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PostPosted: Fri Apr 22, 2016 11:07 pm 
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***First Time Posting so want to give a small backstory:
Got addicted to prescription pain killers while best friends with a girl who illegally sold them. Had a friend on suboxone who started giving me her leftover films so I could stop hunting down pills after ending my friendship w my drug dealer friend. Tried to just stop talking the subs, ended up in severe WD. So my husband paid $550 out of pocket (didn't have insurance at the time) for me to start a suboxone program at the most successful treatment place in our area. Everything was great---four months later I was pregnant and terrified.
I hid my pregnancy (I know I know) for 2 months because I was terrified of being cut off. Finally cried and told them I was pregnant expecting the worse, instead was assured he had many patients who had successfully delivered healthy babies on suboxone. I took 8 mg a day, I immediately cut down to 4mg. Not sure if I had WD Bc I had a severe case of hypermesis (severe nausea/vomiting) so I was bed ridden w a home nurse anyways. Pregmancy went great (well besides the hypermesis)---the same as the 2 before that were before my addiction. At 38 weeks pregnant I was at my sub doc for my last visit before I delivered when they noticed my BP was a little high and suggested I call my OB. My OB suggested I go to the hospital---where upon my arrival my BP had risen to 178/121. I had preclampsia and had to be induced. Found out this had nothing to do w my sub intake. I was given magnesium to lower my BP, and was immediately striped of my sub (I couldn't take any while in active labor). My labor was excruciating---on a scale of 1-10 when compared to my other 2 it was an 15. Epidural wouldn't work---IV pain medication wouldn't work. The anesthesiologist stated he gave me enough pain medication to take out a horse and yet he visibly saw that with every contraction I was no lying about feeling every ounce of pain intensified (I'd had my other 2 without pain meds or any epidurals). After 20 hours of labor, I gave birth to a 9 pound 3 oz beautiful baby boy who was completely healthy. He exhibited no signs of any opiate/sub WD. The charge nurse over the newborns stated if I had not been up front about taking suboxone she would have had no knowledge that my baby was born to a mother taking it. She did however say she's seen babies actually WD from it. I was told by my OB if I wanted to get pregnant again, for my health I would have to be off of suboxone Bc what that delivery did to my body. He said at one point he did think my life was at risk. I know they say it's safe, and I know other women who had successful pregnancies and deliveries on higher doses than myself. I was not one of those lucky ones. My post is To warn women to make sure they seek an OB that has experience on suboxone and pregnancy. My OB had no idea even what the medication was and obviously didn't research it at any point during my pregnancy. Later I found out the magnesium should not have been pushed into my body until I had been off of suboxone for at least 24 hours. He even prescribed me Percocet to take home (I gave my mom the prescription to destroy). Just research. My son is now almost a year old and awesome----totally worth it all looking back.


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PostPosted: Sun Apr 24, 2016 6:01 pm 
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Congratulations on the birth of your son. But for the record, being on buprenorphine has NOTHING to do with your epidural not working. As a lifetime Boarded anesthesiologist, I can assure you that epidurals use local anesthetics, which have ZERO connection with Suboxone or any other opioids. There was a technique introduced 15-20 years ago where intrathecal fentanyl was used during labor, and that approach could conceivably be affected.... but that approach was mostly abandoned because or the high incidence of nausea and itching, and because it only lasted an hour or two. It was a 'spinal', not an 'epidural'-- so I'm relatively certain that is not what you are referring to.

It irritates me when doctors screw up, and blame nonsense instead of admitting that they made mistakes. In this case, your story will likely make other women think that buprenorphine/Suboxone interferes with epidurals. it DOESN'T.

Likewise, there is NO connection between buprenorphine and magnesium. Whoever told you 'you should have been off Suboxone for 24 hours' is an idiot. Buprenorphine leaves the body very slowy-- over days to weeks-- and there is no value in stopping it for 24 hours.... and no REASON to stop it before giving magnesium.

You got lousy anesthesia care-- and they blamed the lousy epidural on an unrelated medication, knowing you already felt guilty and that you would likely buy their excuse. Shame on them.


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PostPosted: Sun Apr 24, 2016 10:15 pm 
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Thanks, I am glad you responded as strongly as you did. The response I was going to post was quite tepid. I went back and reviewed the TIP for Buprenorphine and pregnancy and could find nothing about the Magnesium. I was genuinely puzzled if I had missed something in my training and reading.
I've had 3 patients on buprenorphine get epidurals and they did beautifully, their words, not mine. Epidurals do fail, ask my sister and the person she nearly throttled.


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PostPosted: Wed Apr 27, 2016 9:18 pm 
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Hello, I just wanted to follow up about the Buprenorphine - Magnesium conflict posted by the OP. I posted the question to http://pcss-o.org/ . A site sponsored by SAMHSA with many partner organizations that work with addictions. They refer questions to a subject matter expert and here is the reply:

Dear Dr. McClure



I am aware of no evidence to suggest that buprenorphine would affect the therapeutic action of magnesium in the treatment of pre-eclampsia. Nor is there any guidance for altering the treatment of pre-eclampsia when a patient is on buprenorphine therapy.




Thank you for your inquiry.

Tony Tommasello, Ph.D.

Medical Affairs Manager.



Thank you.




Medical Affairs Manager



Exactly what Dr. Junig had said.


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PostPosted: Fri Apr 29, 2016 7:46 pm 
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That's what I suspected with my 15-y-o information... thanks doc!


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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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