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 Post subject: In a dillemma..
PostPosted: Mon Apr 06, 2009 10:37 pm 
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I have been on Suboxone for about 3 weeks now and have been doing awesome. I was put on suboxone for my addiciton to painkillers. I started self medicating myself 2 years ago to help deal with my Chrohnes disease pain then it soon became purely recreationally. The problem I have now is that I was given a script for percocet from my primary care due to a flare up of my Chrohnes disease. I never told my primary care that I was seeing a Dr for Suboxone because of my painkiller addiction. I quite frankly was embarrassed and thought I could do this on my own. I have never asked him for painkillers in the past nor my GI DR. I was in on a routine visit and happened to be going through a flare up of my conditin at the same time. He offered to give me some pain meds to help and I of course did not turn them down.
Today I went to fill my Rx and the pharmacy that I went to called my primary care DR to see if he was aware I was also being RX'd Suboxone from another Dr. Well of course my primary doesnt know about the suboxone becuase I never told him about it. The pharmacist then called me over and said that he had called my primary about the Rx and that he did not know about the Suboxone I was also being RX'd. He also then said he was going to call the suboxone Dr to inform him of my other script. At that time I told the pharmacist to forget it I did not want the RX filled.
Now I dont know what to do..
My primary now knows about the suboxone and Im not sure if the pharmacist called the suboxone DR after I left..even though I had said to forget it..

The worst part is that I have been in extreme pain and tried to fill the RX to legitimately help with the pain. I dont really care too much about getting high like I used to.

What do I do..
I feel like crap because Im sure my primary thought I was trying to pull a fast one on him.
I also dont know what to tell my Suboxone Dr as I am seriouse about my rehab.

What do I do when I have serioiuse pain issues...

I have an appt tomorrow to see my Sub Dr and I think I may tell him straight up what had happened instead of him finding this out 3rd party.

Any advise??


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PostPosted: Tue Apr 07, 2009 2:01 am 
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I hate to burst your bubble, but any opiates you take while you're on Suboxone won't do a daaaaamn thing. Believe me, I have taken MASSIVE doses of morphine IV, but Suboxone completely and totally blocked the effect, and once or twice I actually had an allergic reaction when trying to use both at once.

Your best bet is to take Advil or Aspirin, things like that. Or look for some natural remedies to help with your pain, because the pills honestly, won't do anything.


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PostPosted: Tue Apr 07, 2009 2:15 am 
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Thanks for the reply however that wasnt my issues. My issues was the fact that now my primary care is aware of my suboxone and Im worried my Sub Dr found out about me getting a script for percocet.
Will I have an issue with my insurance filling my Suboxone script now seeing I got a percocet script filled too?
I have blue cross blue shield HMO.
Id hate something as stupid as this screwing up my rehab.


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 Post subject: a little insight
PostPosted: Tue Apr 07, 2009 11:29 am 
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I just joined this forum and I want to first start off saying. I have been on Suboxone for 1 year and a 1/2. This is my second attempt at suboxone and has been very successful.

The first time I took it, I was in a very similar situation as you are now. I didn't actually have a Pharmacist call the doctor, but I did try to use opiates with the suboxone, and i will tell you it threw me into sever withdrawals. I know this is not what you asked about though.

Hopefully you are seeing a doctor that you are getting the suboxone from that has other patients, and understands a little what you are going through. If you are believe me he has patients that have fallen off the wagon, and come back to try again. The bottom line is you are in pain because of the other illness. you have to let the Suboxone Doctor aware of this and then he can hlep you find a pain medication that can go with the suboxone. the most important part is to be honest. To me it is natural that you agreed to the opiate script from the other doctor. I mean you are only 3 weeks into the suboxone, maybe you thought you would be able to take both and you wouldn't be addicted?? that is what I thought then it backfired on me!!
I really think if you are just honest with both doctors they will help you. Just always remember you are getting help and yes it is embarassing to have to admit defeat, but the doctors can't help you unless your honest. I am sure both doctors can come up with something so you are not in pain. But if you hide it you will never be treated for your other illness like you need to. Also I do nto think the Insurance company is going to do anything.


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 Post subject:
PostPosted: Thu Apr 09, 2009 11:49 am 
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Oxyclean wrote:
Im worried my Sub Dr found out about me getting a script for percocet.


I'm new to this forum but your post caught my eye because I was just prescribed Ultram yesterday for pain. I realize that Ultram is not a narcotic; nevertheless, I have read where addicts have had issues with it.

I'll be perfectly honest with you... I'm going to tell my Suboxone doctor about the Ultram script because I have to be honest with myself in my revovery. I hope that my Sub doc has no issues with the Ultram, but at the same time, I hope that I can at least get a LITTLE benefit (read numb/buzz) from the Ultram, which of course I'll have to admit to my doctor which in turn will probably preclude him from permitting the script. This honesty stuff sucks!! Like a previous poster, he'll say... Advil (which doesn't work BTW).

I guess what I'm saying with this post is, first of all, I can't imagine getting a perc script filled strictly for pain (my DOC being oxys). To me ... that's simply unfathomable and I encourage you to speak with your addictions doc or someone (sponsor maybe?) to see if your disease is clouding your reasons for filling the script. Sorry to question your motives, but THIS addict... percs solely for pain... there just ain't NO WAY!!!

All that being said... I didn't know that a pharmacist could call a doctor NOT prescribing a drug to tattle on you about a prescription from another doctor. So that... the primary could be called about the perc script, but the sub doc couldn't be called until you tried to fill a Suboxone script with a valid perc script still open. Live and learn the hard way??? Ouch!

As this was posted a couple days ago, I'd be interested in reading what happened. Hopefully, your sub doctor realizes that stupid stuff, like you just did, is what addicts do (especially if your motives weren't pure). The insurance company shouldn't have anything to say about it. IMO. actually, if I were you, I'd call them and explain the situation. Unlike an oxy lover like myself, they might not scrutinize your motives.


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PostPosted: Wed Apr 15, 2009 6:41 pm 
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Well, tramadol isn't a "narcotic" in the legal sense (it's not in the schedule of controlled substances maintained by the DEA), but it gets about 1/2 of its analgesic activity by acting as a codeine-like "pro-drug": tramadol is a mixture of 4 stereoisomers (mirror-image arrangements of molecules), one of which is converted by the liver into a mildly potent (say, between Darvon and Demerol) opiate agonist. So, you would expect that opiate aspect of tramadol's analgesic activity to be fairly well blocked by a drug like Subutex or Suboxone.

Strangely enough, when tramadol is administered along with a pure antagonist like IV naloxone (naloxone taken orally or sublingually either isn't absorbed well and/or is destroyed in the first pass thru the liver), tramadol still seems to keep about 1/2 of its pain-relieving activity; this is believed to be because of non-opiate effects on the neurotransmitters serotonin and (prob. more important) norepinephrine. This is somewhat similar to the antidepressants Effexor and Cymbalta, which are sometimes used to treat neuropathic pain such as is seen in diabetes, shingles or fibromyalgia. So, the other stereoisomers of tramadol act on the reuptake of these neurotransmitters and somehow contribute to the reduction in the perception of some forms of pain, without acting like opiates.

This is another reason why the very small group of people who get really hooked on tramadol find that tramadol's "withdrawal syndrome" is unique, because it includes some features of opiate withdrawal, but is also mixed up with the well-known spacey/weird problems with suddenly stopping or even missing doses of some SSRI and SNRI antidepressant drugs, especially those with short half-lives (Paxil and Effexor are notorious for this). That can really complicate matters and confuses the hell out of doctors and patients who assume that tramadol is just another weak/mild opiate.

/FooBear


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 Post subject:
PostPosted: Mon Apr 20, 2009 10:56 pm 
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but I did try to use opiates with the suboxone, and i will tell you it threw me into sever withdrawals.



Hey micki how can that be posible? The subs would block the opiate. The opiate would not tear the subs off the receptors.


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PostPosted: Tue Apr 21, 2009 12:32 am 
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As for the first post... patients don't realize that pharmacists call the docs all the time! I get a couple calls per day about this or that patient who just got a script from a different doc, and do I still want him to fill the other script?

All Suboxone programs will have a 'contract' that says you MUST tell the sub doc before using any other narcotic (and before getting a script filled). I don't 'fire' patients for the first violation-- usually-- but at some point if it is clear that the person isn't being honest, you have to stop. Some will say that you should continue because it is still helping the person, but in reality opiate dependence is very powerful and very dangerous-- and once a person goes back to routinely lying, even Suboxone won't save him-- things will soon fall apart.

All of us addicts want to be our own doc; it is sort of funny how people start to take narcotics so lightly, and just take them while ignoring the instructions-- even though they are more dangerous than most other pills! When an addict decides to stop-- either using Suboxone or using steps--he or she has to put up firm, permanent boundaries to certain behaviors. NO MORE treating one's self; even I (I'm a doc) had to call the doc to take anything-- even to take ibuprofen-- because the risks are so great that I would violate a boundary and then keep going further with it.

The other point-- you don't generally get sick if you are on bupe (sub) and then take an opiate; SOME people claim to get some pain relief, and there is some science behind the idea that an agonist may do something at a different receptor subtype in SOME people and reduce pain. But you won't get w/d because the bupe is there for days, at a high level; taking the next dose of Suboxone doesn't appreciably change plasma levels of buprenorphine-- it just helps keep the level from dropping.


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 Post subject: don't know???
PostPosted: Tue Apr 21, 2009 1:24 pm 
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Hey micki how can that be posible? The subs would block the opiate. The opiate would not tear the subs off the receptors.



Sorry I have been on vacation, and haven't been around for a week. I would have answered sooner.

You know I wondered the same thing when that happened to me. I don't have an answer for you. At that time it was my first time taking Suboxone and I of course relapsed and wanted a Lorcet (that was my addiction) So I convinced myself that it had been 2 weeks, the withdrawal phase from the Lorcet was done, so I should be okay to take Lorcet for a couple fo days, and then I will be done with both forever (yeah right) So that is what I did. I bought 10 Lorcets I took 5 one day, and 5 the next day. THe night of the second day, I could not sleep, I had the chills, just like when you go into withdrawals, when you stop taking opiates. At that time I was going to a daily clinic that dispersed Methodone, and Suboxone. So i had to see them everyday. Of course they were calling me for 2 days wondering where I was. I called them the next morning, explained to them that I had fallen off the wagon, explained how I felt the night before and they of course todl me to come in. When I got there the Doctor told me, that while Suboxone is in your system, and you take an opiate it throws you into sever withdrawals. He said Suboxone stays in your ssytem, and you have to wait for it to get out of your system, before you can take any opiates.

So I believed him. I have never tried it again together, because I hate the withdrawal feeling. So maybe he was wrong, I am guessing he was by the other posts. I was just sharing what happened to me and was going off of what I was told.


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PostPosted: Thu Apr 23, 2009 12:05 am 
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A Doctor told you that? See how unimformed some Doctors are. He is the type that is just in it for the money. Never learned a thing when he had to take his so many hours of education to give prescription for subs. Thanks for clearing that up micki.


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 Post subject: now
PostPosted: Thu Apr 23, 2009 10:23 am 
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Well now I have a wonderful doctor, that is supportive and seems to know Suboxone pretty well... I have never asked him about what would happen if I took opiates with it, because after the first time I don't want to go through that again, but also I really haven't wanted to. The clinic situation where you have to go everyday to get your medicine, really makes you feel dirty and like you are a criminal, the way the nurses treated some of the people was unreal!! they even treated the Suboxone patients like we were special. One nurse even told me, the heroine addicts stay out in the waiting room, the suboxone patients are patients that didn't mean to get addicted to opiates. He even went as far as saying the heroine addicts had a choice! I have to say, me, myself disagrees with that a drug addict is a drug addict and I am one. I think if you are truly dedicated to stop the addiction then they should support the best they can. There was no support given, nothing. I should have known that was not true!! :? Oh well, at least I don't have to go back there!! It was also the only doctor at the time I could find that was even willing to do a suboxone treatment. It seemed like after I relapsed and started using again and continued for a year... after that year when I decided to stop it was much easier to find a doctor.

I know I am rambling, but I do talk alot!!

I have to say I love this forum it is very helpful. I should have searched a long time ago!!


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 Post subject:
PostPosted: Sun Apr 26, 2009 1:19 am 
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I think that doc told you that taking opiates while on suboxone throws you into severe withdrawals was just trying to scare you from relapsing or something i dunno. I do know that I have taken opiates while suboxone was still in my system and I most definitly did not go into withdrawal what so ever. I really dont see how that is physically possible.


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 Post subject: well......
PostPosted: Wed Apr 29, 2009 8:16 pm 
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it worked :D I didn't do it again!!


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PostPosted: Thu Nov 19, 2009 3:19 pm 
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The only way you'd be thrown into severe withdrawals is if you decide to take Suboxone AFTER taking a full mu agonist opiate. The Sub will kick the other opiate's receptors off the site (suboxone competes for and wins most receptor sites). It is the fact that your drug of choice is being ripped off the receptor sites is what causes precipitated withdrawal, just like with Narcan in an ER used for an overdose. However, you will NOT get high if you take an opiate AFTER taking suboxone. The Suboxone sits on the receptors, thus keeping them filled and blocks any receptors from your DOC.


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PostPosted: Sun Mar 07, 2010 4:27 am 
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Being over 50, I am getting arthritis in both shoulders. When I mentioned this to my caseworker, I asked what to use for the pain as aspirin/paracetamol/ibuprofen do nothing and i can't take an opiate. He suggested DICLOFENAC, which is marketed under the trade name VOLTAROL in the UK and VOLTAREN in the US and Australia. It is a NSAID ( non-steroidal anti-inflammatory drug).This comes as tablets or as a topical gel, I have had both and they are very effective at damping down the pain, which can be bad enough to keep me awake some nights. See this link for more info:
http://en.wikipedia.org/wiki/Diclofenac
I have searched the web for articles on possible dependency on this drug, but have so far found nothing. However, I would be cautious. The drug companies would have us believe that EVERYTHING they sell is totally safe, until the casualties start suing them. I have kept my own use of this stuff to a bare minimum, using the gel only on nights when the pain is simply unbearable ( it works a treat!) . The only time I took the tablets was during a hospital stay in the summer of 2009, and found a single tab works very well also. One tablet contains diclofenac potassium 12.5mg.
I hope this information will be useful to some of you who are suffering chronic pain, we have suffered enough already.


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