Suboxone, Fentanyl and Other Spine Patient Medications

[Justin]

Hey Justin,
How great to have all the pain relieved!!! This oxycodone is just not working well for my pain (2 yrs). Tolerance I suppose. Are you going to be taking this for a short time? Can you tell me more about this suboxone? I've read about it some but you explain things so much better!
Two thumbs up to that pain relief!
Have a nice night,
Linda

Hi Linda,

Suboxone is a drug that is usually prescribed to patients that are opioid dependent. Many of these patients are psychologically dependent on opioids (taking an excessive number of narcotic pills a day).

One benefit of Suboxone is that it is a drug that is 1/2 a partial opioid agonist and 1/2 an opioid antagonist. Since Suboxone contains a partial opioid agonist instead a of full opioid agonist like oxycodone, patients do not experience the euphoric high that is often associated with full opioid agonists (another drug to think about is heroin).

The opioid antagonist component in Suboxone is called naloxone. Naloxone is one of the drugs used in emergency departments to treat patients experiencing an acute opioid overdose--naloxone "antagonizes" (displaces) the opioid off of its receptor and promptly takes its spot. When the opioid is no longer on its receptor, the opioid is rendered inactive and the patient no longer experiences effects of the drug.

Suboxone is best absorbed through mucous membranes and the tablet is placed under the tongue to be dissolved; it is not chewed or swallowed. The naloxone component that was discussed above will not enter the bloodstream when Suboxone is dissolved under the tongue. However, if Suboxone is injected, a patient will go into opioid withdrawals because the naloxone will now reach the bloodstream.

I will be taking Suboxone for two months total. Suboxone can be very expensive because there is usually a monthly cash fee for treatment to be paid to the health care provider and then there is the cost of Suboxone medication itself. I started on Suboxone to get off of the remaining full opioid agonists I was on (oxycodone) and to minimize the withdrawals associated with discontinuing opioid therapy, which can be experienced during a "traditional slow taper."

By the way, I am completely off of my oxycodone. :thumpup::thumpup: Two thumbs up like you said! Switching to Suboxone treatment requires one full day free of your prescribed opioids. This frees up the opioid receptors so that the Suboxone now has free receptors to bind.

I hope this makes sense.

[muddy]

I purchased an eBook from this guy, an MD/PhD at this site. Pretty helpful.

http://suboxonetalkzone.com/

[Jack-of-all-trades]

This seems to be a help site that deals with Suboxone. Finding a doctor, and getting peer support. I wish I would have known of them last year when I tried Sub with a doc that wasn't up to the standard necessary.
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[trkdoc714]

Justin,

Great topic! Possibly opoid dependence should have its own chapter in the pain management section?

Suboxone does work for withdrawal symptoms but can replace the opoid dependence with suboxone. Psychological therapy is an important component of the treatment to prevent this from happening.

It's a shame the final chapters of our battles with spine issues are trying to get off of the pain medications.

Bob

[SemperFi]

Re WC insurance I hope that I can get a referral to someone that can prescribe Suboxone and they will approve it. I've just stopped taking Neurontin so much of the head fog is gone however have wanted to stop taking Methadone for over a year now and my PM doesn't have credentials to prescribe Suboxone and current practice he's in doesn't want him prescribing it. I think it's just cheaper all the way 'round for insurance companies as well to keep the patient on Methadone. My script costs $8/month if I had to pay for it. I want to be free of this drug altho am grateful for the pain relief that 10mg/day provides. Have tried to take it down myself under this dose and my stomach goes into such a horrendous revolt I can't even leave home to walk the dog!

[Jack-of-all-trades]

Just a guess and maybe I'm a little to critical but think there maybe something to the idea that the reason pain management clinics don't do much with Sub involves $$$ or lack thereof. I would like to hear how WC handles this.

The insurance company we have now might pay for this but I suspect a person would be labeled as an abuser. I saw in the booklet we got from them that they have an "abuse program". Pain control with meds and getting off of them should not label the person as a drug abuser, especially in our computerized age where information is sometimes shared. I'm a little more less likely to sign the waiver to share information than I use to be.

[SemperFi]

My PM orginally offered to refer me t o a doctor that could put me in a program for drug users to detox and rehab but I said "what for??" if anything I use far less of this medication than prescribed. I get 3 scripts for 120 pills/mo and I fill one script per every 3 months thereby utilizing more or less 90 to 120 pills in 3 months not in one month. Does that sound like a person that is addicted and abusive to this medication? Perhaps physiologically dependent, yes, I'll give it that.

If I were planning on going into my doctor's office in withdrawls I could have done it several times now and quite some time ago. I've tried to take myself down unsuccessfully.

I know WC is going to have a hissyfit re filling a Suboxone script instead of Methadone (cost) tho you'd think the doctor at least would lilke to see me off this medicine. I've been t old that it's a "noble effort"~ give me a break. I want to try it for my mental health and overall well being~

[Jack-of-all-trades]

My PM orginally offered to refer me t o a doctor that could put me in a program for drug users to detox and rehab but I said "what for??" if anything I use far less of this medication than prescribed. I get 3 scripts for 120 pills/mo and I fill one script per every 3 months thereby utilizing more or less 90 to 120 pills in 3 months not in one month. Does that sound like a person that is addicted and abusive to this medication? Perhaps physiologically dependent, yes, I'll give it that.

If I were planning on going into my doctor's office in withdrawls I could have done it several times now and quite some time ago. I've tried to take myself down unsuccessfully.

I know WC is going to have a hissyfit re filling a Suboxone script instead of Methadone (cost) tho you'd think the doctor at least would lilke to see me off this medicine. I've been t old that it's a "noble effort"~ give me a break. I want to try it for my mental health and overall well being~

My pain management doc had success in tapering people off methadone but couldn't prescribe it so I passed on his offer. After finally getting off fentanyl patches (worked well but very potent) and to 60 mg oxycodone prior to surgery, I went up to 120 mg a day of Percocet immediately after surgery and taper to nothing from there.

In a way, I found it kind of like quitting smoking. You have to build up your resolve, then stay in it for the long haul. Everyone is different but what worked best for me was a slow taper over months like maybe 5-10% at a time every week. If withdrawals got to bad I would up the taper dose a little. I still have two bad lumbar and 2 bad cervical vertebra which complicated tapering but so far I feel I'm better off. There is some solace in knowing if I have to resume pain meds at a later date I can resume at a lower dose, hope so anyway.

[SemperFi]

I'll try to bring my dose down a bit more myself. I do so want to see where I am truly at with less Methadone or none (wishful thinking for now) tho like you I'm in it for the long haul tho have to be able to get out of the apt. and function on my own since I live alone. My poor dog needs bathroom breaks and walks too! Thankfully she's got good bowel/bladder habits!

Oh well at least I'm very happy to be off Neurontin and feel so much clearer minded. It's nice to know that at least half if not a majority of my brain drain was the Neurontin fog.

Like you I still have some lumbar and cervical disc probs so probably need something for pain and it is good to know that I do have good pain relief/control. I haven't forgotten what it's like to be in chronic pain but it's a much dimmer memory than prior to good pain control.

[rsaylor8326]

I have been on Subs know for over a year know. I started pain meds for lower back pain and went from Vics to Percs AND Oxy to MS contin to the big Fentenyal I was spiraling down a dark tunnel of death before I got on Subs I am now in a lot of pain becous of stoping the pain meds but the main ingrediant in Subs is buprenorphine witch is a pain killer. Subs just doesent do it like the others do but I am a much better person to day, stuck in bed a lot but I will have my back fixed in Nov keep my fingers crossed. Subs does help some for pain but its better then being on the full agonist I'm lucky that my insurance pays for my Subs very pricy. I will take full agonis after surgery but hoping to get off of both if sugery is a success I have tried to come off it before but I have way to much pain to do so. So that shows that the Subs do help with pain just not like Percs. There was mention of suboxon talk zone further up on the thread I go there often and there is a lot of information on Subs there please fill free to send me question