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PostPosted: Tue Oct 04, 2011 1:27 pm 
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I HOPE YOU GUYS SEE THIS AND CAN GIVE ME SOME FEEDBACK. I NEED TO HAVE SURGERY ON MY FEET TO REMOVE BUNIONS. I AM CURRENTLY ON 16MG. GEN SUBUTEX FOR ADDICTION ONLY. I HAVE READ WHERE YOU TAKE IT FOR ADDICTION AND PAIN. DO YOU THINK I COULD HAVE THIS SURGERY AND GET BY JUST TAKING MY SUBUTEX AND ADVIL ( A HIGH DOSE OF ADVIL)..THIS SURGERY DRILLS INTO THE BONE WHICH IS THE BUNION THAT STICKS OUT ON MY FEET BY MY BIG TOES. IT LOOKS AWFUL, HARD TO FIND SHOES, AND NOW GETTING HARD TO WALK. IKEEP PUTTING IT OFF BECAUSE OF THE DRAMA OF REDUCING SUB, TELLING DR.S I WILL NEED LARGE INCREASE OF PAIN MED. ETC.. THESE DOCTORS (NON SUB) JUST DON'T LISTEN...AND THEY WOULD BE HORRIFIED TO GIVE ME A LARGER THAN LIVE DOSE OF PAIN MED. ....THEY DO NOT UNDERSTAND SUBUTEX AND THEY DO NOT WANT TO UNDERSTAND IT EITHER. THEY WON'T LISTEN AND WON'T BE TOLD WHAT TO DO. I HAVE WORKED BESIDE THEM FOR YEARS AND THERE ARE VERY FEW THAT HAVE AN OPEN MIND AND AN AVERAGE EG0...SO WHAT DO YOU THINK...ANY IDEAS WOULD BE SO MUCH APPRECIATED...I HOPE YOU SEE THIS...JUDY


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PostPosted: Tue Oct 04, 2011 8:25 pm 
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I am not breezy or hat but I was on suboxone for 5 years for pain and addiction recently switched to methadone for better pain management control. To your question I saw you said it is getting difficult to walk so you are having pain now already I take it while the bunions are the way they are so the pain will only get worse for the first week or two after the sugery like any operation. So if you are already have pain issues on while on subutex and your pain is going to get worse before it gets better than that answered your question in a sense meaning it prolly won’t be enough to hold you over till the operation starts to show results. I really never got good pain management from suboxone but it kept me clean which is why I stayed on it so long, but I also have some pretty serious injuries. Overall I think your best bet is talking with your DR and see what he has to say and he should prescribe you the pain meds if needed! I am sure Hat will post a link to this print out you should bring into your Sub. DR and the DR doing your operation to help them better understand your situation.

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PostPosted: Tue Oct 04, 2011 11:58 pm 
slipper wrote:
I HOPE YOU GUYS SEE THIS AND CAN GIVE ME SOME FEEDBACK. I NEED TO HAVE SURGERY ON MY FEET TO REMOVE BUNIONS. I AM CURRENTLY ON 16MG. GEN SUBUTEX FOR ADDICTION ONLY. I HAVE READ WHERE YOU TAKE IT FOR ADDICTION AND PAIN. DO YOU THINK I COULD HAVE THIS SURGERY AND GET BY JUST TAKING MY SUBUTEX AND ADVIL ( A HIGH DOSE OF ADVIL)..THIS SURGERY DRILLS INTO THE BONE WHICH IS THE BUNION THAT STICKS OUT ON MY FEET BY MY BIG TOES. IT LOOKS AWFUL, HARD TO FIND SHOES, AND NOW GETTING HARD TO WALK. IKEEP PUTTING IT OFF BECAUSE OF THE DRAMA OF REDUCING SUB, TELLING DR.S I WILL NEED LARGE INCREASE OF PAIN MED. ETC.. THESE DOCTORS (NON SUB) JUST DON'T LISTEN...AND THEY WOULD BE HORRIFIED TO GIVE ME A LARGER THAN LIVE DOSE OF PAIN MED. ....THEY DO NOT UNDERSTAND SUBUTEX AND THEY DO NOT WANT TO UNDERSTAND IT EITHER. THEY WON'T LISTEN AND WON'T BE TOLD WHAT TO DO. I HAVE WORKED BESIDE THEM FOR YEARS AND THERE ARE VERY FEW THAT HAVE AN OPEN MIND AND AN AVERAGE EG0...SO WHAT DO YOU THINK...ANY IDEAS WOULD BE SO MUCH APPRECIATED...I HOPE YOU SEE THIS...JUDY


Buprenorphine is dosed for pain at much lower doses.

I do not think anyone on this high of a dose could use bupe for pain control in the surgical sense. Daily use might control chronic pain somewhat (well even, in some people), but I don't believe someone on 16 mg/day could use it for acute pain. I would need a medical study or something written by a doctor in order to feel comfortable changing my opinion on this.

Buprenorphine is 20-40x more potent than morphine. 16 X 20 at a conservative estimate, is 320 mg. That is your usual per day dose..so logically, it would take a hefty dose of even a full-agonist, through an IV, to alleviate your pain.

This is exactly the situation that makes me nervous for people on high doses of Suboxone for maintenance purposes.

Good luck to you in your surgery. Maybe something like Tramadol or Toredol would help you? Also, you should try having your Sub doc talk to your surgeon/prescribing physician. That may help you.


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PostPosted: Wed Oct 05, 2011 4:58 am 
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ironic has a good point". slippery'. i had surgery on 16mg sub.
i stop the sub in 2 or 3 days. had surgery and did not feel any pain in my in my belly.
came off 100mg oxycntin a day for one week. went back on sub's with no problem.
ITS EASY!!!!

i woke up from surgery no early'r or later than any other patient.

Well that's how it went for me!! you can go through with it.


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PostPosted: Wed Oct 05, 2011 6:25 am 
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johnboy wrote:
ironic has a good point". slippery'. i had surgery on 16mg sub.
i stop the sub in 2 or 3 days. had surgery and did not feel any pain in my in my belly.
came off 100mg oxycntin a day for one week. went back on sub's with no problem.
ITS EASY!!!!

i woke up from surgery no early'r or later than any other patient.

Well that's how it went for me!! you can go through with it.


FIRST OF ALL, THANK ALL OF YOU SO MUCH FOR ANSWERING ..I ONLY USED HAT AND BREEZY BECAUSE I HAD READ WHERE THEY WERE ON SUB FOR PAIN AND ADDICTION....

bBOY THANKS SO MUCH FORYOUR INFORMATION. YOU ARE SO RIGHT AND I AM GOING TO TALK WITH MY SUB DOC AND MY SURGEON ABOUT THIS AND SEE IF THEY CAN GET TOGETHER ON A PLAN FOR ME

IRONIC..I READ A LOT OF YOUR POSTS WHERE YOU ARE CONCERNED ABOUT HIGH DOSES OF SUB. AND I SEE YOUR POINT..I AM OLDER AND I WORRY ABOUT THINGS THAT COULD HAPPEN TO ME AND I WOULD BE UP THE CREEK IN TERMS OF PAIN MANAGEMENT. I DO THINK I COULD COME DOWN TO 8 AND MOST LIKELY 4MG SURG OR NOT AND I MAY WORK ON THAT. I REALLY AGREE WITH EVERYTHING YOU SAID...

JOHNBOY THANK YOU FOR LETTING ME HEAR YOUR SURGICAL EXPERIENCE...IT SURE MADE ME FEEL BETTER!

SO.....NOW I WILL TALK TO THE DOCTORS, WORK ON MY SUB LEVEL AND THEN DECIDE WHAT I AM GOING TO DO.

THANK YOU ALL AGAIN FOR YOUR INPUT..I REALLY DO APPRECIATE IT...............JUDY


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PostPosted: Wed Oct 05, 2011 7:59 am 
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First of all, here's a link to an article about treating acute pain in suboxone patients.

http://suboxforum.com/viewtopic.php?t=1812

There's an NIH article that gives a few different options on how to do that. I would suggest you read the article (7 fairly-easy-to-read-pages, with 7 pages of references) and print it out a couple of times and share it with your surgeon and your anesthesiologist (you'll meet her/him before the surgery). This is the person that you absolutely also need to discuss your sub use with.

Also, I'd suggest you speak to your sub doctor and have her/him touch base with your surgeon also. That's an important step in coordinating your care.

And since you asked specifically about using only Sub and Advil, I'm also giving you this link of a case study:
http://suboxforum.com/viewtopic.php?t=3127

Like I said, it's only a case study (one person's experience only). This person went up to a grossly high dose of suboxone to treat post surgical pain. (And when i say a grossly high dose, I'm not exaggerating.) But check this out as well. I'm not endorsing this method, I'm merely sharing this case study with you.


Lastly, as for 16 mg of sub = 320 mg of morphine, you can't convert full agonist dosages to sub dosages in a linear fashion because of the ceiling (being a partial agonist). Check out some of the forum posts (do a search for CONVERSIONS). I've posted Dr. Junig's explanation of it several times in the last month or so. It should be pretty easy to find.

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PostPosted: Wed Oct 05, 2011 11:40 am 
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Hi, sorry for the late response. My grandma has stage 4 lung cancer and took a turn for the worst so I have been at the hospital.

To answer your question, yes i get quite good pain control with sub but my pain is chronic. I don't think you would get the pain control you needed after surgery from sub. Read hats link on how to treat acute pain in sub patients. You could talk to your sub doc and ask him to prescribe your post op pain meds. You are not tolerant to 320mg of morphine. Like hat said because of subs partial agonist properties after 4mg the opiate effect does not increase so you can not convert the numbers with doses above 4mg. Look at the links hat posted and check out Dr. Js videos on you tube. I hope this helps and that everything turns out ok. Post if you have anymore questions after reading hats links and watching Dr J's videos.


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

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