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 Post subject: Suboxine and surgery
PostPosted: Mon Oct 31, 2016 9:45 am 
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I am having a complete hysterectomy tomorrow. The Drs will also be taking out several large masses attached to my ovaries and uterus to check for cancer. I have been on suboxine for over 5 years on and off. Originally given to me for opiate addiction and continued use for serotonin for depression. I have weened myself down to less than 2mg daily for over a year now. My pain doc wanted me to switch to bupenorphine before and after surgery but I have been trying to get off subs for a long time and don't want to switch from one drug to another one that I will have to ween off of. I have no desire to take opiates any longer since it has been so long... However, because of the horror stories I have read about bup and anesthesia I decided to stop subs altogether this past Thursday which will mean I have had none in my system for 6 days (including tomorrow - my surgery date. I decided to take a low dose benzo and 1 hydrocodone a day to help with the withdrawals instead. My fear and question is how will I do with opiates for pain relief after surgery? Will they work? Please help!!


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 Post subject: Re: Suboxine and surgery
PostPosted: Mon Oct 31, 2016 10:21 am 
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Courtney,
You ve done a great job getting down in dosages. Your surgery and post pain relief should be just fine.
With your taper down low and the fact that you ve stop taking Buprenorphine all togather 6 days ago tells
me you will get pain relief afterwards.

Your tolerance is so low now that there shouldn't be an issue. I say this because ive what ive seen myself in others and from read Dr Junigs Talkzone on the subject.

You might want to go over there and look yourself for peace of mind. Your going to be fine Courtney.

And best of luck with your overall surgery.

Razor..


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 Post subject: Re: Suboxine and surgery
PostPosted: Mon Oct 31, 2016 11:55 am 
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Hey Courtney,

I moved this topic over to the surgery section so you can peruse all the old messages. There's a ton of information regarding having surgery while on Buprenorphine.

As razor said, read Dr. Junig's blog about this subject and come to your own conclusions.

Good luck,

rule

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 Post subject: Re: Suboxine and surgery
PostPosted: Mon Oct 31, 2016 3:02 pm 
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Agree w the others on great job getting down!! Will help you lots. I assume your surgery will be via an open abdominal incision? I know a gal w a history of addiction but never was on bup who underwent the same and her Dr, utilized an epidural for ~1.5 days post surgery and cut all pain. Dr J has mentioned this too. In my reading here, even if buprenorphine is stopped a week or two in advance of surgery, the person still has a high tolerance to opioids, and still requires additional doses of opioid agonists for adequate post-operative pain control. Be insistent and if needed, demand to get it.

FYI, Some Drs perform your needed surgery via minimally invasive surgery but if there is the risk of cancer then there is the risk of it spreading thru power morcellation. Surgeons make small incisions and morcellate, or grind up, fibroids and tissue, cutting it into smaller pieces, then vacuum out the residue. The concern is power morcellators can spray bits of tissue throughout the abdomen which can adhere to other tissues and organs, seeding new growths. Some GYNs disclose morcellation risks and others don't.

Wishing you my best and please let us know how the surgery goes, how you manage w full opiates and if you decide to remain off bup. P

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Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


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 Post subject: Re: Suboxine and surgery
PostPosted: Mon Oct 31, 2016 7:57 pm 
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Hi Courtney. So you see there is no simple yes or no to that question. Regular pain management for post op pain may do the trick, but I'd still do my homework if I were you and you were put in a position to have to ask for more. It could go either way. Good luck and let us all know how your doing when it's over tomorrow. Bama girl Feel better soon.


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 Post subject: Re: Suboxine and surgery
PostPosted: Tue Nov 01, 2016 12:51 am 
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What I didn't say and wanted you to find it yourself was that Dr. Junig suggests not getting off the Suboxone prior to surgery as your tolerance will still be very high. Mine was still quite high after being on 1 mg for months prior and stopping beforehand. I did not receive adequate pain relief. Half was my fault and the other half was my surgeon. We need a strong dose of pain meds to get relief. Even if I had printed out the paper from Dr. Junig I doubt my surgeon would have complied.

I don't want to scare you but I suffered greatly. This was in 2011/12 but now we know much more about it. And hopefully your doctor does too. 3 weeks after being off Suboxone and taking a lot of hydrocodone it still didn't make a dent. But that was only me. Others have had success. It may have just been where I was cut. A lot of pain fibers in the tongue.

So please be your own advocate for pain relief. Read his blogs, print what you need and make sure your doctor knows about how Buprenorphine raises the tolerance level. Problem is, most doctors don't like the patient telling them how to do their job regarding pain relief. Especially those on Suboxone. We are viewed as untrust worthy addicts and they assume we are drug seeking. Nothing could be further from the truth.

That's enough scary talk from me. Do your homework and I wish you the best.

rule

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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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