called 'Relistor', and I am a 'speaker' for the drug, meaning that I will be going to dinner meetings and presenting the studies that show how the drug works. It is a very interesting medication-- it is naltrexone plus a methyl group; the molecule does not pass across the 'blood brain barrier' because it is too bulky and 'polar'. It somes as an injection, and it is given by the patient to himself, in the sub-cutaneous tissue of the abdomen. The drug binds to mu receptors at the colon, causing withdrawal of the opiate effect at the intestines... but it doesn't cross into the brain to produce CNS withdrawal! So 20 minutes after a shot, the bowel starts pumping, and the person has a massive BM-- without any other withdrawal symptoms. Cool, eh?

It was funny at the briefing-- a lecturer said that 'Suboxone doesn't work like other mu drugs, and so it doesn't cause constipation... and doesn't block pain pills'. I told him that he was... um.... wrong... No wonder I don't make friends well at those meetings!


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PostPosted: Fri May 08, 2009 1:09 am 
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Interesting doc on that new drug.. So its an anti-loperamide basically? Wouldn't you still get goosebumps or is that purely controlled past the BBB?

Dason, I hope you're feeling better though and they found some way to deal with it without taking away the sub.

I wonder if this is true:

Quote:
Concurrent administration of P-glycoprotein inhibitors such as quinidine with loperamide has been found to produce respiratory depression, indicative of central opioid action. [5] Other P-GP.I.'s include grapefruit juice, black pepper, and most proton pump inhibitors.


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PostPosted: Fri May 08, 2009 2:50 pm 
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Thanks all. The treatment was to not take Sub for a day, stay in bed, clear liquids only. The hospital dog suggests lowering my dose, but I'm not sure i will based only on one occurence.

Doc...you're right it is caused by all opiates, that's why i titled it Narcotic and not Suboxone ileus. Since I'm not on any other narcotics/opiates, its safe to say that IF it was caused by narcotics, then it was the Suboxen which caused it. Having no other history of this it would seem likely that that was the cause, but we will never know for sure. The rarity of it might also be why i never have read anything about this problem with Sub in all my past or current readings. The good of Sub, still out ways this problem, unless it occures again.


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PostPosted: Fri May 08, 2009 3:13 pm 
suboxdoc wrote:
The condition isn't unique to buprenorphine/Suboxone-- all opiates cause an ileus, and it is a major reason for delayed discharge after surgery. So I'm a bit skeptical that a surgeon would be able to identify that it is from 'Suboxone'-- I would imagine that an ileus from Suboxone would be uncommon enough that a person could write up and publish a case report about it.

My trip to DC a month ago was, in fact, a meeting with a pharmaceutical company over this topic. Wyeth has a new med called 'Relistor', and I am a 'speaker' for the drug, meaning that I will be going to dinner meetings and presenting the studies that show how the drug works. It is a very interesting medication-- it is naltrexone plus a methyl group; the molecule does not pass across the 'blood brain barrier' because it is too bulky and 'polar'. It somes as an injection, and it is given by the patient to himself, in the sub-cutaneous tissue of the abdomen. The drug binds to mu receptors at the colon, causing withdrawal of the opiate effect at the intestines... but it doesn't cross into the brain to produce CNS withdrawal! So 20 minutes after a shot, the bowel starts pumping, and the person has a massive BM-- without any other withdrawal symptoms. Cool, eh?

It was funny at the briefing-- a lecturer said that 'Suboxone doesn't work like other mu drugs, and so it doesn't cause constipation... and doesn't block pain pills'. I told him that he was... um.... wrong... No wonder I don't make friends well at those meetings!




Wow, that is interesting. I've been through opiate withdrawal many, many times...but not quite like that. "Be right back honey, im gonna go withdrawal..." KABOOM! Massive BM! "Ok, im good!"


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PostPosted: Sun Aug 09, 2009 10:23 am 
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After a lifetime of narcotic use, I am very familiar with the constipation issues. The product that I have found very helpful is called " Natural Calm". it is an ionic magnesium citrate supplement that you make as a hot drink ( comes in nice flavors) and take at night. It produces a very easy BM within an hour of waking next day. I also take psyllium each day as well. This combo has saved my ass, so to speak, and feels healthier and safer than laxatives. Both products can be found at Whole Foods or most health food stores. or cheaper online. There is no need to suffer that side effect!


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PostPosted: Fri Sep 04, 2009 11:00 pm 
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Location: CHARLESTON S.C
HEY ALL,
THE FIRST TIME I TOOK THE SUBOXONE (WHICH WAS MONDAY), MY DR. DIDNT HAVE ME WAIT LONG ENOUGH FOR THE METHADONE TO BE OUT OF MY SYSTEM. SO THEREFORE I HAD A HORRIBLE W/D REACTION. THE FIRST THING THAT HAPPENED IS I HAD THE SCARIEST BM EVER AND I WAS AT WORK WHEN THIS HAPPENED. I HAD TO GO HOME! ITSCARED THE SHIT OUT OF ME!


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PostPosted: Sat Sep 05, 2009 8:09 am 
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Quote:
I HAD TO GO HOME! ITSCARED THE SHIT OUT OF ME!


No pun intended i'm sure. How much time had actually passed after your last dose of Methadone before you took your first dose of Suboxone?

_________________
An addict in pain suffers thrice:

Once from his disease,
Once from his addiction,
Once from his physician’s ignorance.

Karen Miotto, M.D. - Integrated Substance Abuse Program, UCLA


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PostPosted: Sat Sep 05, 2009 9:00 am 
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Location: CHARLESTON S.C
MY LAST DOSE WAS ON SATURDAY MORNING AT 6:30. 50mg OF METHADONE. MY FIRST DOSE OF SUBOXONE WAS 16mg ON MONDAY MORNING AT 8:00. SO SUNDAY WAS THE ONLY DAY I DIDNT DOSE AT ALL. IT WAS SHITTY....NO PUN INTENDED :D


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PostPosted: Sat Sep 05, 2009 2:12 pm 
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Quote:
Wow, that is interesting. I've been through opiate withdrawal many, many times...but not quite like that. "Be right back honey, im gonna go withdrawal..." KABOOM! Massive BM! "Ok, im good!"


:lol: Lmfao!

I also have learned to manage constipation issues due to my Oxycontin use. I also noticed that constipation is a bit worse on the Suboxone? Here are a few things I can share that help me keep regular once a day or every 2 days max...

1. Raisin Bran or anything Bran. Small bowl in middle of the night or AM works well.
2. Yoplait Fiber One is excellent any time of the day.
3. Over the counter laxatives (Bisacodyl 5mg). I never need more than 2 before bed and I am good the next morning.
4. In a few serious cases I have used a suppository (over the counter). Installing it is not the most exciting thing in the world (lmfao) but 15 min later WHAMMO! :lol: :lol: :lol:

And remember when you FEEL THE URGE (lol) DONT WAIT! Run, don't walk to the nearest toilet and grab some reading material. :lol: :lol: :lol:

_________________
An addict in pain suffers thrice:

Once from his disease,
Once from his addiction,
Once from his physician’s ignorance.

Karen Miotto, M.D. - Integrated Substance Abuse Program, UCLA


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