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PostPosted: Sat Nov 13, 2010 1:10 pm 
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Hi All,
Last visit my Dr said a new directive came down to the maximum recomended dose, but didnt say from whom/where. ( I will ask on this weeks visits) The max dose is now 16 mg. I was cut almost in half. I am a chronic pain patient. The Sub Definitly had made my life productive again. Its been a very rough month.
Anybody eles getting this from Addiction/Recovery centers?
-SD


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PostPosted: Sat Nov 13, 2010 1:18 pm 
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I've heard this on the forum before, but I thought it was merely a guideline. I have no idea who would issue such a directive. I am prescribed 24 mg a day, although sometimes I only take 16 (I take it for pain, too). My doctor hasn't said anything to me about needing to lower my dose.

I hope you reduction in dose doesn't increase your pain!

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PostPosted: Sat Nov 13, 2010 3:25 pm 
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From my understanding, this "best practice guideline" came out about six months ago already. Not sure why your doctor is first getting wind of it and implementing it now. I do know that the maker of Suboxone sent this information out to providers and I know it has been published in other communications, newsletters, journals, etc. The thing is, this guideline IS NOT for pain! This guideline, in my mind, actually makes a whole lot of sense for addiction patients. It has been very well demonstrated that there is little if any physical benefit from daily doses over 16 mg. However, when it comes to using Suboxone to treat for pain, this guideline is not valid. The reason is, the addiction remission properties and physical withdrawal abatement will last over 24 hours on a 16 mg dose. But the analgesic properties, which honestly are not all that great for many patients anyhow, only last about 6 hours. That is in part why addiction patients are suggested to dose only one time each day while pain patients are suggested to dose three or four times a day. From all that I have read, the max daily dose for pain remains at 32 mg. I guess the questions would then be:

1. Are you being prescribed Suboxone to treat pain as well as addiction? Or was it just helping your pain but you were under treatment only for addiction?

2. If you are being treated for pain, I would strongly suggest you bring this information to your doctor's attention and ask him if he is aware that the max dose for pain patients is not at 16 mg but is still allowed to go above. If he re-reads the information that he first read that brought this to his attention, I'm pretty sure he will see that it clearly states what I've provided above.

I hope that will help you. I really would have a conversation with your doc about this and see what he has to say.


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