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PostPosted: Sun Jul 22, 2012 6:27 pm 
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I have an urgent question regarding my surgery and subutex I have deep trust issues w/ my doctor as he only had the minimum training & seems very inexperienced in prescribing Suboxone/Subutex. I will discuss my issue, but let you know that I contacted Reckitt Benckier a year & a half ago and they said I should have never been prescribed suboxone & should get off it immediately. I started taking Suboxone/Subutex June 14, 2011.

I was addicted to Fioricet 6 yrs ago during migraine headache treatment, not an opiate, & been clean for 6 yrs. I had arthroscopic knee surgery May, 2011, took percocet for 5 or 6 weeks then switched to loratab. I took opoids totally for 3 months post op before finally being swithched to mobic. I took lower than the recommended dose of the opoids , afraid of chemical dependence or compromising my sobriety/ clean time b/c I never want to go through addiction hell again & I am Bipolar, too. However, instead of tapering me off the 10mg loratab, the doctor decided to do a 1 week detox on suboxone, starting theapy at 8mg bid, which made me very nauseased, extremely intoxicated, extreme headache,&extremely anxious w/tremors. Put me on Klonopin 3mg/day for the anxiety (which I got tolerant on & switched to valium & clonidine to get off the Klonopin), switched me to subutex for the headache side effect, & told me to hold the taper subutex dose at 6mg Qd until the next visit. The afore mentioned symptoms continued until my dosage got to around 2mg to 1.5mg per day, many months later! Told me he was tapering me slowly as he thought my symptoms were w/d related, even though I told him they were listed as serious side effects per the prescribing information & I thought my dosage was too high as I was dependent on 10mg of Loratab, only for 3month prior to treatment w/Subutex. My rate of breath at bedtime was 6 bpm, which he said was no cause for concern & said that my nurse sister was making me paranoid over it as she told me they bag patients when their respiration gets that low. Hence my distrust with my physician. Was going to switch docs, but was almost off subutex in the fall of 2011, down to .5 or .25 every 2 to 3 days, but I have had various chronic pain issues arise since then & he keeps changing my dose. Recently had a bad rxn to botox injections for spasmotic torticallis & inc. my dose again to 4mg of subutex daily 6-9-12 along w/ 50mg of predisone. Herniated my lumber disc 3 or 4 weeks ago,& dispite the sub, predinsone, occassional sprix nasal spray, flexor patches, heat, ice, ESI,etc., my condition has worsened in my disc & requiring surgery. My pain management doc that did the ESI and MRI wants to talk w/ my sub doc regarding post surgery pain control. However, I do not trust my sub doc. I have read the paperon your website re: acute pain/ surgery, & subs verses opoid treatment. My sub doc says that information is "Old School" and not be used.

Prior to going to the Neurosurgeon consult on Monday, June 23, I wanted to discuss this with you. My pain mgt doc did not know if increasing the dose of my subutex pre &/or post surgery was appropriate as exclusive or combination pain control & felt certain the Neuro would have the same questions. The pain mgt doc said he would rather see me on traditional opoids, taper off after surgery, especially since I is was NEVER ADDICTED to them to begin with & never took more than prescribed. He was not sure that inc. my subutex dose would give me adequate pain control. In addition I experienced extreme side effects taking higher doses of subutex, anyway.

If you think I should go the direction of traditional opoids, when and how should I switch over to them? We are anticipating that I have an open disectomectomy, discussing switching or combining therapy w/ subutex. I have read to titrate down on subutex (my dose is 4mg QD) while titrating up on opoids prior to surgery; stop subutex cold turkey 24-48 hrs prior to surgery; use subutex in combination w/ opoids, etc. I want to avoid withdrawals by not going off subutex too soon or at all prior to surgery. Even though subutex has a long-half life, I do experience some withdrawal symptoms if I do not take my subutex on time daily.FYI: I am a former District Manager for a major Pharmaceutical company prior to my disability 6yrs ago, to give you some information of my pharmaceutical understanding with a degree in Medical Technology. In this last paragraph, I am asking multiple senarios as I do not want to compromise respiratory depression. I think I read that could be an issue coming off subutex because you do not know where your tolerance is on opoids, as mentioned, been on subutex since 6-14-11.


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PostPosted: Sun Jul 22, 2012 10:39 pm 
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Hi SN,

I took 1.5mg sub per day plus 10mg hyrocoodne every 5-6 hours after my recent surgery (tympanomastoidectomy), it worked out fine. If you just switch to full agonists you will likely get withdrawals when they wear off in between doses.

Check out this thread: http://suboxforum.com/viewtopic.php?t=6415

Good luck,
Gb


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PostPosted: Mon Jul 23, 2012 5:48 am 
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Oh my goodness AnxiousSn, I am so so sorry to hear that you are in this position. And it seems like it's because of your sub doc. I don't have any experience with surgery while I am on sub, so I am sorry that I can't give you any great advice. I personally would be done with the sub if my situation was yours. But that is just me.

Good luck to you sweetie, and PLEASE let us know how everything goes. I'll keep you in my prayers.

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PostPosted: Fri Aug 10, 2012 7:43 pm 
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@anxious

I too am getting off suboxone for surgery but my surgery can actually wait. Wanted to get an update and see how things are with you.

Hope you're doing better.


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PostPosted: Sat Aug 11, 2012 12:31 am 
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Yes, how are you doing??

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