Maximum Dose Of Suboxone/subutex & Chronic Pain (Page 2) (Top voted first)

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

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Maybe you should go to med school. Suboxone had been used as a pain killer in other countries for years. Why would they make subutex without the blocker? It is a painkiller. I have scoliosis, 3 herniated discs, arthritis, disc deterioration, spinal stenosis. Suboxone is giving me my life back and I have never been addicted to opiates. it also has taken away my painful, awful withdrawal/side effects of Effexor. I've been trying to get off the AD but when i do i experience awful brain/body zaps and my pain comes back ten fold. Suboxone has cured both, I feel like a new person. It is a painkiller. Look it up.

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Hi, it's been a year and a half and I see a number of responses to what I wrote.

To the guy who respectfully disagreed. I am so happy that you are drug free and, I sincerely hope that anyone who can manage their addiction and remain drug free without drugs do so without the aid of drugs. I admire you. However, there are a great many of us who do not have such an easy time of it. It is to those that I was addressing when I wrote what I did. And I truly hope that everyone one understands that there are many ways to treat a disorder and that if you succeed, the worse thing that you can do is criticize or offer a negative opinion so much so that the addict feels guilty about taking medication and not doing your particular way.

Had Dr. Drew given Mike Starr Buprenorphine, would he be alive today?? And if he were on buprenorphine twice daily would that be so bad? At least he'd still be making music. Yes, I agree, if we can taper someone off of BUPRENORPHINE, WE SHOULD. But if we can't, what is the alternative other than sobriety. H, Vicodin, Oxycodone, death from overdose. I am a physician, and I don't treat every person the same. Some go to rehab and do well, others have been to rehab 2, 3, 4, or more times and buprenorphine gives them their life back. Yes I agree, some people have a hard time getting off of opiates. But what you don't understand is that many of us are genetically damaged and are missing certain genes that control various neurotransmitters. When you were on Oxycodone, H, or anything else, the reason you became an addict is because your brain began to crave the drug to fill in the vacant gaps. That is why you can go your whole life without a problem and then one day break your leg, and once you get vicodin, your on your way because your brain got a taste of what it needs. This only happens in 15-20% of people. But when it does, it comes out with a vengeance. What cam first, the chicken or the egg. If you are addicted and cannot get off of your drug of choice, and buprenorphine helps you to do so, that's great, but don't expect that you will be able to get off of buprenorphine easily if your brain hasn't changed. Just like they say in AA, take one day at a time. Just because you stopped the craving with buprenorphine and you have got your life back doesn't mean that your can stop the medication easily. For instance if you are a diabetic and on insulin, once your sugar is controlled doesn't mean that you could survive without insulin. In fact, most will never get off of insulin. Remember, that what is true for you, may not be the answer for someone else. If Phillip C. Hoffman had had buprenorphine, I believe he might be alive today. I certainly could be wrong. But I do know that he was in rehab 3 or 4 times and tried to follow AA / NA and it didn't work FOR HIM. So remember, don't throw stones at glass houses, because we all must be treated in a way that fits our physiology and psyche.

Remember, there is little difference in the outcome with either suboxone or subutex. the naloxone is there only to prevent IV drug abuse. That being said, about 5% of people may have a reaction to suboxone because of naloxone. Similarly about 5% of people seem to notice the difference between either drug despite the fact that it isn't supposed to happen. There is no explanation for this. I have patients who swear that suboxone works better than subutex and vice versa.

Lastly, believe it or not, as long as one is on constant buprenorphine at least 12 mg daily, the doctor can give that person an opiate for pain and it will work because 2-8% of MU receptors are still open. However, if you are on subutex, you cannot feel high. Also, as long as you were on subutex first and it is maintained at 12 mg daily, the added opiate for pain will not make one ill. However, never ever run out of subutex because if you do and then try to start an opiate and then later try to restart subutex, you will become deathly ill. The bottom line is that no one should be on subutex unless they are under doctors supervision. It is too complex of a treatment. Usually, people develop their own theories like "it doesn't work" or "I couldn't get off of it," but weren't under the care of a physician. What addicts do is try to control treatment and usually they fail because they don't understand what they are doing. Americans make up 4% of the planet's population yet our country consumes 80% of the licit and lillicit drugs in the world. We have the most AA NA CA groups, rehab programs, methadone clinics and spend double what anyone else spends on healthcare yet we have the most overdose deaths, relapses, and addicts in the world. Think about it. If what we are doing doesn't work, why do we keep doing it? Addiction is the only area of medicine that is treated by lay people. If you had a heart attack and I told you that Bill here also had a heart attack and I trust him, so since he had the same experience he will be your sponsor and get you through this heart attack, I would hope that you are skeptical. I treat more people as an outpatient successfully than I ever treated in a rehab center. Why? because patients are on the right medications and treated long term. Anyway some of you will argue the points, but the point is to have an open mind and constantly re-evaluate what you are being told.

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Does it make sense to restrict doctors in the amount of patients they can have? Does anybody get turned away when trying to find a Sub Doctor? It makes no sense at all. Suboxone is a wonderful drug that can be used for pain relief without all the negative effects that comes with the traditional pain meds. It saved my life. I have chronic pain and was on hydrocodone for 8 years. Of course I became physically dependent- or addicted. I wasn't getting pain relief and took more and so the story goes. My mind became obsessed with the pills but I still had pain. Now I still have some pain but suboxone takes the edge off without any foggy headed high and without the obsession. I never run out and I never obsess. I wish more people that were ready to stop the cycle of addiction with pain pills knew about this and I really wish it was more accessible. Because it was a real problem trying to find a doctor that wasn't over the patient limit. But why have a patient limit in the first place? I tell you- I wish I could become a politician and change the laws. The only thing that makes complete sense is that it WORKS! IF more addicts got help that truly made them better well that would change the enormous amount of money being made off those pain pills. PLEASE if anybody out there is thinking about suboxone - DO IT- keep looking for a doctor. IT may cost some up front cash at first but hell it is sooooo worth it and it truly works. NO withdrawals no sickness and if you have pain it does help. You may not be at the right dose. I have had doctors that think they know everything but they don't. I have been on this for 3 years now so if anyone has any questions please feel free to write me back. I want to change the laws governing Suboxone and I know the world's percentage of addicts would go down tremendously!!!!

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Hi! My daughter is on Suboxone and is also on medicaid. Medicaid is paying for it completely. You might ask your pharmacy why your ins is denying to pay for it and see if there is a way around it. My daughter dropped to a lower dose, a 2mg film, and since it was new, medicaid didn't have it in their system yet as a covered item so they denied it. The dr called in something that was covered.

As for everyone that is knocking this medication...I suffer from fibromyalgia and need both of my knees replaced. I work full time as a nurse and about 10 yrs ago (before I went back to work and before I got my pain under control) I was going through the frustration of taking way too much pain medicine. Every opiate known to man kind. Ended up addicted and miserable. Suboxone has literally saved my life and my RN license!! I don't know what I would do without it! I might be dead, actually! I've been able to postpone having my knee replacements several years and because of a divorce, I have gone back to work full time. I agree with one thing....it DOES change you....for the BETTER!! When you feel better, your mood is better and everything falls into place! Life is just so much better now!

I hate that people don't understand the drug, however. My mom isn't a fan of me taking it. But she hasn't experienced what I have been through either. Unless you have dealt with chronic pain first hand, it is not fair to judge the drug!

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Unless you have a PHD or you're a licensed pharmacist do not give INACCURATE advice about the uses of ANY medication.

There are countless medications that are prescribed for many other uses other then their intentional ones.

Suboxone is one of them. Just methadone, suboxone can be and is used to treat pain. It is considered safer in fact then opiate painkillers, how true that fact is, is very arguable. However the FACT still stands that many pain management centers actually prefer the use of suboxone and methadone to traditional painkillers.

Everyone is different and not every medication is the answer for each individual patient.

Ask your doctors these questions people, not random know it alls on the internet. ..

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I'm an Addiction doc as a previous Suboxone patient. The active opiate is buprenorphine, a mixed agonist/antagonist with high affinity at opioid receptors but with lower intrinsic activity. Therefore it binds very strongly to receptors but doesn't produce the same "kick" as full agonists. Regardless of using Suboxone, Subutex, methadone etc etc the truth remains...there is a price to pay for addiction and anyone expecting to find the "no pain" method ought to give it up. You can spread out the pain or deal with it more acutely but when taking this drug for addiction you'll just have to deal with some withdrawal at some point. As an analgesic it is very effective but as a partial agonist it will not have the potency as full agonist meds. It has a slightly lower dependence risk and easier withdrawal than a full agonist like methadone. I currently work in a clinic which uses methadone and have to say that buprenorphine is a better choice for most, but nt all people. And I agree with the post about spouting off ignorance here. There is no place for that when you are dealing with pain such as requiring opiates or addiction requiring formal treatment.

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ourselvesyone that hasn't bothered to educate themselves bupenorphrine has sooo many possible uses, not merely opiate addiction. Its moderate mu receptor activity does make it a valid option for pain management for some, and its high affinity for saturating but not stimulating the kappa receptors make a wonderous drug for depression.... it is the combination of these actions that make it practical for opiate addiction. That being said we still don't even know everything its useful for, only time and study will tell. Keeping an open mind and avoiding instances of judging others seeking help for themselves will help us make these discoveries. Lets keep negativity to ourselves children and keep in mind we are all in the same boat.

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100% agree. I just started yesterday after 8 years of 200+ mg a day of oxy. I feel so much better already!

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AMANDA: There are several people on this site, and even on this very THREAD, that say Buprenorphine (Subutex, Suboxone) works very well for their chronic pain. It would probably be better if you (and others on here) said something like "it doesn't work for ME"....I would hate to see someone refuse to even try Bupe as an option because of what you said, when in reality it may be the very thing that could work best for them. Just saying.... we are all different; what may work wonders for one may be useless for another. Thanks.

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RACHEL: Four milligrams of Suboxone a day is a pretty low dose, so I wouldn't worry too much about your liver with that small dose. Better that you are on the Subs, instead of taking opioid pills, that are worse for your liver than the Subs. Especially if you take things like Vicodin, which has Tylenol in it. Tylenol (Acetaminophen) is EXTREMELY hard on the liver. Be glad you are only on 4mgs a day. That is about as low a dose as you can get, and shouldn't be horribly hard to detox from. Your Suboxone doc should help you with this.

As far as your recovery "being honored" while on Subs, that depends on who is doing the "honoring". If we are talking N/A, they do not consider an addict to be truly "clean" if they are on Methadone or Suboxone. You can attend the meetings, sit and listen, but can not participate, can't get your "chips" for being clean, etc. This is why I do NOT recommend N/A for opioid addicts. Opioid addiction is VERY different than most other addictions. We change our brain chemistry with all these artificial endorphines being "forced" into our receptors, and many of us may need ORTs (opioid replacement therapies) for the rest of our lives. Having an agency dedicated to recovery telling opioid addicts that they are "still dirty" because of using ORTs does more harm then good. The recidivism rate for opioid addiction is over 80%, so ORTs are VERY necessary for many of us, and one should not be penalized for doing what they must to stay off of their drug of choice. Look into Life Ring; they are an alternative to N/A and they DO NOT JUDGE the addicts for being on Methadone/Subs. Good luck.

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Hello sorry im a little nervous never commented on a post before. But i am a suboxone patient have been for many yrs i was feeling a little down today about taking it for so long and found your post. I just wanted to say thank you. Reading your post helped me in more ways then one. People who have never felt withdraw,depression and just worthless from this addiction just dont understand. Unfortunately my mother and husband are the main people in my life and with all the other addictions they have had they dont understand this one and it hurts sometime. I have been clean and on subs for about 5yrs and they cant understand why i need this medication. But it really does help me function and gives me motivation to take care of my daily duties as a mother and provider. So i just wanted to say thanks for your post you never know how much words can help.

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Actually do the research!!! Bupenorphine was developed for pain. Surgeons used it for surgery. It wasn't approved for drug addiction until 2002 at which point a lot of doctors stopped giving it for pain. Yes!!! It does help that's what the original purpose was.

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ZYDOT: Those Precipitated Withdrawals are a blast, eh? I actually SAW DEMONS! After being an opioid addict for 30 years, I thought I knew what really bad withdrawal was....oh no, not even. Au contraire.... that s*** is RUGGED!! I was in the bed, then running to the living room, then back to the bed, then back to the living room, then I would try to go get in a hot bath...about 10 SECONDS after getting in the bath, I would be JUMPING out of the bath. Then the vomiting. Then the leg cramps that were LITERALLY making me SCREAM. I would stand in the hallway, bend down at the waist and grab my calves, and just friggin start SCREAMING!!! The walls were breathing, I was seeing things. I was absolutely, hypothermia-level FREEZING, yet I was sweating as if I had just ran a marathon. I mean, WET T-SHIRT CONTEST, but not in a good way. I was literally in and out of consciousness and don't even remember some of it. My spouse had some Trazodone that was prescribed for sleep, the spouse started shoving them down my throat, until FINALLY I passed out from all the pills, thankfully. The spouse says it was SEVEN Trazodone. That is enough to kill someone, actually. I woke up about 8 hours later in a pool of my own sweat, in the floor NEXT to the couch, not even ON it. I felt like I had been hit by a train.

This was all going on at night. I couldn't even get relief. The next day, as you said, I was so tired I could barely move. I was pretty much useless for the next two days, I was so wiped out. My legs were BURNING from being so cramped, I couldn't eat and could barely drink any fluids. I basically spent the next 36 hours or so getting back into bed. So pathetic. Anyone else reading this? As Zydot says, YOU DO NOT WANT THIS!! When you think you have waited long enough to start your Bupe, WAIT LONGER!!! It just isn't worth it.

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Re: feelinbettergoinbroke (# 2)

I just wanted to say that I take Suboxone for chronic pain and I am almost pain free. I've had 3 lumbar fusion's. I've got spinal stenosis, osteoarthritis, severe nerve damage in my low back, edema in both hips and a few other pain related issues. It works better for my pain then any of the oxycodone, morphine or dilaudid I was taking. I didn't take all those at the same time, I'm just saying the Suboxone works so much better for me than any opiates that I've been on over the years of struggling with chronic pain.

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Re: RPhd Houston (# 6)

I used to take oxycodone, opana, norco, lortab, and every other opiate....fentanyl, hydromorphone, and only one worked with no side effects for me. Subutex pretty much saved my life. I take it when I wake up and have a bad back, due to herniated discs L1-L5. It helps phenomenally. I feel no pain the whole day. So don't go back to med school. It's legit. Only 8 mg.

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Wait at least 18 hrs. This will decrease the potential for hyper withdrawl syndrome.

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You CAN get your life back. Find a doctor in your area who is able to prescribe suboxone. You will not regret it!

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Does suboxone constipate you? Does it cause you loss of appitite? It causes me both of these and thats why i'd like to stop using it. I have chronic back pain. Would appreciate an answer. I know it's very personal. But I just bared my soul on here somewhere(and now I can't find that post. I got an email and it mentioned facebook and twitter. I hope to hell that they don't show that post on facebook.

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I disagree that prescribing Subutex for pain is a psyche job. There is a tremendous amount of scientific data showing it is a successful mix. I also speak from experience. You didn't mention why you think the way you do. I'm curious.

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My 70 year old Mom takes Suboxone Sublinguals every day for her disfiguring Arthritus. She takes 1- 8 mg in the morning and 1- 8 mg at night. Dr even prescribes 3 per day, but she only uses a third one when she is in severe pain. So it is prescribed for pain and the does doesn't depend on metabolism, or body weight.

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