HI I was on methadone and had to have my colon checked, thought I would die from the pain I kept reaching for the drs hand to get the thing out he knew i was on methadone but did not care. Everyone else in the room was sleeping, none of that stuff helped me wide awake. When I went back for the results he laughed and said you thought you were gonna die, I wadded up the results and threw them at him called him a stupid prick and walked out. I am so strung out on oxys for so many fractured bones. I am going back to methadone, I am scared but too addicted so I have to. Scared as hell but have to do it. I am so sorry of all your pain but the drs don't know about these meds, lv Tudy
I have been on Suboxone 8mg/day and I am facing surgery in 2 days. My surgeon also didn't seem to understand anything about the Suboxone. In speaking to my Sub prescriber, she is very aware of this "disconnect" w/ many docs/surgeons and this issue surrounding surgeries for Sub pts. She ALSO suggested to me what you were told -to take my Suboxone as normal, and to have some extra on hand (which she provided), in case it is needed for pain relief when I wake from surgery. She said that I am on a relatively low dose (at 8mg) and the max should be 24 mg/day, so we have room for me to take up to 3 of my 8mg pills, during this surgical time. She states this will be better for my pain relief, since we have that wiggle room to increase the subs, vs. stopping it all together & hoping that the surgeon/hospital could treat my pain effectively w/ narcotics (under an ignorant umbrella of not knowing hot to treat someone w/ a higher opiate tolerance), then having to "start all over" to wean off the narcotics and start the Suboxone again.
** I'm wondering how this worked for you and your surgery? Was the Suboxone effective for surgical pain?
Thank you & I'm very hopeful you are doing GREAT 1 year post-surgery! :)
If you are taking opiates or heroin and are not at least in the beginning stages of withdrawal, taking subutex/suboxone will make you VERY VERY sick. It is called precipitated withdrawal, meaning your body will force you into full on, worst possible withdrawal imaginable. However, if you are in the beginning stages of withdrawal and take subutex/suboxone, the subutex/suboxone will stop withdrawal and your dose will be increased to avoid cravings or any further withdrawal symptoms. Once you are on subutex/suboxone, whether it be a week, a month, or years, and you attempt to take narcotics in any form or are given narcotic pain medication during or after a surgical procedure, you will not go into withdrawal. The suboxone/subutex covers your pain receptors making it impossible for the narcotic pain medication to penetrate or work at all. The more you wean down off the subutex/suboxone, the pain receptros in your brain become less and less covered. Think of it this way: say your body has 30 pain receptors(just as an example to make it easier) and you take 8mg subutex/suboxone per day for 2 years(subutex/suboxone/buprenorphine are basically the same medication except subutex does not have the naloxone in it which is only activated if you try to inject your suboxone into a vein. In that case, the naloxone is activated and will put you into severe withdrawal. Other than that specific case, the naloxone does nothing as long as it’s taken as prescribed and not injected into a vein). Ok so again say you have 30 pain receptors and take 8mg subutex for 2 years(3 months/2 years……doesn’t matter the Length of time) and you have surgery coming up in s month. Once you’ve begun subutex or suboxone treatment, if you take 8mg everyday, it has around a 36hr half-life. This means that you are adding 8mg on top of 8mg on top of 8mg and so on…..everyday. The ceiling dose is 24mg. Anything beyond 24mg is basically disposed of by your body and broken down and has no effect. Essentially after 5-7 days, depending on how quickly your body breaks it down since it is stored in fat cells, the more fat cells you have, the longer it takes to be excreted by your body. By day 5-7 you essentially have 24mg of subutex in your bloodstream and since 24mg is the ceiling and all 30 pain receptors are fully covered, the rest is excreted as waste and has no effect. If you stop the medication cold Turkey……after about 36 hours(1.5 days) you will still have 12mg of subutex in your bloodstream and 15 out of your 30 pain receptors are still fully covered and the other 15 are not (again, the more fat cells you have, the longer it will take to be broken down). By day 3(72 hours) you will have about 6mg of subutex in your bloodstream and approximately 7.5 of the 15 pain receptors that were still fully covered on day 3, are now fully covered and impenetrable, leaving 22.5 of your 30 pain receptors no longer covered. On day 6(144 hours) you will have 3mg of subutex in your bloodstream, with around 3.75 pain receptors still fully covered, leaving 26.25 of your 30 pain receptors no longer covered. Now this is where it gets the most difficult as far as withdrawal which is why a slow taper is a much better option if possible because once you get below the 4mg mark, your body really start to feel the symptoms of withdrawal and you will start feeling pretty lousy. On day 9(216 hours)you will have approximately 1.5mg of subutex still in your bloodstream, with about 1.88 of your 30 pain receptors now covered and the other 28.12 pain receptors uncovered. On day 12(288 hours) you will have approximately .75mg of subutex in your bloodstream, with about .94 of your 30 pain receptors covered, leaving 29.06 of your 30 pain receptors uncovered. On day 15(369 hours) you will have approximately .38mg subutex in your bloodstream with less than 1/2 of 1 of your 30 pain receptors covered leaving the rest uncovered. However, the miscommunication with most surgeons, doctors, nurses or any other healthcare professional completely uneducated with how subutex effects pain and pain receptors; it takes a long time for your natural pain receptors to transmit your pain level to the brain because they haven’t had to do any work for the past few months to few years essentially rendering them completely dormant since the subutex basically just gave them months and months of “vacation” . Now, those receptors are like “ok, something doesn’t feel right, I gotta maybe start to kick into action”. The pain receptors are again having to wake up and do their job and that takes some time. This is why any surgical procedure or accident where narcotic pain medication is necessary, it takes much higher doses of that narcotic to have much of an effect because your pain receptors have remained dormant for such a long time. Doctors, surgeons, anesthesiologist etc. may know the basics of what subutex does(and by basics……I mean that they automatically and wrongfully ASSUME that anyone who takes or has taken subutex in any form, anytime recently, is a drug seeker and an addict) causing them to wrongfully judge you and be very hesitant to prescribe narcotics at all, especially since subutex is 10-20x stronger than morphine, and fentanyl is the only drug that will penetrate the impenetrable pain receptors that subutex still has a grip on or those receptors just recently came out of hibernation. All surgeons and all anesthesiologists should be REQUIRED to take continuing education on subutex so they can be better prepared in the event of an emergency or upcoming surgical procedure so they know how to adequately control their patient’s post operative pain. Sorry for the long message……..but I am a medical professional and although I don’t have the ability to prescribe the medication, I was however, on subutex for 2.5 years after being on high doses of oxycodone and having over 20 surgeries in 9 years until the root cause of most of my issues was able to be removed and I wanted to go off of the pain medication since I no longer needed them. Hope this helps anyone with an upcoming surgery or just needing to know information about subutex. Again, these are approximate details, as no two patient's body chemistry is the same and everyone’s individual chemical makeup is completely different. There is a lot of scientific analysis that goes into each person’s dosage as well as how quickly or slowly medications leave each individual person’s body. If you’re able to wean off this medication, my recommendation is to do it slowly and allow your body time for your blood levels to level off before weaning down more. I’d recommend cutting your dosage by 50% for 2-3 weeks until you are down to taking 4mg per day, and at that point only cut back by about 25% for 2-3 weeks as long as your body tolerates it. If not, go back up to 4mg and wean even more slowly by allowing 3-4 weeks for your body to level off and only go down from 4mg to 3mg for 3 weeks, then to 2mg for 2-3 weeks, then continue going down by 1mg for 2 weeks. Once you’re able to tolerate 1mg, then you can cut back by 25% for a couple of weeks as long as you are tolerating it ok. Hope this helps!