Chronic pain management

Does buprenorphine or methadone treat chronic pain? How to treat pain on Suboxone? Is Suboxone an opiate? Does buprenorphine treat oxycodone addiction? Heroin addiction? Cocaine addiction?
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Parkrapids
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Chronic pain management

Post by Parkrapids » Sat May 29, 2021 3:43 am

Hello, curious on any thought please. Been on buprenorphine since November 2011, have several diagnosis and typically am able to deal with through tylenol and advil but beginning in March I've had a new issue I'm dealing with and part of it is severe nerve pain where nothing really relieves the pain and did through a referral of my primary and also from the Dr that prescribes the buprenorphine to go to the pain center BUT right off the bat once they found i take buprenorphine I was sent a letter advising that being the 2 Dr referrals they would accept me and make an initial appointment as you cant be seen without the referral as well as what they decide as far as if the think they could help and did not ask for narcotics though the sub Doc has increased the buprenorphine dosage in the past as it did provide pain releif but with new rules he's unable to increase the dose. He has only done that one time for about 6 months before dropping back down and I have every intention to want to be at the 24mg 3 tablets a day. I've been on disability since 2015 and I have only used narcotics once for approximately 2 months after I had broken my neck and went back to the buprenorphine as I'd healed for the most part though it'll never be the same as it was prior to breaking it. And as of this day and the new diagnosis I've received is it inappropriate to ask my primary to allow me to be on narcotics for up to 2.months max as I'll be having either an MRI or Ct scan next week and once results back from that it will tell a lot and this new added pain aside with the other chronic pain that has over time slowly gotten more and more and tylenol and advil do nothing and I can't and or an at the end of my rope, I dont drink and tr would even offer to be called in to clinic for a pill count as I am not out to do anything than get releif that I know for sure I will get being on a narcotic. Is that an unreasonable request on my part? They have taken and seen just last week my BP was 190/89 which is way up as it typically is 160/80 I would say on average and that 190/89 was taken almost 2 hours after taking 1000MG tylenol and 800MG advil if that tells you anything, and the issue is the procedures at the pain center aren't being started til AUGUST 25TH, as that's the 1st available appointment which I was blown away by I figured maybe 2 or 3 weeks but not damn near 3 months. I've had same primary doc for 12 years now and he seems to understand but just wanted someone opinion on this as it's a drag having or wanting to use a narcotic temporarily but this to me just isnt life being in the amount of pain I'm in and not being able to have pro til late August. Anyways thanks and I apologize i also have central sleep apnea and havent slept for 65 fours and it starts to affect me a little bit. Thanks for anything I may get back.

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Re: Chronic pain management

Post by suboxdoc » Thu Jun 03, 2021 12:45 pm

Unfortunately, many docs either don't know how to use opioids in patients on buprenorphine and aren't interested in learning. There are also other reasons that docs are reluctant to use opioids, whether or not the patient is on buprenorphine.

There are guidelines for treating acute pain in patients on buprenorphine at this link: https://www.ncbi.nlm.nih.gov/pmc/articl ... ing%20OAT.

For neuropathic pain, consider gabapentin or lyrica. Those meds often work better than opioids for neuropathic pain. Also, you can combine ibuprofen and tylenol, since they work by different mechanisms.... but DON'T exceed the max listed on the bottles, because taking too much of either substance can harm your body(!)

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