How To Convert To Suboxone For Pain Management? (Top voted first)

I have been in Pain Management for 15 years. I have the usual round of diagnoses. Herniated discs at cervical, thoracic and lumber spine. Bone spurs through out. I have spinal cord compression in my neck. Pain. I just switched from 16mg of Exalgo (Dilaudid ER) with Fentanyl ir for breakthrough- back to 100mcg Fentanyl patches with 15mg Morphine 3x a day for breakthrough. I feel like a trapped rat. To the outside world I'm a professional woman, mother of 3 grown children. I'm no different from any other junkie though. I wanted to go into suboxone assisted substance abuse treatment. Then I found out that, for quite a while, you have to be at the program every day to pick up meds (and go to therapy/group). I'd lose my job! I can walk into Pain Management, ask for Suboxone and leave with a 30 day prescription. Yet I can go to the local harm reduction clinic and they give me one day supply and 2 hours of counseling. I'm the same person whichever way I'm treated! I'm confused. Has anyone here been through the process of deciding where or whether to seek Suboxone treatment?

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I too was in the same place for the same reasons. I actually went down on some of my medicine before I switched over and besides my mind being more clear I couldn't even tell I switched. The only bad thing is that if we ever need something for pain people look at us like we're drug addicts because suboxdone is used mostly for opiate addicts. I was just in the hospital two days ago and they refused to give me anything for my pain because of suboxone which I think is really wrong because people like us are trying to better ourselves. You would think that they would take that into consideration. I hope this helps you and good luck.

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Yes, I have been to pain management because of cervical stenosis and excruciating neuropathy from MS. I was also an opiate addict for 20 years so I know about either way feeling like a criminal. Because yes, I was one, and then I was a patient. First of all, you have to talk better to yourself if you want to be successful. You are not an everyday Junkie. You are on a s***load of meds from what originally started as pain. So even if you have become addicted, you are physically dependent and will be on Suboxone as well. That's it. The good news. I don't know what state you are in, but if you go to a licensed Suboxone prescriber you can have a 30 day supply but you will have to come way down on your meds first. Yes they have Suboxone clinics, just like methadone clinics. And if your pain is still super bad, perhaps get on one drug that has an incredibly long half life. Methadone has a stigma. I know, but with your pain you can get it prescribed too. You take 4 pills in the morning and it will last you through your whole day. Very strong too. Because to be honest, you will just have to kick Suboxone in the end too, and it is not fun either. So I commend you on wanting to get off but look at your options and you are not a junkie but rather physically dependent. We love you for your honesty.

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Suboxone, what they don't tell you? Yes it helps to take you off pain meds and it does that but when they take suboxone from you, you are right back they same way you were, in pain. Now you will have a harder time getting your meds for pain, it's to only take you off what they call a addiction? Not what happens when you have nothing. RG

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Hi Mya,
I also have major spinal issues and 7 spinal surgeries. The 80mg of oxycontin x3 and 10mg x3 plus percoset wasn't working on my pain after being upped over 10 years. I was going out of my mind and didn't want to leave my house. I read about Suboxone for pain and decided to try it. I was getting my oxy from my primary, so I found a wonderful Pain Management doctor. The first few months I had to go in every 2 weeks, then it became monthly. I absolutely love him, he is an OA and Primary Care Doctor as well. His office has PT in the same little building, he always runs on perfect time. I changed him to be my primary care also. He is a private group practice, so it isn't a clinic where you would go every day for a dose. His staff are a bunch of great girls, who greet me with smiles.

The first few days on the suboxone I cried a lot, for all the time I lost staying hide away. I cleaned so much of my house it was insane. Suboxone definitely works for chronic pain.

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Hi my name is Vicky let me start out telling you i am 39 years old with multiple sclerosis ,between nerve pain headaches body aches ect and became addicted to my pain medication and just about lost everything i had untill i heard about suboxone !!when you first start you will get 1/2 pill 3 or 4 times a day for 2 days then you will be put on 6 day supply 2 suboxone strips once a day and if you stay clean and everthing goes well you will be moved to biweekly and once a month ,i have a life and can do things with my kids and my pain is controlled good luck.

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Hi there. I am in a program as well, but there are Drs around (like mine) that give you a monthly supply. I went into treatment, because I was clean for just a few months & then I started taking one here, 5 there, 30 there and so when I was in my treatment place they give you subutex (spelling maybe wrong) but in classes there was a lady who came in to teach a class and I remembered her telling us about more Drs are going to start treating and writing prescriptions because the hard truth is prescription abuse is the leader of all the drugs out there. So about a week after I got out I started up again and then I called their office and she told me about 3 drs in my area and I got in to see the dr. They don't take insurance and the first visit is $125.00 and then after that it's a phone appointment every month and it's $75.00. The Dr calls you on the phone and talks to you about the month and if your going to counseling and all that. I've been with him since dec 2015 we have tapered down from suboxone 8mg to suboxone 2 mg but I don't ever want to stop taking this cause I already know me. But we will see. So if your area has any rehabs I would call them and just ask a lot of questions on who will help you. I'm in west Texas. Also those lady's that taught that class said as of feb 2016 there was suppose to be a whole lot of Drs that were going to do the opiate programs. Just look around and call everyone. Praying for you.

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It's up to you which way you want to do it. Like I mentioned, I had to work up to monthly scripts. Once I started taking it I started feeling my emotions, and my doctor encouraged me to take time for myself. As I was trying to makeup for years of lost time. If you do the monthly route, you can always pick your own therapist and schedule convenient times, if you feel you need it.

I would think the daily clinic would be a cookie cutter program. (Just my opinion) They would want everyone on X Dose by X Date, and tapered off by XYZ. The biggest problem I see with this type is not everyone is there by choice. A lot is Court Ordered Probation. (around here) What happens when you put people who want help with those who don't? Usually the "don't" know every trick in the book! And being physically dependent, feeling like s***, being in pain, and just wanting to feel better, our brains take over to do anything to feel better. It's not our fault, but that's what our brains tell us.

My Cousin signed herself into a Detox Hospital to get off Benzos. 95% of the other people were Court Ordered/Tricked into signing in, then wouldn't let out. She said all they talked about was where she could buy them when she got out. Others were getting off other things, and would pretend to take their Benzos and give them to her for stuff Doctors were giving her! All of these meds were given in front of a nurse, then they had to open their mouth to prove they took them.

I would stay clear of clinics and find a Doctor's office, if at all possible. Especially if you will need to continue on Suboxone for chronic pain.

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Patricia,

They refused to give you pain meds in the hospital? That's insane! I have been to the ER twice since being on Suboxone. My husband knows to tell everyone not to give me Opiates. I was delirious from the pain and they gave me two shots of something before I was able to relax. The Doctor commented how much pain I must have been in needing 2 shots in the IV. Not enough for when he sent my husband home, as they were keeping me for observation. Then he tells me he is going to do surgery...suckered wouldn't buzz me out of the ER, because of the IV in my arm. I told them to take it out or I would. They said if I took it off I would bleed to death...Really? Bleed to death in an ER. ?? My husband and I say I am on Suboxone for my back pain.

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Mya s. I've been in the exact same position. I had to choose between my job or opiate treatment. Drug and Alcohol services here in the UK are terrible. You should never have to choose between medical treatment or work.

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Two things everyone considering Suboxone should be aware of: 1) the Naloxone in Suboxone will BLOCK any other opiod from taking effect; and 2) once you have Suboxone listed on your records, NO OTHER doctor will EVER prescribe pain meds to you again. It DOES NOT matter if the Suboxone was prescribed for pain or not. There is a major push underway by the government to switch EVERYONE taking pain meds onto Suboxone. I am NOT trying to discourage anyone from taking it. However, docs are NOT giving all relevant info to patients before switching them. Please understand, if you take Suboxone and are injured accidentally, and require emergency surgery, NO amount of anesthesia or opiods will work to ease pain. You have to detox from Suboxone BEFORE you can have any type of surgery, as the Naloxone (Narcan) blocks pain meds from working.

Before you switch, PLEASE read the other Suboxone threads here on Medschat. Also, Docs will tell you Suboxone is used for pain, but that's NOT how other healthcare providers look at it....they see Suboxone, and automatically classify you as an ADDICT. Thus, it is almost impossible to get any other Pain Mgmt. doctor to treat you! Please dont fall for that BS line. Look at the other Suboxone threads, and you will see what I mean. I have lost count of the number of people switched to Suboxone, who completely lost any chance of getting pain mgmt. later on. Also know that, once on Suboxone, you will eventually have to detox from it, and many say the withdrawal from Suboxone is way WORSE than withdrawal from any other opiod.

Again, not trying to discourage anyone from taking it. I just want to make everyone aware of ALL the facts, not just the "rosy" side. Good luck everyone in trying to obtain pain relief in this barbaric, inhumane environment.

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Hello can u list the doctors in the area of 07011...tu

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Joe,Where is those numbers from. 07011? I'll see if I can find you any doctors in your area!

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Thank you everyone, for your responses! It helps me feel less alone!

"Suboxone, Suboxone, what they don't tell you? Yes it helps to take you off pain meds and it does that but when they take suboxone from you, you are right back they same way you were, in pain"

I want to find a Physician who would manage my PAIN long-term with Suboxone. I'm not interested in being weaned off pain medication, so I can be completely debilitated and unable to function. I've been put on Methadone before, for pain (several years ago). I was never looked at as uncontrollably addicted to drugs. I never had anyone comment about it or refuse me medication. I could not DEAL with Methadone! I'd pass out driving, while at work on my computer- all I could do is sleep. OH! It also made me extremely HIGH, which never went away.

"You are not an everyday Junkie. You are on a s***load of meds from what originally started as pain. So even if you have become addicted, you are physically dependent and will be on Suboxone as well. That's it. The good news. I don't know what state you are in, but if you go to a licensed Suboxone prescriber you can have a 30 day supply but you will have to come way down on your meds first."

I appreciate your comment Matt! My main concern is that it took me 15 years of using opiates for pain to get to the dosage I'm taking now. HOW and WHY does a Doctor expect me to "cut down a lot" before starting Suboxone? I can barely move to get out of bed or off of my couch a great deal of the time. I can't stand feeling groggy and altered. Nor can I stand living in such pain that I'm seriously contemplating suicide. That's what I meant about feeling like a trapped rat.

Thank you so much for responding to my post! All of you... It is SO helpful to me!

XOXO,
Mya

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I been on high doses of opiates for 15+yrs an i was told that Subutex or suboxone would help my pain an get me off pain meds for good well they meant emotional pain not physical pain an also told me I'd get a monthly script all lies I had to go daily just to dose it cost way to much an I had to go back to my pain meds but it took forever cause addiction was then put on my record an all this has ruined my life as no doctor wants to help me an UVA doctors told me no surgeries available pain meds the rest of my life an they only gave me a recommendation letter for my family doctor to do it if he would cause I live to far away for them to do it I wish I would have did my research on all this before I took a step that I'm now regretting so to all ppl make sure you no everything before you act upon it hope this helps

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I guess what I was trying to say is that I would only consider Suboxone an option if it was being prescribed BY a Pain Management Doc for pain. I don't want to go to an addiction clinic and try to substitute it for my regular treatment. I believe this is what some of you have been advising me.

My treatment is in Spartanburg SC. The treatment here has been terrible compared to where I came from. My Doctor sees 100 people a day (!!!) and obviously can't spend much time talking with/considering his patients. He's put in that position by the company he works for. I was used to a Doc who was very thoughtful and took his time! Anyone know Docs here or in Greenville?

Mee-- I know exactly what you mean regarding "Once I started taking it I started feeling my emotions, and my doctor encouraged me to take time for myself. As I was trying to makeup for years of lost time."

9 months ago I trimmed way back on Dilaudid and started taking an antidepressant for pain. About 2 weeks later I "woke up" to the fact that I've basically sat on my couch for 10 years, feeling nothing. My mother died of leukemia and I felt nothing. I've barely seen my kids and thought to myself, "Well, that's just the way it is." When I realized this had gone on, I started to panic about the time I'd lost and "feel bad". I stopped that antidepressant and reupped the narcotics. I don't like the numbness anymore though. I have realized that instead of looking back at what I missed out on, I need to get on track for "now" and make some decent memories!

THANK YOU ?? ALL!
You give awesome feedback!
XOXO

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Why is it so dangerous to take klonopin with Suboxone more so than any other opiate? I have severe anxiety with panic attacks and I got off of pain meds but they won't let me take klonopin for the anxiety; when I was on every opiate you can think of in the past 17 yrs and I took klonopin. What is it about suboxone that is more dangerous than 12 80mgs of oxycontin and 6 30mgs of oxycodone and klonopin? I never abused my meds, I just decided I was done. I don't crave them or want them. But my anxiety and panic attacks have been so awful I don't sleep at night. I'm ready to tell them to take me off of the suboxone and go back in the hospital to get off it so I can take my anxiety meds. The anxiety and panic attacks are much worse. So tired of all of it. Need advice. And does activated charcoal help with U/A's?

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Dear Michelle,

I think I understand your question about the activated charcoal. If you took drug (even just one pill) that you weren't supposed to, will the charcoal eliminate the drug from your U/A? NO! Don't try it because you'll get in trouble!

There IS a fairly serious interaction effect between Klonopin and Suboxone. The 2 of them work together to depress breathing, causing blackout, Coma and Death. Of course any other Benzo, downer or alcohol would do the same thing to some degree. BUT Klonopin has an extremely long half-life in your blood, increasing the danger period. The FDA has released this to Doctors:

"To reduce the risk for overdose deaths, clinicians should not prescribe opioid pain medicines together with benzodiazepines to patients unless there are no adequate alternative treatments available, the US Food and Drug Administration (FDA) announced today.

Both classes of drugs are central nervous system (CNS) depressants, which can trigger respiratory depression, coma, and death, especially when they are combined."

There sure are those Patients who have Psychiatrists, who are treating them with both medications. This is because they have a Doctor who is convinced of his/her competence in Pain Management and Addiction Treatment. However, many Physicians fear being censured by their professional boards AND are feeling under skilled at this point in history.

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Dear Folks,
Could you please give me feedback about suboxone docs in the Greenville-Spartanburg SC area? I asked my pain doc and just got told that suboxone and Methadone are not used for pain here!

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Hello,
I have a similar story. My grown kids finally convinced me to switch from fentanyl patches, etc. to suboxone, and I am so glad I did! I feel much better and have more energy. Suboxone seems to help more for the pain than anything else. The only negative part is that you have to go through withdrawal for a day or so, which if you have ever gone through it, is pretty awful, but its definitely worth it and I encourage you to do it! You need to find a pain management doctor near you that is qualified to prescribe suboxone, and then you should be able to visit him/her once a month as you do with pain meds.
Good luck!!

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So interesting about how suboxone blocks other pain meds from working. What a horrible position to put someone in that needs surgery. Often pain sufferers have back surgery in almost on a routine basis. The fact that, if you take suboxone, you're labeled an addict for the rest of your life! Ack! What? You have to withdraw from your opiate to get on Suboxone? WTH? It is downright inhumane and unconstitutional the way pain patients are treated. It's just devastating to think of my future as a degenerative disc, arthritis patient. I'm just scared to death! I don't feel like an addict they only craved to be free from pain. I'm in my 50s working on my second back surgery (the first one was botched by hungover Dr who was fired). I told my doctor that I was afraid that they would take me off pain medicine. Luckily she said that she would just do the best to try to keep me humanely medicated. I really think all the Nsaids are killing me. So is the Gabapentin. I think the opiate Vicodin which is the only thing I'm on is probably the least damaging to my kidneys and liver. I'm just scared to death! We need to stand up for our rights. You can't travel when you can only get medications one month at a time. I lost out on a free trip to San Francisco because of the way my medication had to be picked up at the pharmacy nearby instead of one in San Francisco. It's just all so inconvenient and I just feel like a felon half the time because of the way I'm treated with random drug panels, pill counts, lack of freedom to travel, possible misconception of being an addict, strip-searched and forced to urinate, lack of privacy! It's just all too much for a person who's already debilitated go through! Our doctor should also be not such babies and stand up to these people who are making poor judgements because of people who abused the medicine. I think most of the deaths are on heroin in my area anyway..... but they don't care about that. They just want to control all the legitimate medication. I guess they can't control the heroin. But the pain patients are the only ones suffering and it's really getting on my nerves. Actually causes me so much stress I wish I could be on some sort of anti-anxiety medicine like I used to be but they won't give them back. Cold turkey that was fun.

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