Surgery While On Suboxone

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I'm planning on having all my bottom teeth pulled and I'm currently on suboxone (16mg a day). I had my top teeth pulled 8 years ago & was given hydrocodone, which did not help my pain. I wasn't on suboxone then. It was very painful, hurt like hell. I'm scared and I know it's going to hurt, but I need advice. Since I'm already on 16mg a day, can my doctor give me extra or can the dentist? If not, can I take something else for pain? Are there any remedies for alleviating pain after teeth extractions?

I know when I had my daughter 2 years ago, I was on subutex. I refused all pain meds, I had a c-section & only took 1 anesthetic (you're supposed to have 2) I refused the 2nd 1 which was for pain. I regretted it, I could feel pain & was shaking, crying. My Dr said if I didn't calm down he's going to have to put me totally under. After the c-section I was given extra suboxone. I was given 2 subutex by my doctor & 2 strips from the surgeon a day for the 3 days I was there. I already felt horrible for putting suboxone in my child's system. I didn't want her to have anything else in her system. The nurse said I was 1/100's who did this? They didn't seem to get the point I had a human being living inside me forced to ingest a drug she had no say in. Sorry off topic. But my point was if the hospital & doctor gave me extra will they help me get through this pain?

After my stitches fell out of my gums it didn't hurt, but it hurt until then. I got a dry socket and I had 13 teeth pulled, 6 sewed with stitches and dentures put in immediately. It was worse than the c-section. At least my belly was numb & I couldn't really feel much. But having my teeth pulled hurt 100 times worse. Any ideas, help or suggestions? I do smoke cigarettes but I plan to stop after surgery. That's my goal date to stop smoking. What do I do if my Dr refuses to help me during this surgery since I'm already on 16mg? My Dr says that is the highest amount you can be prescribed now? Is this true? Ty for input, good, bad, pointless and helpful. All ideas and thoughts are welcome!

16 Replies

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1

Wow! I am so very sorry about what you've been through. However, having been through the experience of having my remaining teeth pulled and getting dentures myself, I do have some answers and ideas for you.

The first one is that most doctors and surgeons will have a patient stop Subutex and Suboxone about 3 days, before surgery, so they can make sure that anesthesia and pain medications will work for you.

As to the Suboxone, 32mgs a day is actually the FDA listed limit, but it does not always help everyone with pain, so it might be better to consult your surgeon/dentist and see what they recommend.

When I had my surgery done, I was given a low dose of Oxycodone, which I could double up on, if needed, though I never did take them all.

And stick with soft foods for awhile, it may be frustrating, but it is best for you, overall.

If you have any questions about having full dentures, please feel free to post back and ask. I'm happy to help, if I can.

Are you on any other medications?

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2

When I had all of my top teeth removed, they didn't do stitches. They put the teeth right in. Whatever they gave me, the pain was not unbearable! A little hard to remember, as I was 26 yrs. old, now 84. I was told not to try to remove the teeth, as they wouldn't go back in because of the swelling. They probably didn't do any stitching back then, and learned from that. Those years I never took anything, even aspirin unless absolutely necessary, so whatever they gave me worked really well!

I just remembered the worst part of my experience was that the dentist shot novocaine all over my top gums, the roof of my mouth, up into the top of all my gums, etc.! That is why I wasn't in terrible pain, as I stayed numb for a long time while getting used to the teeth. It was so bad for me because I have a real aversion to needles and didn't know he was going to do this, so when he started, I passed out!

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3

I had breast cancer surgery 7 years ago a mastectomy and Olympic to me and was on Suboxone and at the time. They prescribed me Dilaudid at the time. I was on it the day of the surgery and two days after and went back on Suboxone 12 hours after I took my last dose. I didn't experience any withdrawal nor side effects at the time.

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4

Dear sub 4. from what I hear you can take pain pills immediately after subs but the word is you should wait 24 hrs. before you go from pain pills to subs. I've heard the Naloxone can either make you sick or you won't feel anything from the pills. My best suggestion to you is to ask your sub sub subscriber what to do because he is a professional in his field. Don't be afraid to ask. I am no pro in this but can tell you about me. Everyone is different.. I'm sorry about the pain in your teeth but don't make it worse by doing the wrong thing. I just had an abscess done that may turn into a pull of the tooth.. The best thing for pain is prescribed antibiotics and Listerine. If you have a water pick, use that too. Pain pills sometimes made it worse.for me. Good luck with your teeth and I hope you do well. And give the antibiotics a couple of days. I'm a chronic pain patient an doctors refuse to give pain meds and won't do surgery on my neck and back fearing it will be worse. Sometimes I wish they would go through what we do and maybe they won''t be so stingy. Anyway, try to keep your teeth.Take care and I hope you feel better.

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5

As for pain meds, talk to your Suboxone doctor and oral surgeon. Have your Sub call the surgeon and make a plan for you before surgery. My Sub initiated the call for me.

For emergency situations, as in going to the ER, tell everyone you are on Subs. and tell them more than once...everyone! I was brought into the ER out of it, not knowing what day or time of day it was, I was in so much pain. My husband told everyone, but they were not educated about Subs. I was given 2 huge shots of Morphine and it did nothing...the doctor was shocked. I became lucid for a moment and told him I was on Subs and can't have Morphine, that it won't work. He came back with dilotid (sp) I believe and I was finally able to stop screaming, lie down and sleep.

If your Sub doctor doesn't help you, print out the information for your surgeon. They will probably say to take an extra half a strip or pill for 2-3 days, take antibiotics and Motrin 1000mg.for the duration of the pain.

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6

Depends on your dentist. I had teeth pulled for dental implants. They pulled from the top which hurt like hell. I left while still bleeding onto my shirt. He handed me a 2 oz bottle of Listerine & NOTHING for pain. When I went back 10 days later, I was IN HIS FACE, about how anyone, could yank 2 teeth out of your upper gums. and give NOTHING for pain, even for 4-5 days! I wrote bad reviews about him, warning everyone in the Manchester, CT area. not to go to Dr Laporta (Dental surgeon). Ask before you go. Find someone that will CARE about YOU and YOUR pain.

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7

Not true I am prescribed 24 mgs a day and my doctor is head off chemical dependence at Bayview. I've been on Suboxone for 14 years now and I have been given 24 milligram at least about three months into it

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8

Re: Kim (# 7) Expand Referenced Message

You didn't state what wasn't true. 24mg for that long? That's a LOT...especially for years.

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Re: Kim (# 7) Expand Referenced Message

It was a true for me. my doc cut me to 16 mg. ad day and no more and told me that was all he could legally prescribe.. So that was what i was going by. Maybe he lied because he thought it was all I needed but he was wrong. Are you sure your doc wasn't doing being illegal? Maybe it's different from the location. But that is what he told me.

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10

I had a double masectomy due to breast cancer, which is a major surgery. My Psychiatrist told me to be off Suboxone for 5 days and it would be ok. It was not!!! It takes 2 weeks of being totally off Suboxone for pain meds to work. I wish I could tell you that more Suboxone will help with the pain, but honestly, it will not. I am sorry to be the bearer of bad news, but this is the only way I know of to get through a surgery when you have been taking Suboxone.

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11

Re: Jennifer (# 10) Expand Referenced Message

It all depends on the pain meds they give you.

Say you are on Subs and get in a car accident...will they make you go off Subs for 5 days before preforming emergency surgery? NO! Most doctors don't fully know about Subs, when it comes to Pain Control. Most hear Suboxone and think drug addiction. So, they have no problem if you have to withdraw from Suboxone because
A) they feel you're an addict.
B)Are too high up on their horse to ask someone else with more Sub knowledge what should be done.
I am on Subs for pain control. Luckily for me, my Primary gives me the Suboxone. He will call an ER at 3am and tell them how to treat me, when they refuse to listen to me, or look in their computer to see how my pain was treated last time.

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12

Suboxone doesn't do anything for pain in high doses. I can preach this until the cows come home but no one will ever listen or believe that the less the better, like people that are on subutex for pain management with a patch that lets out a micro gram every so many hours or whatever it's a ceiling effect, the lower the dose the better it works for pain. Yes I know it sounds stupid but I've been on all subs and tex 10 years straight so trust me I know. And as far as the dentist goes, I had surgery to cut out my wisdom teeth and yeah the stuff they knock you out with works great. It's not an op but here's the deal. I had the convo with my dentist and the dentist surgeon about why I can't take them tylenol 7.5s because those are a joke to me, like children's aspirin. My tolerance is so crazy high and on top of that we're on an opiate blocker (subs), so I went back and forth with all my 3 doctors - sub, general and dentist - and did like an ****t and stayed off my subs for three days and I already knew it wouldn't make any difference and just suffered / stayed sick for a couple days. But I thought since it's been years since I've took any kind of opiate just maybe I can feel something off them to help with pain. And ha like I knew I got 7.5 hydrocodone after he told me he would give me something stronger after the countless times I explained my tolerance situation, but he sees us all as junkies even if you been clean 10 years. anywho that's a cause I gave up on a long time ago. But long story short I took 20 7.5s the next day at one time after 2 didn't work and only thing that happened was a super stomachache probably liver shutdown, only thing the dros was doing was trying to take away some of the withdrawals from the subs. You gotta understand subs are not going anywhere out of your body any time soon. if you was to stop now you'll have physical withdrawals for a month atleast and still won't be right in the head for a year.

I can only imagine when I get kicked off of suboxone it'll be illegal to take in a few years. I already can't get subutex because my state tn thought it was best only pregnant woman could get it, that it don't matter maybe hey I don't want this extra ingredient that makes me sick as a dog. The reason I was on subutex in the first place. But the dea has doctors so scared ha they won't even help you find the doctor that you go to to get a diagnostic that says you're allergic to naloxone. I kid you not my doc is an ex-methadone clinic doctor and didn't know of any doctors that do the naloxone evaluation and you gotta have a doctor recommended. So yeah another run in circles type of thing. I'm going through crazy stuff with my regular doctor to get my adhd meds because I failed a d-panel and I know it's a false fail because I haven't took anything in years but there's a new young know it all doctor at my nurse practitioners office now and he don't like me because I have tattoos and a beard and I had to see him one day. I never go to him, just happened to have to that month and yep the first d-panel ever from that office in 15 years failed. Can't tell me what it was for but ops and hey guess what I took a way better d-panel from my sub doc a day before that and who would've thought it, I passed because I'm clean with all the other documented d-panels ranging 10 years back, but I just so happened wanted to throw it all away that day in their eyes, but it's all good. You can sit there and tell this person that has control over your life that the panel is wrong, check me again, this is crazy, and they'll look you in the eyes and say the paper doesn't lie.

I'm not stooping to their level. God knows the truth. He'll be judged not by me. Sorry to go on a rant but yeah I have to call myself an addict still to get subs because I'm a recovering addict and pain management and there's no dr for that. It's like being caught in limbo. No dr will prescribe methadone. Only a clinic can. I can't pay for that so I just gotta claim I'm still an addict to get subs, so I can at least get out of bed in the morning. But here's a funny one if you wanna hear some humor out of it all, when I still had hope to maybe get something for pain that I wouldn't abuse, my ex-methadone dr told me to go get a long lasting op like morphine lol. The stuff I was taking that got me where I am now, that's like the most craziest thing I've ever heard and coming from someone that should know better I thought I was in the twilight zone. I'm at the point in my life that I don't have another round of ds. I'm too old. Well not really old, but in drug years I'm 90 and I would die if I went another round. I don't have it in me. I just wanna be normal but the harder you try the more they don't want you to be. People might think well he's making stuff up. No, the establishment is against recovering addicts. They think everyone is gonna stay in that cycle. Forget that. So what I'm trying to get rich by my career hopefully in next couple years and I can buy any dr I want and get exactly what I need. A crying shame but who cares - nobody. And I hope the best for you. I feel for you and I'll pray for you but it's facts, sorry. Best of luck. Thank you for your time. I'm not being sarcastic. I really do feel for you and will pray for you. God bless everyone. Thanks again.

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13

Sub 4--one time I went to the dentist to get a root canal and at the time I was seeing a pain doctor that prescribed Morphine for me. The dentist told me he wrote 2 scripts, one antibiotic and one for pain but I did not ask him at the time what they were.When I left his office I noticed the pain med was Vicodin. I thought he would give me something like naprosin.or some kind of anti-inflammatory. I didn't want to get in trouble with my pain doc so I called him and told him about what the dentist prescribed. It seemed like no big issue to him because it was such a smaller dose and for Vicodin, But that was him. So I don't think they know all the time what you get but I'd be careful if I were you. Are you getting your subs from an addictionologist? Because I know one that I heard of will give you the best pain meds until your pain is gone but then cut you off and back to the usual. So you might check with the doctor that prescribes you the subs and let him know. Maybe try to make the same kind of deal. Sorry, that's all I can offer. There is long lasting local anesthetic my latest edodontist gave me that worked great for at great 24 hrs. I don't know if your dentist would have the same medication. I don't know what the name of it is.but you might ask him about it. I don't know if that will be lasting enough for your pain but probably not... .

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14

Re: The Truth it hurts (# 12) Expand Referenced Message

You speak the truth. I am on Suboxone for pain management due to tolerance to opiates. I've had Student Doctors ask me if I abused my Oxy 80mg. I just look at them with a stupid face and say, "Hu? I swallowed them." They ask why I have been on Subs for 2+ years..because I am on it for PM. They say I should only be on Suboxone for 3-6 months, then ask how much I take. I guess they can't read charts. I tell them 4mg, but am allowed to take more if I need to. I love screwing with these guys.

At this point they are fumbling over their words, trying as hard as they can to get their hands on my films to count them, so they can run to my doctor. I tell them I only allow my Doctor to count my films if he wishes to, that I don't want any discrepancies. (My doctor hasn't counted my old films in over 6 months, he just asks how many I have left.)

So he comes back in with my Doctor, and makes a total ass out of himself. I told my Doctor in front of the Student Doctor, that the student has a lot to learn about Suboxone and bedside manner. That he should 1st introduce himself and his first question shouldn't be if I abused my Oxycontin. Maybe it should be, "How are you today Mrs. Blank? I see in your chart you are here today, at your PCP, for refills on your Meds. I see you are on Suboxone, may I ask you some questions about why you are on that Medication?"

If he did it with that bedside manner, I wouldn't have to have called him out, in front of my PCP. If it was my 1st appointment with him as a doctor, I would have walked out, way before my PC came in.

We need doctors who see us as a clean slate before they speak to us, and who have compassion. Not jacka**es who look at us as a piece of paper and a check.

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15

Re: The Truth it hurts (# 12) Expand Referenced Message

Why do you think it will be illegal? I also agree less is more. I am prescribed 4mg ..1/2 strip a day. (I asked to lower the dose.) I take 1 8mg strip every 2-3 days. If I forget the 3rd day, I start to feel icky. Not full WD, but enough to think, what the hell is going on. Then I remember and take a strip.

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16

Re: Verwon (# 1) Expand Referenced Message

I know this is from yrs ago but I’m having all my remaining teeth out I think 12 - 13 total , 7 on top and 5 on bottom which some have to be cut out , I do take suboxone / subutex for yrs . I’m not so much concerned about the pain afterwards , Bc Advil and ice packs will help and my suboxone ( some what ) but my concern is the sedation or general anesthesia or whatever they are going to use , does anyone have any w patience on this ? Or what did they do to you or somebody who had a similar operation , they are placing the immediate denture as soon as my top teeth are out

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