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PostPosted: Fri Feb 18, 2011 12:26 pm 
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I know this subject has been discussed and I have read more than a few posts on the subject of pain meds & surgery. However since everyone seems to have had different levels of success (some horrific failure stories) with controlling pain after surgery I was wondering if anyone could take a stab at what my experience MIGHT be based on the dose of Sub I currently take.

Today I'm going to see a dentist to see about a disintergrating tooth (I'd rather go see a man about a horse, but ...) . Given that my tooth is about half gone (I was laid off and haven't had the money to go to a dentist) there's a good probability that the dentist will remove the tooth. (Even saying that makes me cringe ... don't like dentists! :( )

Of course, I'll tell him the usual, "I'm opiate tolerant, etc.", but here is what I want to know:

(1) [i]I currently take 1.5 - 2 mg per Sub per day[/i]. While that may seem like a low dose I think we all know how powerful Sub is (even trying to get off it at that low dose caused me to be suicidal because I think my endorphins went on a loooong vacation).

At that dose, can anyone with a high level of expertise and/or experience with this exact situation tell me if stopping Sub 2 days before surgery would be enough?

(2) How much Vicodin (or whatever) would I need to take to combat the very severe pain of a tooth extraction? (I'm also a natural redhead and therefore even more sensitive to pain)

(3) I did read somewhere that there was only ONE opiate that a Sub user can take if they are admitted to the hospital that would have any chance of being effective while someone was on Sub... I think it was Fentanyl. Is this true? If so, would it be better to be given that rather than Vicodin?

(4) In either eventuality--whether I go the Fentanyl or Vicodin route--would it be possible to just keep taking the Sub at the current level I'm taking (I could lower it maybe 1/2 mg per day to where I was taking just 1 mg per day) and STILL take normal levels of pain med like Vicodin. (Though I'm not sure what the equivalent "normal" dose would be at my current level of Sub.)

(5) Alternative: Sub is itself a pain med wouldn't it be better just to increase the dosage of Sub (though I'd hate to do that because it took me a long time to get down to this level 1.5 mg (average) a day.

(6) Finally, can I be given the normal kind of anesthesia dentists give, and, if so, is there anything I need to know about that?

Any help anyone can give would be greatly appreciated. [b]Of course I will contact my Sub doctor and I certainly won't substitute any suggestions given on this forum for whatever he might tell me, [/b]but he is so busy and I'm concerned he won't take the time needed to allay my concerns or get my particular ituation straight from another patient's.

Thanks!


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PostPosted: Fri Feb 18, 2011 1:04 pm 
Hi Piper! Sorry about your tooth! I hate going to the dentist too! You asked for opinions/advice from someone with direct experience with your particular situation.....I can't give you that, as I've not experienced that. However I think I can help you a little bit. I'm not an expert, not a doctor, etc etc. I was an RN for a long time, so I do know a little bit about medications, procedures, etc.
Okay....sounds like you're going to just need to have a tooth pulled, right? Not having a root canal or any other extensive dental work like implants or something like that? If so....if it's just an extraction....honestly I don't think it'll be that bad. Probably what tooth it is, how deep and what kind of shape the tooth root is in will play a role in how easy or difficult the extraction will be (just assuming.....I'm not a dentist or doctor or expert.)
The medicine that it used to "numb up" the mouth for the extraction should work just fine. Suboxone won't have any effect on that whatsoever. I know sometimes (like with wisdom tooth extraction or implants, etc) the dentist will use some conscious sedation which might include an IV with some drugs given through it. One of those drugs might be an opiate...that would be the only thing your Sub might interfere with. I doubt the dentist will have Fentanyl, but I could certainly be wrong. In any case....I've heard, like you, that somehow Fentanyl is the drug that will break through buprenorphine. I don't think I believe that entirely. I've heard a few personal accounts in which Fentanyl was used on a Sub patient and it did NOT work. Although Fentanyl is certainly a good drug and quite effective, I think it's about like the other opioids when it comes to Sub.......it takes a lot more than the usual dose to override the bup. The other thing I wanted you to know was that that particular drug (Fentanyl) is only available for parenteral use (not in pill form) so it wouldn't be something the dentist could prescribe for you. The other type of drug they might use if you're given sedation would probably be in the benzo family. Those meds should work fine, no interference from the Sub there.
For some kind of good news....If you've been on 2mg or less a day for a good while (weeks) you may indeed get decent results with taking hydrocodone (Vicodin) or oxycodone (Percocet) It may take 2 - 10mg tablets to do the job, but I've heard of people on that low a dose of Sub getting some relief with only slightly higher than usual doses of pain meds.
I want to also tell you that unless this tooth extraction turns into something far more complex than it sounds.....you really should be able to get by with Advil or Aleve. As opiate addicts, we really need to keep ourselves away from opiate pain meds unless we're involved in a real serious situation. Not to downplay your situation at all.....I know dental work sucks!
I hope I've helped a little bit. Let us know how it goes. And hopefully someone with more experience will come along and give you more info.

edit: I said that Fentanyl was only available for parenteral use, perhaps implying that it was only available as an injectable medication. As many know, it also is available in patch form and in the form of a 'lollipop.' In those cases, to my knowledge the drug is not to be used in acute pain situations....strictly for chronic pain sufferers or for those who are dealing with end-of-life pain. Again, based on my knowledge, which certainly is limited.


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PostPosted: Fri Feb 18, 2011 4:41 pm 
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Actually, far be it for a lowly paramedic to overrule a registered nurse :) but the lollipop fentanyl sticks are actually intended for instant release (IR), acute, breakthrough pain. To add even a little more credibility to that statement, my doctor was actually going to give me the fentanyl lollipops for pain following some dental issues I was addressing. In fact, it would have finally given me personal experience with whether fentanyl is actually able to overcome Bup or not. My doc claims that it will. Anyhow, by taking 4 mg of Sub every 6 hours (for a day or two) and 800mg ibuprophrine - plus an initial injection of Toradol, I didn't need to try the opiates. So I still don't know if they word as well as my doc claims.

Anyhow, my point is, the pops are there for acute pain. They are supposed to work about as well as an IM injection does. However, like the injections, they only provide relief for about an hour as fentanyl has a really short half-life.


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PostPosted: Fri Feb 18, 2011 5:16 pm 
Now Donh, you know I like you and you know that I think you're one of, if not, the smartest members we've got! I certainly think you're smarter than I am! And I'll admit right off that your knowledge base as a paramedic probably trumps my knowledge base as a former RN!! I'll agree in part with what you've said about the Fentanyl lollipops....yes they are intended for breakthrough pain, but I stand by my statement that they are not intended for acute pain situations. Obviously, a particular physician has the right to prescribe things outside the way in which they're intended by the manufacturer. And often I agree completely.

Here's a quote from the Actiq website. I didn't do any research other than taking about 2 minutes to look this up, so if there's something else out there to contradict what this says, I'm glad to see it. But for the record:

"ACTIQ is intended to be used only in the care of cancer patients and only by oncologists and pain specialists who are knowledgeable of and skilled in the use of Schedule II opioids to treat cancer pain."


"ACTIQ is contraindicated in the management of acute or postoperative pain including headache/migraine."

"ACTIQ is indicated only for the management of breakthrough cancer pain in patients with malignancies who are already receiving and who are tolerant to around-the-clock opioid therapy for their underlying persistent cancer pain."


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PostPosted: Fri Feb 18, 2011 11:08 pm 
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Yeah, SetMeFree, you are totally correct. What was in my head did not make it to the post like I meant it to - not even close. I'm glad you corrected this - as me of all people hates it when incorrect info gets put out there. Let me try this again. What you are saying and what the manufacturer is saying is that these fentanyl "pops" are not supposed to be used like say Percocet or Hydrocodone is used. That is 100% correct. My point was just that the fentanyl patches are meant to keep a long-term steady blood level of fentanyl going. An IV injection or an IM injection on the other hand is meant to quickly address pain (in the hospital setting) and works very quickly and very well - if only for about an hour or so. What I was trying to say was the oral sticks work just about as fast and as well as the IM injection will. So, like you are saying, it is used for breakthrough pain - especially in hospice where you don't want to poke the patient with needles. That's what I had in my head. I didn't at all mean to imply that these sticks should be used like pills or something. Does that make more sense?

See, IF and that is still a big if in my mind, fentanyl actually can compete with Suboxone and actually bind to opiate receptors, these pops are all we would have - at home. The patches are out and I don't think we can or should be injecting ourselves with fentanyl. So sending someone on Suboxone home with Percocet won't work, but sending them home with Fentanyl sticks might. Does that make more sense now?

I really am glad you said something - and see, I told you I was just a paramedic LOL. I don't have four years of schooling nor do I have the depth of education that an RN does. I have two things going for me 1) a decent depth and focus in a narrow area - that being emergency medical issues. 2) Close to 25 years of experience. It's really number 2 that helps me the most.

Crap, put to shame by a nurse again! LOL Did I ever mention that I dated and then was married to a nurse for almost 15 years? Is there any wonder I turned to drugs? :)


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PostPosted: Sat Feb 19, 2011 12:30 am 
Thanks for clarifying donh! I know that you know your stuff! I just wanted it to be clear that the Fent lollies were never intended to be used for acute pain, like a dental procedure. But I hear what you're saying too.....bup patients are a whole different animal....obviously quite opioid tolerant and Actiq might in fact be of use in a few situations with us. It's just outside the 'usual' intentions of use for the drug.
And you certainly weren't "put to shame!" I'm the same as you...a decent depth of knowledge and skills in a pretty narrow, specialized field and close to 20 years of experience in the medical field.....so we're about even!! lol!!
I respect you and the knowledge you have to share for sure!
Main thing is the OP now has a pretty good answer to his/her question. Now hopefully we'll hear back on how things went!


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PostPosted: Sat Feb 19, 2011 8:54 am 
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" Do not I repeat Do not stop your Suboxone daily dosage, unless of course you want to feel real bad, stopping your Suboxone for this would be a bad,bad move , at that low of Suboxone daily dosage you will get a little help from pain pills , not much though... anywhy, both Vicodin or Tramadol will help you , dont complicate things with dentist, he wont give you anything , tell your dentist to take it easy, I had an extraction last Dec. and told the dentist to be gentle and not break the tooth, Please pull it out in 1 piece, it took him a few more minutes , he was happy to remove it in 1 piece... That alone will save so PAIN for you, things will heal faster... also, SME and Don should get a room somewhere , GEEEEEESH..... maybe there will be a lot of make-up sex on this forum now !!!!!!! Mike aka " sullimi " I'm back


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PostPosted: Sat Feb 19, 2011 3:24 pm 
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Thanks, everyone for weighing in and providing clarification within your field of expertise!

I tried to weigh what everyone was saying ("In a multitude of counselors there is safety") though I'm not sure I have enough take-away points to know what to do in my situation.

Let me see if I can "regurgitate" what everyone said as applicable to my situation. But first, here is the report from the dentist:

Surprisingly, the dentist can't tell exactly what my problem is until he experiments first with what it might be. Kind of like taking out the engine of your car (and charging you for it) in order to make an accurate diagnosis of what might really be going on.

Bottom line it's either one (or both) of two things: (a) An old cavity that needs to be removed and re-filled and/or (B) A cracked tooth. Obviously I want it to be the former since the latter would be both super expensive (I was laid off in November and do not have dental insurance) and, methinks, more painful? Anyone had a cracked tooth and needed it capped? Would like to know the pain level on that one.

The dentist (who is a teaching dentist at University of SF and top drawer) told me that if re-filling the cavity didn't work (meaning I still had pain) then he would know that it was a cracked tooth we were dealing with. He said he MIGHT be able to tell it was a cracked tooth after "digging" around (really wish he wouldn't have use the word "digging") during the cavity filling procedure, though chances were just as good that still wouldn't reveal the crack.

Gee, I had no idea that modern-day dentistry was such an iffy science ... meaning that apparently there still is a lot of guesswork involved.

But I digress. I want to address the possible solutions to the pain issue that everyone brought up.

I'll begin with SetMeFree (like the name BTW): You said:

"For some kind of good news....If you've been on 2mg or less a day for a good while (weeks) you may indeed get decent results with taking hydrocodone (Vicodin) or oxycodone (Percocet) It may take 2 - 10mg tablets to do the job, but I've heard of people on that low a dose of Sub getting some relief with only slightly higher than usual doses of pain meds. "


HOWEVER, "Painter" said this:


"With that low of Suboxone daily dosage you will get a little help from pain pills , not much though... anywhy, both Vicodin or Tramadol will help you , dont complicate things with dentist, he wont give you anything ..."



So, one of you is saying I will get "decent results," while the other is saying I will get "not much" help.

Painter also said the dentist won't prescribe either Vicodin or Tramdol anyway? So, you're saying I should get a script (if needed) from my Sub doctor? I'm not sure if he would even write me a script since he is, after all, an addiction specialist. (Though I don't really take Sub for that purpose, but rather for chronic pain because of six issues going on with my neck.)

To add one more voice to the chorus, DonH said this:

[i]" Anyhow, by taking 4 mg of Sub every 6 hours (for a day or two) and 800mg ibuprophrine - plus an initial injection of Toradol, I didn't need to try the opiates."


Don, what you didn't say was how much Sub you were already taking before taking the 4 mg of Sub every six hours for a day or two. Because you know I'm only taking 1.5 to 2 mg. per day (actually it's more like 1 to 1.5 now). So, are you saying that by increasing my Sub TEMPORARILY ( a day or two) to 4 mg (based on the current dose I'm on) PLUS 800mg of ibuprophrine, PLUS an initial injection of Toradol that will probably manage the tooth pain?

Again, I know you are not dispensing medical advice, nor am I taking it as such. I will ask my Sub doctor & would have to anyway if what Painter says about the dentist not likely to prescribe Vicodin, etc., is true.

My appointment for the "exploratory surgery" aka tooth cavity filling is March 1. Not having a tooth filled for decades I don't even know if I will have any post-operative pain but I'm pretty sure that a cracked tooth surgery would definitely result in pain!

I just want to be prepared... script in hand just in case. :)

Let me add here that no one needs to be concerned about my taking Vicodin on a temporary basis because I never did take it to "get high" (else I would have escalated my very lose dose I took for over a year but never did ) but rather to deal with the very real pain in my neck! That being said, I did become physically dependent on it therefore the spinal pain specialist at the time put me on Sub. (I wish he would have just gotten me off the Vicodin instead but since we're not allowed to debate the "Pros and Cons of Sub" in this forum we'll leave this one be.)

Okay, that more than covers it. Anyone want to respond to the "pain relief after surgery" issue adding more clarification/insight that would be most helpful!


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PostPosted: Sat Feb 19, 2011 9:11 pm 
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I'm sorry you mis read my post, I'm sure your dentist will give you Vicodin or Ultrams ( tramadol ) for your pain.. I would be surprised if you get anything stronger.... a couple other posters here over the last year told there dentists they were on Suboxone, they came away from the dentists office feeling they had complicated things, one dentist was afraid to do a scheduled procedure, Mike


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PostPosted: Sat Feb 19, 2011 11:44 pm 
Sorry for the confusion, Piper. I'll try to clear the waters a little bit, as best I am able.
I stand by my belief that you will likely get some relief with 10-20mg of hydro or oxycodone (oxycodone usually being considered a little 'stronger') I say this ONLY because you are on an extremely low dose of Suboxone. I have heard from at least a few people that they did indeed get some relief with those meds at those doses while on 1-2mg/day of Sub....one of them was needing pain relief for kidney stones. The thing is our tolerance to opiates is just so high while on Sub and for a good while after stopping it. But it is at least somewhat dose dependent as to how blocked we are. If we're above the ceiling dose (usually considered 4mg or more) then we're pretty much screwed in terms of getting pain relief from narcotic pain meds. So.....I still think that if your dentist feels you need pain control after the procedure, he would likely prescribe something like Vicodin or maybe Percocet and that might just work if you're given a high enough dose....NOT 5mg Vicodin, as that probably won't do anything.
The other thing that could happen is that you ask your Subox doctor to write you for pain meds after the procedure if they are needed. This is how my Subox doc said he would handle it if I ever needed surgery or pain control for any reason. He said he'd make sure I'd get oxycodone...along the lines of 15mg tabs or stronger. Some Subox docs are well-familiar enough to know what it takes to override bup, some aren't or aren't willing to prescribe such things. But it would be worth asking your Subox doc what his take is on your situation.
As to taking more Suboxone for pain....I have heard that can work, although personally I think bup is a piss-poor pain reliever! But that's just my opinion. That doesn't mean that approach wouldn't work for you.
Here's the thing though....I have had a cracked molar tooth due to an old filling disentegrating. The tooth actually broke in two! It did not cause me a lot of pain however. I was actually pregnant at the time and this happened long before I became addicted to opiates. In any case....it wasn't a big deal to have it fixed (crowned and all that good stuff) I didn't need any pain medication at all. Another instance I had was also before my addiction....I had a tooth go bad and that was some of the worst pain I've ever suffered in my life. I ended up needing a root canal and the whole nine yards on that one! The thing was....I was given a script for hydrocodone for the pain and it did really absolutely nothing! It didn't touch the pain. Advil worked better!
During the dental procedure itself you should be perfectly fine pain-wise because of the local anesthetic they'll use. Most of the time once the tooth is fixed, the pain is usually not all that bad. Asking for an injection of Toradol (a strong antiinflammatory) is a great idea as it works really well and follow that with ibuprofen at home and I wouldn't be surprised if you do just fine with that.
I guess none of us can tell you exactly how all this will come down...even your dentist can't!! Just keep in mind, if you do go through some discomfort it will be very temporary.
Congratulations by the way for getting so low on your Suboxone. I'm glad you're not like most of us here and never had a big addiction to opiates, just a heavy dependence. Because if you'd been addicted, I'd beg you to just try and tough it out with no narcotics no matter what!
Let me know if that helped or if there's anything else I can try to answer to make it more clear. I'm just afraid there's not going to be any ONE answer to your questions, you know?
I really do think you're going to be just fine though!


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PostPosted: Fri Feb 25, 2011 9:30 pm 
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I just had a tooth extraction and root canal while on about 3mgs of subs. I took no opiate pain killers no did I stop my subs. The numbing and OTC pain killers were enough. I have a tooth with a root canal that may have developed a crack. I'm going back next week for more work. My dentist has said that I will not need any narcotic pain killers and he has been right. (so far)

All I had from the last visit was a dull ache for about 2 hours after. And that was it.

I do not think you should go off your subs or take any opiates. They will not be as effective, so you'll be tempted to take more, this can raise your tolerance. The sickness you'd have to endure from withdraws to first get off the subs, then off the pain killers and back on the subs will be far worse than any tooth pain.

Ask around, dentists do know how to work without narcotics. They even have tooth numbing medicine that works for days that can help you.

BEST!


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PostPosted: Sat Feb 26, 2011 9:27 am 
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I've had several root canals while on suboxone and I am having a failed root canal extracted on Tuesday of next week. I will not stop taking my suboxone, nor will I receive or need any opiate pain killers for after the extraction, tylenol is more than adequate for that kind of pain - at least for me it is.


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PostPosted: Sat Feb 26, 2011 1:52 pm 
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I had a tooth with an old filling in it crack almost in half. I got it capped with the use of novacaine and was told to take Advil afterward. I didn't suffer any pain, and I'm usually a big baby about these things.


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PostPosted: Thu Mar 03, 2011 12:54 am 
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not sure if this is a bit late for you but I had a similar situation was taking 2mg of sub daily and had some nasty dental work including two extractions a root canal and crown prep done in one visit was in the chair for a few hours. I had my dentist give me a few valium one for before the appt and some for after and I just slept the day away took Advil round the clock but I was ok, boy in the heyday would I have "needed" lots of perc for that one. Advil really works just take it round the clock and it helped me tons I was bale to work the next day and just a little sore. definitely better to get it handled though I could have avoided so much work if I wouldn’t have been so terrified, good luck.


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 Post subject: surgery and suboxone
PostPosted: Mon Mar 07, 2011 9:25 pm 
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I too am a new comer who is potentially facing this issue. I am on Suboxone because I had three joint replacements spaced out over 9 moths plus months of pre-surgery painkillers and then months of physical therapy and painkillers and my knee never healed correctly---the ortho-surgeons want to redo it (I am told this is very traumatic). Naturally I am frightened and holding off as long as I can.

My experience to date with surgery and suboxone:

I had an erupted wisdom tooth and a broken tooth next to that one. Both were extracted. I had stopped taking the Suboxone (16 mg a day) two days prior to surgery. I needed twice daily 50 mgs of Percocet for 2 days to be in a state where the pain/withdrawal was mitigated (no real "pain-killers" I believe unless you are dead). I went back on the Suboxone on the 3rd day after surgery. The dentist, lucky for me, was young and understanding and told me to take the dose I needed of Percocet (though he wrote some ambiguity on the prescription). I needed to dose to 50 mg. By comparison, before I got on Suboxone originally I was on 320 mgs a day combined Oxycontin/Roxicodone as a result of 3 surgeries. I tapered to 60 mgs trying to detox but could get no further so went to a clinic where Suboxone was used. Have been on ever since. It is a fairly good medicine for chronic pain if other narcotics cause you mental/emotional instability like they do me (another reason I am so afraid to have my knee "fixed" again).


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PostPosted: Mon Dec 10, 2012 8:13 am 
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I got a tooth that almost cracked in half, however my dentist was awesome, like he did magic and I forget about my pain, I didn't suffer any pain and he fitted the cap :D

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PostPosted: Mon Dec 10, 2012 10:54 am 
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For what it's worth, my post just before your's may help you. I was on 1.75 mg. of Subs. Had Carpal Tunnel Surgery last Wed. Stopped Subs 24 hrs before, then have managed my pain on Percoset (2 every 4 hrs at first, now stretching time out to 1 pill every 6-8 hrs.) with no Suboxone now for 6 days. I have felt some withdrawal but not too bad. Restless legs, lack of sleep but no horror story yet. My biggest suggestion is let your dentist know exactly what's up with the Subs-this was my greatest tool!
And for what it is worth, I had tooth pulled in Mexico a few years back and the doc there only gave me a NSAID shot of some kind. I never had to have opiates (I think maybe dentists in Mexico cant prescribe opiates? I was not on Subs at the time).
Good luck!l


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PostPosted: Tue Jan 22, 2013 10:09 am 
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My husbands mother, who is now passed was on Fentanyl patches AND Percocet Liquid like cough syrup. She had metal cages in her back and 13 steel rods with screws, she stayed in chronic severe pain every day of her life up until the day that she slipped into a coma. She said that the Fentanyl patches helped her alot, but she hated being on them because they were very strong and made her very sick the first day.
There at one point, she just stopped them for a week or so and used the Percocet cough syrup which was plenty enough for her she claimed. She would never take more than she was prescribed and half the time didnt even take what she WAS prescribed. The only time that I have ever had Fentanyl was when I came out of surgery with appendix or maybe I had it before hand. That whole experience was and remains foggy to me even now. I remember hurting,getting to the hospital and the rest is a fog.
The pain medication that I have had the most when I had teeth pulled or cut out, most of mine have to be cut out because they are in such bad shape from years of pain pill abuse. The pain medication I got the most was either Dilaudid or Percocet 10's.
The drug that they gave me the last time that I had teeth cut out, I honestly have to say I wish I could have one more time LOL. That might be wrong of me to say, but it was hilarious. I cant remember the exact name of it, it was an odd name. It didnt knock me out completely, I did wake up mid OP, I didnt feel a thing just a little bit of pressure. They asked me if I felt anything when they gave it to me in my IV, and I said nothing yet then the wall infront of me kinda extended out like the room was moving or something. It wasnt scary at all, just funny.
It was an odd experience to say the least. If I hadnt been a pill head in those days, I could have taken a few pain pills for a couple of days and been fine. My fear of withdrawal symptoms kept me from coming off anything, I didnt want to have that yucky feeling for a couple of days where I had been on pills. If anything, I would up my dose of Suboxone a little bit to combat the pain and say hell with it to the rest. I know that while being on Suboxone myself, I cant stand to even be around the pills. I dont like them near me or even to touch one makes me shiver. Not sure why I do that, I just cant stand to be around them.
I know its taken alot of time for you to get your dose down, but if you didnt have a ton of trouble getting it down just a lengthy time up it by maybe 1mg or 1.5mg and see if that might help, then slowly come back down to where you are now. You dont want to mess up and take something that might mess up all the time that you have put in Suboxone to waste.
I know now if I have something done like teeth pullings or whatever, I am going to just tell them to let me have my Sub for pain meds. It will keep me from getting on anything else nasty and I wont have to worry about tapering off one and back on to something else.


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PostPosted: Thu Feb 14, 2013 3:29 pm 
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Sorry to hear that, it hard watching someone in pain. Fentanyl was by far the strongest opiate I have ever taken. Years ago before on subs I had one of those fent lolly pops. I thought it was similar to percocet then so just ate it. That was like an outter body experience. I was trying to call for help but couldnt speak. Almost lost it then it wore off rapidly. Good thing its just a quick deal but not sure what the point is of making fast acting pain relief. What happens in 30 minutes when wears off? Few years later I was on subs and suffered massive injury, basically broke my leg/hip multiple spots. On arrival to the trauma center via ambulance I was given maximum dose of iv fentanyl. The whole time I asking nurse for more because not feeling it at all. This was partly due to injury but also because of suboxone. It took several days of taking real pain meds to start feeling the effects. Most drs and nurses never even heard of suboxone or willing to understand my situation. Therefore I lay there in agony for weeks. Finally the pain management team comes and authorizes a morphine drip. They bring in machine and put next to bed but not hooked up. I waiting and waiting and nothing. I think these scum of the earth doctors took my morphine and ran with it. Probably passed out in the lounge while I dying in room. Eventually I made calls and rounded up a huge stash of oxy, roxy, and percs. The nurse would come in a give me my 5 mg perc(lol 5mg for me when I shattered whole left side of body) then I would say thanks and take my real meds. In your face dumb ass corrupt hospitsl of junkie nurses. Getting pain meds is like pulling teeth. I not sure what has to happen to get real meds, maybe head falling off. They make mundreds of useful pain meds better than 5mg perccocet but these doctors think its like giving someone heroin. Basically you have to lookout for yourself. If you know you have a high tolerence to pain meds and most doctors not willing to help you out best to bring your own meds with you. Dont mix subs with real pain meds, huge waste. Just stop for 24 hours and start up the real pain meds. After procedure finished you have subs there waiting for you. Thats what I try explaining to these nurses who thought 5mg perc was huge dose. I a pro at this been going on and off pain meds thru all my surgeries. Always have the subs ready for when it time to stop. I already been a bad junkie and no hopes of returning to that. If I on pain meds belive I in massive internal pain from surgery only. No more recreational medicating what so ever. Just make sure you wait at least 12-18 hours btw last dose of pain meds and first dose of subs and you will have limited wds.


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PostPosted: Thu Dec 12, 2013 7:44 am 
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Joined: Thu Dec 12, 2013 7:38 am
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Hi, I can shed some light on this topic for people. This is 2 years after the thread was started, so my post is only to help people who google searched this topic and came up w/ this old thread, and used it for info like I did. I take 2mg/day of suboxxone. I had an oral surgery that had complications that were unexpected. They were to simply extract a tooth and fill with bone-granules that would turn to bone as it healed. Low and behold the tooth root was attached to my jaw bone. They had to cut some of that bone. Therein lies the pain.
This all happened yesterday. I was in tears, and the dentist wouldn't give me anything (besides ibuprofen which has never done anything for me). After leaving, I called back twice and finally they have me vicodin. I had been crying for hours at this point, frustrated with them. Bleeding still, extreme pain.
I took 2 of the vicodin 7.5s. I got perfect pain releif. No "high" feeling. I just wish they could have prescribed it sooner rather than wait so long until I practically demanded it.
So, I agree with Piper, 5mgs of hydrocodone would not bode well. 15 will however.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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