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PostPosted: Tue Sep 20, 2011 8:52 am 
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my brother was admitted to a hospital about a week ago for MRSA . It has spread throughout his insides and the pain is unbearable. He is prescribed Subs and the staff was not administering pain relief to him for who knows what reason. First we thought it was cuz hes an addict and they refused, or cuz the Subs automatically block the relief from Pain meds?? either way we finally got a new dr. to look at him yesterday ( mind you, he has been in pain for 5 days prior to this drs. visit and has yet to receive any help) And this dr. was furious that the hospital has not done anything for him. Her suggestion was to give him Methadone w his Subs.. So my question and or concern is - will that work for his pain?? and if not, what will? why would they make a medication ( subs) that allows for no releif of pain meds when they are highly needed. What do you do if you need surgery?? i dont understand. Please help. I have not called today to see if the methadone has helped at all or not. I do know last night they wanted to do CT scan and his pain was so bad he couldnt even lie down to get it done. I dont know how much longer i can bear to see him in this pain. Any advice or knowledge would be greatly appreciated.. thanks

Concerned Sister


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PostPosted: Tue Sep 20, 2011 9:07 am 
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I would strongly suggest they give him methadone WITHOUT the Sub, as the Sub blocks the effect of full agonists. Has he been off the Subs for the past 5 days? If so, he should be able to get some relief from any full agonist, such as IV morphine or dilaudid. He probably will need more than a typical patient. Treating an addict in pain with opiates is NOT a relapse. They need to stop the Sub and give him whatever will give him some relief. I wish him the best, and if you can please come back and let us know how he is doing.
Lilly


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PostPosted: Tue Sep 20, 2011 9:31 am 
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I was going to say the very same thing Lilly said - that they can administer Methadone without the sub. There's no need to combine them and methadone is a great pain reliever. But - also like Lilly said - morphine or the like should also help.

As for suboxone blocking other opiates, it's a manifestation of suboxone's treatment properties for addiction. It blocks opiates so even if the person relapses, they can't get high. There are different, often challenging, ways for us to get pain relief if we require surgery while we're on suboxone.

I hope your brother gets the pain relief that he most definitely deserves.

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PostPosted: Tue Sep 20, 2011 1:37 pm 
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How awful! That poor man having to deal with such pain and receiving no relief from the hospital.

What I don't understand is when I was first started on Sub my doctor gave me a card to carry with me at all times in case I was hospitalized and needed pain relief. It clearly states that the patient will need more opiates for pain to have an effect due to the Suboxone. Did he not get that card? If not, I would contact his doctor for another one or print something out from Here to Help or a website that describes what Sub does and how to receive pain relief.

He should not be suffering like that for any period of time. And if they are refusing the meds because they are calling him an addict then that would be grounds for some type of complaint. When on Suboxone, the patient is considered "In Remission". At least that's what my doctor calls my diagnosis.

It is really good you are there to act as an advocate. At least someone is fighting for his well being.

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PostPosted: Wed Sep 21, 2011 10:19 am 
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Hey 5yrscln...I'm sorry you all are going through this. Doctors can be insensitive when it comes to addicts. It sounds like they would like to keep your brother as clean as possible. I'm a former Pharmacy Tech, and am presently a RN. Sub IS used for pain. It's an old drug...a synthetic opiate, also known as Temgesic. They have been using the patches for years. I used to fill in-patient orders back in the 90's for patients who were in acute pain. It sounds like it's not working for your bro though. DEMAND a consult with the pain clinic. They put together cocktails that can be used for pain. Some of the drugs are addictive, many of them are non-addictive. See how it works. MRSA is a bear and I truly pray that he will be o.k. Good luck!


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PostPosted: Wed Sep 21, 2011 10:24 am 
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Oh, and the card they give you to carry usually tells the doctors that you are a sub patient. Sub has naloxone in it and if you are given opiates you could go into precipitated withdrawals. The sub has only a little naloxone, but IF you are on naloxone for cravings, then you're REALLY at risk for the precipitated withdrawals.


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PostPosted: Wed Sep 21, 2011 11:51 am 
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foundhelp wrote:
Sub has naloxone in it and if you are given opiates you could go into precipitated withdrawals. The sub has only a little naloxone, but IF you are on naloxone for cravings, then you're REALLY at risk for the precipitated withdrawals.


Actually, if a person on suboxone takes a full agonist opiate they will NOT go into precipitated withdrawals (P/W). It's actually the reverse - if a person has been on full agonist opiates and they take suboxone too soon, then they will go into P/W.

Also, when this was said: "IF you are on NALOXONE for cravings...", I think the author meant Naltrexone. Suboxone has naloxone in it, but that is different from Naltrexone. It's a common error and we've all done it. The naloxone in suboxone is there to deter people from shooting it.

I hope this clarifies things.

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PostPosted: Wed Sep 21, 2011 5:15 pm 
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Yes Hatmaker, I did mean naltrexone. Both are opiod agonists. Naloxone being the better of the two when used in overdose. However, the hospital mostly uses the IV push method to quickly administer pain meds. Right into the veins....Same as shooting up. If they give him the pain meds he should take them via the oral route.


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PostPosted: Wed Sep 21, 2011 8:13 pm 
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I'm sorry to be nitpicky, but buprenorphine is the partial opiate agonist, whereas the naloxone is the antagonist (as is naltrexone).

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PostPosted: Wed Sep 21, 2011 10:10 pm 
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Please keep us update sorry I haven’t posted but I have been following this thread closely. The whole methadone with suboxone thing like the others said is really not the best idea. He will not get much pain relief, it is a strong opiate but not strong enough to break through the blocking effect of suboxone unless in doses that are unheard off. As of why the DRs didn’t help him for those 5 days is not right but most ER Dr don’t know enough about suboxone to understand the protocol to give someone pain relief on suboxone. You need very strong medications and the average DR in the ER is not going to give these meds out to most people in general on suboxone or not. But the best route you should take is call his suboxone DR he should know what to do and in most cases would prescribe the medications he needs to get pain relief.

I really hope your brother gets better.

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