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 Post subject: tolerance
PostPosted: Wed Sep 21, 2011 7:26 pm 
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I just wanted to share my surgery experience on suboxone. My knee was completely destroyed by 20 plus years of treatment resistant Gout. Just about every ligament and tendon needed to be replaced. I have been taking 24mg of Suboxone for almost 5 years. I had to quit cold turkey once because of lupus pain that needed to be controlled and it took six days for the Suboxone to clear my system to the point where narcotic pain killers worked. So this time I timed it out and on the day of my surgery i was able to take narcotics. My sub doctor is a psychiatrist and talked with my surgeon because he wanted to prescribe my pain meds because most people in the practice are grossly underprescribed pain meds. Well when i got home i slept through the night and awoke at 5 am in pain. It took SIX 30mg of roxycodone JUST TO STAY OUT OF WITHDRAWAL! Oxycodone has never been a good pain reliever for me but to take anything else i would have 5000mg of nsaids in me, hence the roxy's because of the lack of nsaids. 160mgs just to stay out of withdrawal and 6-8 hours of pain relief, then stick it out till the next day, this time he is prescribing fentanyl and hopefully it will work out. i just cant believe how high my tolerance got, any one else out there that has had this happen to them?

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PostPosted: Thu Sep 22, 2011 12:55 pm 
I'm sure sorry for what you've been through with your knee surgery and all. To add to that, having lupus (a bad-ass diagnosis) really bites! You have my sympathies.
Although I have not experienced any surgeries or any true need for pain relief while I've been on Suboxone, I have had a few lapses while on Sub in which I have used enough oxy or hydrocodone to override a relatively low dose of Suboxone ( ~2mg/day.) Even on that very low dose compared to your fairly high dose of 24mg/day, I still experienced an extremely high tolerance after being on Sub. Although I realize this is exactly the purpose and design of buprenorphine, it has always bothered me that, in essence, by choosing treatment with Suboxone, I have in fact, increased my opiate tolerance exponentially. It's an issue that has come up every once in a while here on the forum. For instance, when I started Sub, I could take 40-60mg of hydro or 40-50mg of oxy and get quite a buzz.....not an extreme dose for an addict. On Sub, my tolerance most certainly is way, way higher than that. In my opinion, this is one of the flaws of treatment with Sub, or more accurately, a flaw of how we tend to be treated for pain if we're on Sub. There seem to be only a few good doctors out there who understand and are willing to dose agonists beyond that tolerance. We're hard pressed to find a doctor who is willing to write 30mg oxycodones in a quantity enough to even touch the tolerance created by having been on Sub, much less willing to write for Fentanyl or give it IV in a hospital setting in dosages high enough to break through that tolerance. The dosages required for pain relief or sedation are likely 3-4 times the dosages generally accepted by medical professionals. I think it scares the crap out of them to have to document that they've given enough opiate to kill the average non-addict individual!
I feel for you and again, I'm sorry for what you've been through. But it does sound like you've got one of the few doctors who 'gets it' and is genuinely trying to address your pain needs. Hope you feel better soon! Thanks for bringing up the subject....perhaps there will be more replies.

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