Suboxone

[Bobbywong]

I was given suboxone as a solution to my fear of addiction. I was prescribed 2 8mgs a day I have recently suffered a  lifelong injury in the last 6 months and when told by my Dr. It would be treated with surgeries and on-going pain  medication. I was unwilling to use pain medication for any length of time due to fear so my dr. Prescribed suboxone that its perfect for people like me and that although there was narcotics in it i would feel nothing. Sounded perfect to me. A week later i looked it up and was horrified when i saw my dr. To discuss he asked me not to read the internet that the medication was perfect and if i continued reading internet i would only bring alot of fear to my head.... Well almost 4 months now and i have continued to read some. I really want off this stuff and much to my dismay i am probably addicted to this stuff physically and who knows what else. In the last month i have decreased to about 8-10 mgs than in last 2 weeks down to 4 a day in the last 2 days about 2mgs or less. When can i safely stop 100%. i will see my dr. This thursday but like the last 2 times when i have asked if i could stop he says no just go with it. Can someone give me a little help? I am willing to listen

[vicki595]

Jim-  What have you researched about Subutex/Suboxone when used as pain management in the absence of addiction?  Not exactly for chronic pain but for 2-8 weeks?
The addiction quality and withdrawal type response is surprising. Check it out when you've got some time.

Yes, it's all interesting to me.  Subutex is used more than one would think in a controlled setting(hosp,LTC facility,etc...) It's used often in PCA (patient controlled analgesia). It often depends on the facility,particular discipline of the physician,etc...anyway...hate to take away from the OP. He's struggling here...

[Oxy480Jim]

They may well be, but until they make recommendations to the FDA to  amend the application,  the use for which it was approved for  and  can only be prescribed for- stands. That's just the law of the land.

I know what Subutex is, Bup and any other name it's marketed under are all listed in those applications-  2000, 20002 (amendend to raise the number of patients allowed to be treated from 30/1 to 100/1) , and 2010 to include the film version.

It's all bup, except suboxone, which is bup plus Narcan, but it all falls under that same application.

The only Buprenorphine that has been approved for use for chronic pain recently is Subtrans,  which was released Jan. of this year.  It may even be effective, because of it's long half life.

I looked and looked and looked, Checked for new  house bills, everything.

I'm sure there will be other new formulations/configurations of bup in the near future as well, we all know the competition in the pharma industry is fierce.


Of course there is the post op liquid Bup you mentioned as well, but that's only used like you said,  peri/post op treatment in hospital only.  I think it's 4mcg per 100ml sol iv drip. Which is set to flow out in what, an hour at the most? Morphine is used 5- 10mcg per100ml  and that's good stuff. I know i've had buckets of it.  And I don't have any problem with bup being used this way, because it is in a hospital setting and not used very long at all, more or less the use the same protocol as they do with morphine.

Now,   note that this guys Doc has prescribed him Suboxone for  long term pain,  Which as far as I can see is a no-no, among other things. From what he tells us, his doc isn't listening to him and what he wants, plus either doesn't know or purposely misinformed his patient about its highly addictive quality. He doesn't WANT  anything thats going to make him go through terrible wd's later. There is no anti-sub treatment either. Plus you are guaranteed paws after long term sub use.


I certainly wouldn't take that stuff for my chronic pains. Oxy is bad enough.

Later, hope you find the info interesting. I do sort of keep an eye on these things, and unless I missed something, I was pretty sure bup wasn't out of the box yet. I'm always looking for the next miracle drug so I can get of these darn oxys. But pain is worse, so not yet.

[vicki595]

Jim...I realize a lot of things. Please don't condescend...I am not a superior authority but I know a thing or two. The Harvard study and clinical trial was well received in peer review. I'm not for or against...it's just the fact.

Also, when I'm speaking of Subutex(buprenorphine) I know what I'm saying. I can appreciate your reference to Suboxone above and what you state is true for Suboxone. Subutex(buprenorphine) is different in that it doesn't contain Narcan. While on this subject, BuTrans IS delivered in mcg. That's true. But,it's mcgs. per HOUR.

[Oxy480Jim]

Realize also that clinical studies are just that. They are controlled trials that very few people can volunteer for.

When buprenorphine first came out, they said it wasn't as addictive as other opiates. HA!  That sure wasn't true. Now  Reckitt Benckisser warns otherwise in their own more recent literature.

[Oxy480Jim]

Post op, liquid iv,  not long term chronic pain mgnt. prescripts.  Found the most recent fda approval.  It's still approved only as :

"Suboxone® sublingual film is indicated for maintenance treatment of opioid dependence and should be used as part of a complete treatment plan to include counselling and psychosocial support."

"prescription use of this product is limited to physicians certified under the Drug Addiction Treatment Act, 2000. "

This amendment is only to include the film. buprenorphine, suboxone, subutex, is still licienced only for opiate addiction treatment. spelled out in the 2002 fda approval.

There is a separate approval for butrans patchs for pain control

[vicki595]

Bobby:  You have a lifelong injury which can be difficult to manage. I'm sure your doctor is doing what he thinks is best for you. If you have concerns in this regard, it's much better to address them with your doctor or a second opinion.

Be careful of info you get from the internet and forum or personal opinions. Search for reputable sources. For example, look up buprenorphine and read. It was actually marketed in the 80's for pain management,peri operative anesthesia, and post operative pain. It's been used in a clinical setting for many years in this country; it has been the subject of clinical trials recently as to it's effectiveness in depression.

So,if you don't get anywhere with your doctor on Thursday, you'll need to talk with a different doctor.  Good luck!

[Oxy480Jim]

I agree, Ibuprofen is a bit better than Tylenol. If you take Tylenol too long, like a week straight it can cause  a "Tylenol headache" when you stop taking it. it's ok if you just take it occasionally.
Many people find Ibuprofen works better, but like everything, too much can cause problems. Stomach bleeding seems to be Ibuprofens abuse indicator.

If his doc gives him a hard time about internet info, he can always print the drug information and recomended usage from the manufacturers web site. They all provide it. The name of suboxone's maker is Reckitt Benckisser Pharmaceuticals inc.

[worried878]

Everyone is different.  I am sure u said how long u have been on the sub but I skim read!  lol  Anyway, the longer the harder as a rule to get off the sticky stuff.  I am not sure if u stated ur previous habit and amount u took....but sub is pretty drastic if it was a small habit.  I used to use it when I was outta hydros...i used 100mgs of hydro a day for 5 yrs.  I am a chronic pain patient.  2 mgs of sub was enuf for me and unlike what they say, I got a buzz from it.  I did not use it to stop as I kinda liked the stuff.  I had read enuf about to know i didnt wanna go that route.  Again, we are all different.
Most subbers get down below 2 mgs before they really feel it as it is likely many are on too high a dose in the first place.  It is not like other narcs, where the more u take the better u feel.  Sub fills up the receptors then it does no more.  Many people go down to lil pieces or shavings before they jump off totally.  It is a powerful drug and even a lil piece can tide one over after slowly reducing their dose
Your doctor should help you with this as it sounds as if you want to get off.  Sub is not a powerful pain reliever altho it was marketed, in mexico I believe, as a pain reliever and the name escapes me.  If you feel u cant taper off without help, and he will not help, find a dr who will.  I know that is easier said than done as it is expensive to see drs...specially sub doctors.  You can do this.....educate yourself on where u r at and what u need to do,.  The health pages r full of great info

hang tight,,,,Is there a sub group that meets in ur area?  there are a few here where I live.  Perhaps take a look.....keep posting

[mellie4]

A lot of doctors don't' want their patients reading things on the internet.  And in some ways, they have a point.  You have to be careful what sites you're looking at.  But if you are looking at reputable sites, then there shouldn't be a problem.  You should be educated about what you're taking.

There are some doctors that are using subs for pain control, though I think using it for that is somewhat controversial.  And I'm also not sure how effective it is for pain control.  Personally, I think there are better ways to control pain than with subs.

But Oxy480JIm has some good points.  I agree with him about taking things with Tylenol in it.  Why take something you don't necessarily need.  If you need to take Tylenol, you can always take it separately.  And I personally think ibuprofen works better than Tylenol for pain relief.  I also agree with him about the way you take narcotics.  IF you need to take narcotics for pain relief, and many people do, the lower the dose the better and the less often you take it the better.  Some people do need round the clock pain management.  But in doing that, you will become physically dependent.  That's where I found myself.  I have tapered off a ton of narcotics and am now on a small amount.  I have found taking the smaller amount works just as well, along with ibuprofen.  And I am actually going to try to come off that soon just to reevaluate my pain.

If you have chronic pain, look at the Pain Management Forum; there's a lot of good information there.  And I don't know what your pain is from, but for me, I also have procedures done that can bring relief, even if only for a short time.

Lastly, your doctor should be working in your best interest.  If you want to come off something and he just says no, well, that's wrong.  At the very least he needs to talk to you and tell you why he thinks you should stay on it and also, if you're anxious about it, he should try to alleviate your worries.  Maybe you need to look for another doctor who is willing to actually talk to you.