Maximum Dose Of Suboxone/subutex & Chronic Pain (Page 22)

What is the maximum dose of suboxone or subutex when you have severe pain?

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Oh, I didn't mean to come off like i thought you were saying something wrong! I'm sorry. I was just saying that it's not really good for pain, especially after you've been on something that really works (for awhile, at least.) Buprenorphine (Suboxone)is used for opiate addiction, but I think some Dr's are pushing it for pain management bc they're afraid of prescribing narcotics now. My grandfather had pain in his shoulder for years and had to get a shoulder replacement surgery for it. But he still had to take Lortabs for the pain until the day he passed away (about 6 years later.) He refused anything stronger because pills affected him much more strongly bc he was older. I'm sorry you're going through that :( You could get the surgery, but you'll likely still need pain management afterwards. Do you see a Pain Management doctor who specializes in managing pain or do you just see your regular doctor or a specialized doctor for your shoulder? If you're not already, you should see a pain management doctor in addition to your regular doctor. They can tell you everything about how to help live a normal day to day life with pain. I remember I saw my grandfather cry over the pain in his shoulder once, and this wasn't a man who cried much-I can could on one hand in 30 years how many times I saw him cry. So, I hope you get some help for that and soon!

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JJ: Actually, Bupe (Subutex, Suboxone) can be a great option for pain relief for people that need mild to moderate pain relief. It is a partial agonist (pain relief) partial antagonist (blocker), so it does have positive pain relieving properties, while keeping the patient from abusing other, stronger opioids, or from overdosing on it. But any doctor who is prescribing Bupe along with other opioids is doing their patients a great disservice. It's just completely counterproductive, not to mention wasting the patient's money. Anyone being giving Bupe AND things like Opana, Vicodin, Oxy etc., should seriously consider getting a different doctor.

The statement by "Zydot" that Bupe was "not meant to treat pain" is incorrect. The first use of Bupe was as an inj. for pain, in Europe. It wasn't invented to be an addiction treatment. It was invented by English scientists as a pain med that didn't come with as many "unwanted side effects" as other full-agonist opioids (like physical dependence and respiratory overdose). They later realized the potential as an ORT, but that was not it's initial purpose. Or course NOW it is used as an ORT more than for pain relief. And yes, many people do find relief from it. But I don't doubt, with the injury you mentioned, that a full-agonist opioid such as Morphine Sulfate would be better for you.

By the way, you say that you are on 30 mgs, 4 times a day "with no withdrawals". I'm not sure what that means. The withdrawals will happen when you STOP taking the Morphine every day, not while you are on it. Forgive me, I'm just confused by that comment.

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Thank you for caring! I have seen many drs in the last 15 years of problems I have had. I'm scared if this surgery because nt last syrgery my lung collapsed and I had ventilator for 18hrs in ICU with my arms and legs tied to the bed. I have had 12 surgeries in all, lost a child to leukemia, lost my father, mother and brother in hospitals. I an scared to death of hospitals. My pain is really bad like your fathers sometimes and I just want to end it all, but my doctors say my smile shows a strong will from my spirit and in November I will sooner or later make a decision. Both shoulders need help. There is hardly anything left of either of them. Thank you for again for such kindness! I look forward to talking with you soon! JJ Sacramento CA

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If the surgery is really dangerous for you, could they maybe give you a pain pump or steroid shots in your shoulders? That sounds awful to be in both shoulders. I remember you said you had several surgeries -could the problems have been because you had several too close together, maybe (if that was the case?) I'm sorry you are so afraid and I hope the Dr's can find a solution for your pain without surgery...I hope it's okay if we pray for you. Good luck!

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Dear Zydot, I have had steroid shots and no one will give me any more pain control other than the 120mgs of ms contin ER that I am taking now. I am having too many other health issues too. Yes I had 3 neck surgeries. I have a metal plate in the front of my neck and had cervical fusion also. It seems like a no end scenario. Thank you for being there and your prayers! God will find an answer. God bless us who suffer and those who are weak will stand strong as long as we can. JJ

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My husband was on MsContin for 15 years for pancreatitis. The insurance started making him pay a little more and so he talked to his doctor and they changed his medicine to GENERIC Oxymorphone (Opana). It was MUCH cheaper than anything he had been on before. If at all possible, try to talk to your doctor about changing to generic oxymorphone and tell them that the morphine has not been effective for awhile for the pain. When you've been on any medication for a long time, your body will get used to it and develop tolerance pretty quickly and so they become ineffective against pain after awhile. The Dr should be familiar with this. I genuinely hope things work out for you :) I just wish there were something more I could do because I know how painful that is...xoxo

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JJ: DO NOT END IT ALL!!! If you are having breakthrough pain, TELL YOUR DOCTORS. You may need a higher dose or additional meds. Screw the "addiction" part...there's no sense in being miserable.

PS: I grew up in Sacramento/Davis/Oakland, and most of my fam/friends are still there. I love Colorado but miss the Nor Cal coast dearly.

Hang in there...

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I was in very high doses of methadone and percocet for breakthru. I recently tried Suboxone and was surprised at the amount of pain

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Re: Blue Valentine (# 1)

You can decrease the frequency. Speak with your physician. I am sure you will arrive at a tollerable daily dose.
Prescribing guidelines are 4-16 mg daily divided.
My script. Take 1-2 every 6-8 hrs but do not exceed 6 tablets a day.
Works well fir me.
Please disregard prior comments on not using buprenorphine for pain, it works fine. It is the naltrexone component of Suboxone that blocks opiate receptors.

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Re: Untangledhealth (# 429)

It is mainly the NALOXONE (not Naltrexone) that blocks opiate receptors if Suboxone is injected. If it is taken sublingually as prescribed, it is the Buprenorphine itself that does it. The availability of Naloxone is only 5% or less when taken under the tongue.

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Re: kkh (# 430)

I have to agree with you. This is knowledge that I had heard from 3 different Suboxone doctors, from the streets from people who have taken it and experimented with it, and from myself (having been on it for 6-7 years now.) The Naloxone doesn't eve come into play unless you take it against advice and INJECT it. If you take it orally like you should, the Naloxone is a negligent amount entering your body. Buprenorphine does indeed block opiate receptors, and it does so for anywhere from 24-72 hours after taking it. Trust me, I know from experience and doing stupid things in my past.

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Re: Zydot (# 431)


Yes, people seem to think that Subutex and Suboxone are so different because of the Naloxone. But it is the BUPE ITSELF that is doing the "blocking" when taken sublingually, because Buprenorphine is a partial opioid antagonist. Naloxone is in Suboxone to keep people from injecting it, that's all.

When we put things into our bodies, knowing how those things actually work is a GOOD thing! :)

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Re: Blue Valentine (# 1)

Taking it later in the day like you said 6 times a day deffinetly mess your sleep time all up that's why its a first thing in the morning type drug

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Is 40 mg of suboxone a waste, as it hits the ceiling effect? Or will the pain relief increase with a higher dosage?

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Re: feelinbettergoinbroke (# 2)

Not true. While it will not address the acute pain, it does help some with the all over pain. If you have severe chronic pain, the positive is it tricks your brain and helps you deal with the pain yet doesn't take it away like narcotics do.

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Re: RPhd Houston (# 6)

Buprenorphine was created during the 80s and used solely for pain management. It wasn't until 20 years later that they began using it for withdrawals. So before you say s*** know what you are talking about.

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Re: feelinbettergoinbroke (# 2)

This statement is not true. Myself along with many other ppl take suboxine for pain relief. Most insurance companies don't like paying for suboxine for relief of pain.

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Re: fireman625 (# 3)

Suboxone film/tabs are not used for pain. However, an infusion of buprenorphine 0.3 mg IV/IM q6hr is FDA approved for pain; for IV, administered slowly over 2 minutes; may be repeated once (up to 0.3 mg) if required 30-60 minutes after initial dose

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Re: feelinbettergoinbroke (# 2)

That's untrue. It's used for both. It just simply blocks the euphoric effect. One suboxone strip is the equivalent to 60 milligrams of hydrocodone or oxy, ECT. So two 8 strips is 120 milligrams. I have a major dependence. I have had female and back problems for 17 years. My lumbar was broken in a fall. It helps me more than anything else I have ever taken.

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Re: feelinbettergoinbroke (# 2)

Sorry "feelinbettergoinbroke" but you are 100% wrong. I have many severe spinal problems from c-s, I was on a regimen of 160 mg opana plus 4mg dilaudid for breakthrough pain for aprox 10 years. But when the meds wore off I would feel so bad. I knew someone who also was a chronic pain patient and also had the same problem when meds wore off. I could not go any higher as I was on the max dose for these type of meds. This someone's doctor had switched him to Bup 8 mg 3x daily, and walla... no bad feelings when meds wore off, just the pain. I asked to do the same and found that this drug was much better at controlling the pain and had no effects on the body, brain. I will never go back to main stream opioids for controlling my chronic pain.

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