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 Post subject: Need some advice please!
PostPosted: Sun Jun 09, 2013 11:23 pm 
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Hi all,

I'm in a little predicament and I was hoping for a little help.

About 6 months ago, i started a suboxone program for moderate opiate abuse. After dealing with my really crappy doctor who was trying to over prescribe me suboxone, I designed my own taper program and as of about a month ago, I got down to 1/16th of a strip.

I found out I would be getting invasive nerve surgery on my elbow so I stopped taking suboxone a day before my surgery. The surgery was very painful and I definitely didn't give suboxone enough time to get out of my system, so even quite a bit of fentanyl didn't help much with pain relief. I am currently 4 days out from my surgery and obviously have had to take more than the recommended dose due to my high opiate tolerance.

Originally, I was scared to talk to the surgeon about the suboxone and figured it would be a huge headache trying to get actual pain relief and have them question my every move. Now I'm in a difficult spot. I'm actually really proud of myself because I've been taking the opiates responsibly and not to get high, however I have a really high tolerance to opiates and need to take almost double their recommended dose just to get any relief. It's getting to the point where I'm running out of my first bottle, and honestly need a refill, yet it is too early given the doctor's recommended doses. If I ask them for a refill now, it will surely look like I'm either selling the pills or abusing them.

Does anyone have any advice on what I should do besides tell the surgeon? I know that would have been the best bet from the start, but I just look sketchy if I didn't tell them from the beginning and tell them now. My dad was in the recovery room afterwards and when the fentanyl didn't really effect me he told the nurse I've had problems in the past feeling relief from pain medication (he doesn't know anything, he just saw me after my shoulder surgery a year ago and I had a hard time getting pain relief). I only need one more refill and I'll be good from there, but my next appointment isn't for two weeks and I know I'm gonna run out before then. Should I just call them and be honest and tell them the level of pain I've been dealing with and that I've had to take a little more than the recommended dose?
If anyone could give advice or help out id really appreciate it.

Thanks,

Militarydent.

P.S. please don't tell me to tell the doctor about the suboxone or lecture me on what I should have done from the first place. Telling the doctor now isn't an option for me, and I know I should have told the surgeon in the first place but I was just scared.


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 Post subject: Options
PostPosted: Mon Jun 10, 2013 2:26 pm 
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Hi MD,

By saying "P.S. please don't tell me to tell the doctor about the suboxone or lecture me on what I should have done from the first place. Telling the doctor now isn't an option for me, and I know I should have told the surgeon in the first place but I was just scared. It doesn't leave much of anything else to suggest. No one is going to tell you to do something illegal, or lie to get more. You know as much as anyone here about Suboxone and surgery. The only other thing I can think of is to go back on your regular dose of Sub. But cut it up so you can dose about 4-5 times during the day for pain relief.

Same thing happened to me and I told my Dr. and Anesthesiologist about my Sub use. The end result was the same as yours. Had to double my dose for them to even barely touch my pain. So it might not have done you any good to tell them up front. Most Dr's out there just don't know enough about Buprenorphine unless they've had training. Mine sure didn't.

What I did was call my Dr. and tell him I was doubling up my dose because of tolerance. He went ahead and authorized an early refill. That wouldn't be lying, your tolerance is very high so just say that and see if he'll agree just this once. Tell him that too, only this once.

Good luck with finding some decent pain relief MD. I know exactly what you are going through and how helpless you feel trying to control your pain.

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Don't take yourself so damn seriously


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

  • Board Certified Psychiatrist
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