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 Post subject: pain
PostPosted: Fri Sep 18, 2009 3:28 pm 
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I am taking 16mg of suboxone a day, 4mg tabs 1 twice a day. I have been on suboxone for a little over 2 years now. I started taking it after several failed attemps to stop using opiats. I have taken nothing but the suboxone for the last 2 years. I have had 3 surgeries for cervical fusions, 1 to fuse c5,c6,c7 and the other 2 to fix the mistakes from the first. Between the first and second surgery I developed severe musce atrefy in my left soulder and back. I was much better after my last surgery July 5th 2007. Quit taking pain meds July 11th 2007. Nothing but suboxone since then. My problem now is I have severe pain in my left shoulder that requires surgery. Can I take pain meds while on the suboxone, or do I have to stop the suboxone. I fear if I stop taking the suboxone I will be right where I was prior to July 11th 2007. My addiction to drugs started when I was a teenager and I am now 42 years old. My addiction to opiates started in 1991 and until the suboxone the longest I had made it since 1991 without doing opiates was 2 weeks. Dont know what to do, can"t take much more of the pain.


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PostPosted: Fri Sep 18, 2009 7:37 pm 
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Hi & welcome to the forum. You will need to speak with your Sub doc and your surgeon about pain management for the time right after your surgery. You will likely have to stop taking the Sub for at least a few days prior to surgery, but the lower you can get your dose before that the more you can bring your opiate tolerance down.

A few people around here have had surgery while on Sub. Most of them just stopped taking Sub for a few days before surgery and for a short while after they took whatever full-agonist opiates their doctor prescribed. Then they went back on Sub. A member called Opiate Dependent MD said he keeps his surgical patients on a low dose of Sub (2mg maybe?) and then prescribes full-agonist opiates for post-surgery pain. Yes, you can take both at the same time. As long as the Sub dose is low enough the full-agonists will still work. Another member suggested a nerve block as another option.

Because of your Sub dose, your opiate tolerance is going to be high, so make sure there is understanding all around and a good aftercare plan in place for you. Best of luck and let us know how things go.

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PostPosted: Mon Oct 05, 2009 3:45 pm 
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Even at 2mg, Suboxone binds tightly to the receptors. I don't think most people would get adequate pain relief even on 2mg. Personally, I'd get off bupe before the surgery and once you begin to heal and no longer need narcotics, take your sub dose 24 hours after discontinuing your full mu agonist opiate. That's your best bet in my opinion.


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PostPosted: Mon Oct 05, 2009 7:57 pm 
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The problem with stopping Suboxone alltogether for post-surgery pain control is that you will have a really high tolerance for pain meds & most doctors aren't going to prescribe strong enough painkillers in high enough doses for Sub patients to get adequate pain relief.

If your normal dose is something like 16mgs, a 2mg dose is not going to fully cover all of your opiate receptors. It will cover enough though that you can get a decent amount of pain relief from a full-agonist opiate. When I was passing a kidney stone while I was on about 4mgs of Sub daily, the shot of dilaudid they gave me did provide pain relief. The ER doc gave me a percoset scrip to take home. When I tried not taking any Sub and just taking the percoset I was in pain AND in withdrawal. So I used a small dose of sub, which took care of the WD, and then the percoset worked just fine to relieve pain.

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