Suboxone + surgery + post surgery pain meds?

[ndts]

Hi,

I am currently taking 24mg of buprenorphine a day as Suboxone.

My wisdom teeth are coming in incorrectly, therefore I will most likely have to have them removed.

I know that I have to tell the practitioner in advance that I am on suboxone so there will be no problems with anesthesia, etc.  My question requires some pretext.  After the sugery I will obviously be in a lot of pain.  My opioid tolerance is substantial because I am on buprenorphine at a moderately high dose, so the routine painkillers that are prescribed post op in most circumstances (e.g. vicodin) would not be strong enough to alleviate my pain.  What do practitioners most often do in these situations?  Do they prescribe stronger pain killers to suit the patient's tolerance level?  Or do they play it safe and prescribe the routine, weak pain killers, even at the distress of the patient?

One reason I ask this is because during a recent stay in a hospital (before I was on suboxone), a nurse reported to my attending doctor that I had scars or "track marks" on my arms, and that I was a possible drug user (used to do IV heroin).  During one of his visits, he asked me if I was an IV drug user.  Feeling as though I was caught, and also putting myself out there hoping he would not judge me, I told him the truth about my drug use.  I was on 3mg morphine IV every 2 hours at this time.  The next day, a psychiatrist came in and interviewed me further about my drug use.  I was also totally honest with him.  He prescribed me Celexa and left.  Shortly after, I requested more morphine as I was in legitimate pain.  The nurse came in with the morphine, but after checking a computer she told me she could not administer it because it was no longer prescribed to me, but said I had some percocets prescribed.  I asked for the percocets, and after a couple hours of waiting, the nurse finally brought me a 37mg tramadol/325 APAP pill which is DEFINITELY not adequate pain relief.  At this point, I was in serious pain, descending into opiate withdrawal rapidly and losing my wits.  I sensed a change in all the nurses and doctors who were attending me, they were less compassionate and looked at me differently; as though they didn't fully believe anything I said.  This made me extremely angry and upset.  I was apparently being denied adequate pain relief just because of my past drug use.  I repeatedly told the nurses I was in pain and that the tramadol wasn't working, but the most they would do is give me a warm pad to lie on which, in my opinion, is a big slap in the face.  They would not prescribe me anything else, so I had to wait in pain for another couple days before being discharged with a lousy, useless bottle of tramadol and a referral.

That was a very negative experience for me.  I put myself out there and was totally honest with the doctors about my drug use hoping I would not be judged and discriminated against, but that is exactly what happened.  I hope the prejudices and discrimination I experienced is not the norm for other hospitals/practitioners... If I have to get my wisdom teeth removed, I do not want to suffer immensely while it heals.

[Fantasyland]

Doctors or anyone else in healthcare are are only human. Many have that high and mighty attitude and DO NOT CARE about someone else's pain because they are not experiencing the pain themselves. Most DO look down on drug addicts. They could care less if you were in a serious accident etc. and became addicted through their very own prescribed treatment and seem oblivious to the reasons many people choose death rather than request or want their help. When you are dealing with doctors what you say can easily put you in a sub human category. You have to say or do whatever it takes to look out for your own best interest. Whether they will admit it or not they can't lie to the face in the mirror. I know more than one person who seriously needed medical attention and because of prior treatment like they were an animal or something would reply " f*ck them I would rather die" and sometimes did. When someone tries to tell you "the rest of the world doesn't care if you live or die" and you doubt that, if you live long enough ,you learn from experience it may be sad but it's the truth.

[tommm70]

Sub is an opiate receptor hog, so if you take an opiate while on it you will not feel any euphoric effects. So I dunno how that will work. I would definitely talk to your doctor and see what they want you to do.

Good luck with you surgery! I am having a dental implant put in next week. So I feel ya on the mouth pain, it su,cks!!!!

[ginsa]

I'm sorry to hear about your experience too. Yeah, I had a similar  experience with health care professionals. Once one of them labels you as a "drug seeker", you're cut off. Doesn't matter if it's true or not.

I don't know if this is any help, but I didn't get anything but ibuprofen post proceedure when I had 4 wisdom teeth extracted. Three were impacted and had to be surgically removed. One had fused to my jaw bone. It wasn't a cake walk, but I survived.

[road2recovery]

I am so sorry about your experience...That makes me so angry..You were totally honest with them, and then they left you in pain...And some people wonder why we are not completly honest..Well i have been in that place once, the only difference was i was not honest with the doctor, i was in extreme pain because of my tolerence, and I don't wish that on my worst enemy..No one should suffer because of a past addiction, That you were honest about...
As far as the wisdom teeth, I have no idea about that..
Good luck
r2r

[TrayCee]

why do you need to tell the dr your on bupe? (maybe u do, I'm not a MD) just asking..

  My Dad, brother & sister are all DDS's and for wisdon teeth extraction they all write 5mg lortab, if you get "dry socket" post surgery you'll get a few mepergan.  Youre DEFINITELY not going to get stronger meds because your an addict.

I may sound harsh, but suck it up or keep the wisdom teeth.

Good Luck!