On Suboxone and Need to have Surgery

I hate to read all these horror stories especially since they should have been avoided. Any Dr. prescribing suboxone has to take a course where they learn a week prior to surgery to switch patients to subutex. The only difference is suboxone contains naloxone which totally blocks opiates and can stop the anesthesia from putting you under.

So anyone needing surgery please ask your Dr. to switch you to subutex which contains no naloxone. Its the naloxone in your system preventing the pain meds from working not your tolerance to opiods. Though your opiod tolerance will be higher than some regular Joe off the street.

Sorry I didn't find this sooner I wish I could have helped some of you to prevent these horrible ordeals.

Duncan

There is NO BLOCKER in suboxone. The naloxone is there to put you into withdrawal if you shoot it. Its the main ingredient (buperphine) in suboxone which binds to you receptors stronger then other opiates which causes the "blocking" affect. Think of suboxone as crazy glue and other opiates as elmers, which one stronger? hence the bupe stiocks to your receptors the most. Bupe has a half life of 36 hours so after 72 hours you should feel the effects of other opiates, but you will have a very high tolerance due to bupe being about 40 times stronger then morphine. I would stop taking suboxone 4 or 5 days before surgery and take a weaker opiate such as percocet or vicodin to help with the withdrawals.

Not true Subutex has both the agonist and the antagonist effect that suboxone does. Thats why there is a ceiling effect. I asked my sub doc about this because of frequent kidney stones, I thought I could take subutex and still be able to get some pain relief. He told me which you can confirm for yourself, that it wouldn't make a difference. The only difference is Naxolone which is only put in there to like you said throw you into withdrawals if you shoot it up. There's no way around it, no matter what they put in your veins its not going to help! If I was having surgery (or could have predicted the kidney stone attacks) i would come off the suboxone completely before going into surgery. That stuff sticks to your receptors for ever. Well not forever but for a long time. :!: :!:

I am a pain doc and anesthesiologist. I would tell patients to stop the suboxone 24-36 hours before the surgery. Restart the suboxone when the post op pain is over. Ask for nerve blocks, to numb you up, if possible.
The severe postoperative pain is a result of your body's tolerance to opiates. Whether it is suboxone, morphine, oxycontin or vicodin that you take, it causes tolerance to the pain meds used after surgery. It is like a person who drinks a two bottles of vodka a day. One or two drinks won't even make them slightly tipsy.
The bottom line is: plan on needing alot more pain meds than the typical patient to give you relief postop. Ask your suboxone doctor to prescribe your pain meds if your surgeon is uncomfortable with this. Speak to your surgeon and anesthesiologist about nerve blocks and toradol (an anti-inflamatory). Lyrica has also been shown to help reduce post-operative pain. You might need to be admitted to the hospital for post-operative pain relief with a PCA pump. This delivers morphine or other pain medications through the IV.

First of all no one ever informed me how to go about the Suboxene and Pain Killer. I used my own strategy after a shoulder replacement. I know that if you use Sub and opium at the same time the effects would block out the opiate. Therefore I stopped the suboxone June 10th the day of my shoulder replacement. From that time on, I was released from hospital next day June 11th 5pm. I had no suboxene up till this point. The doc prescribed 60 percocets, 30 oxicodin-5mg and I was in Pain. I decided to take the pain med without the sub till pain went away then I would stop the pain med and resume suboxene. In the meantime there was noone from my primary doc, the surgeon, to the house drs. No one said anything about the suboxene. By sunday night I felt good pain wise but for some reason i was feeling tooo good. It felt tooo good to be true. I woke up on Monday morning, 4days after surgery and no sub., feeling like the sky was going to fall. I felt like I had the hangover of my life! My blood pressure went way up. Although I was not in any pain I felt worse than I could ever feel in my life: sluggish, depressed, unhappy etc. I had NO physical pain but I am still dealing with the mental pain and the concerns of blood pressure along with SEVERE headaches. So I thought, since my shoulder felt good Monday morning while all this was happening I thought it would be wise to do my suboxene. I do 11/2mg/day so usually when I feel like this I take my sub. or another half and it would usually make me feel good. I did take one tab of sub. within 20 to 30 minutes, I felt 70% better. I did not do the other half of sub that I normally take at lunch time and that evening I took one Oxcodin trying to limit the amout of opium in my body. I was proud of myself of this but I realilzed that when I did not take that 1/2 mg sub I did not sleep all nith my blood pressure was 150/100 and had massive headaches. Now, hear I am the next morning after taking my sub. and I will resume my regular sub. regimen. I will inform my surgeon of my nightmare. Doctors have to be informed and educated on how to prescribe pts like myself and others in order for us not to suffer. This is riduculous. I have like many of you a medical disease called addition and I felt like I did not get the treatment I would have if I had some other type of diagnosis like diabetes. Now at the moment, should I take 2 sub or my 11/2 because the pain is gone from the surgery. HELP. Good luck

%-) I've been on suboxone for 18 months. I had a severe back injury and I need to get back on pain managment untill after surgurey.Itake 16mg a day.Iheard if you go back to opiates you can have severe withdrawl.What the hell do I do? I'm in severe pain every day.I need info please.

%-)
Hello everybody,
I need help please! I have been taking Suboxone 8mg 3times daily for about 2 years now. I know we all know how well Suboxone creates wonders. However, I am going to be getting surgery in about 2 months on my left ankle. I have never had surgery before, but my orthopedic explained the process as far as meeting with the doctors. My question is, do I stop taking (by taper) that week the suboxone, or do I continue. I know I am going to be in terrible pain after the surgery. Also, does Suboxone affect the anesthesia? I dont mind getting opiates prescribed because i can have them monitored but if anybody could help me out, itd be MUCH appreciated!!

Thanks ALOT!

ALWAYS take your Sub with you for surgery . No matter who you tell they will not have any and you will be in agony !! Take your own bottle and the Nurse and Dr. should be made aware of this before you go under .
I awoke from a shoulder replacement and nearly died from pain .Finally my sister gave me my suboxone from my own bottle -NONE of the meds they give you will stop pain as Suboxone blocks opiates . No matter what they say they will NOT have sub in their pharmacy .

Hi,

I had heart surgery last December. It was bilateral thoroscopic surgery for a minimaze procedure. I had been taking suboxone for about three months prior to the surgery and stopped 24 hours before the surgery like my addiction specialist doctor told me to do. I woke up from surgery with tubes coming out of me and in the worst pain of my life! I was writhing in bed and moaning with my teeth clenched and swearing like a sailor. I begged anybody I saw for pain meds. Turned out they had given me a couple of mg of morphine IV, but it didn't do anything.

They finally decided to give me 2more mg of morphine and there was no effect. Then somebody thought to give me IV toradol. That saved my sanity and mediated the pain enough so I could pass out. I was in the hospital for five more days and by the third or fourth day, the IV morphine had started working. But then they said that I had to switch to pills in order to be discharged. I needed a lot more hydrocodone than they prescribed, but being a former addict I had to hand the pills over to my wife and take no more than 10mg/4 hours. It dulled the pain a little, enough to keep me from suffering too much, but I did suffer until I went back on suboxone after three weeks. I think I would have been pain-free on the hydrocodone if I could have doubled my dose, but being an addict, that's looked at as drug-seeking.

I have knee surgery coming up in two weeks. I plan to stop the suboxone one week prior to surgery. I expect to have withdrawls, including a lot of severe anxiety for the last half of that week, but I think that the drugs they give me after surgery should work. I'll let you all know how it goes.

Bob

:shock i am new to this sight and i am absolutely freakin out! What is the answer? I am on suboxone 24mg daily, i transitioned to sub from 5yrs of methadone (which was the worst thing i've ever experienced). I have been doing well but now i have to have major oral surgery, my sub.dr. was debating what to do - my nurse at the dentist office said she didnt know what suboxone was, i explained it contained naloxone-an opiate atagonist..she asked, "what's an opiate!!" I was lost for words. My sub. dr. decided that i should just go thru the surgery taking suboxone as normal, he explained that it has simular pain management as morphine, and concluded that what ever the dentist gives me, even if tapered off-prior to, will not be sufficent. I am very concerned. I will be under anestesia for 5-6 hrs. I don't even know if that will work the way it should. The only peace of mind i have is that my dr will be on call and wants me to call if i am in too much pain, he will either prescribe extra sub. or switch me over to fentinyl , but from these stories that is not as easy as it sounds... i am scared.... (sorry for any mis-spelling)

Well I am scared to death now also. I am having foot surgery on Dec 10. I willmake sure I tell all my drs about this drug. I hope I do not have to go off it one day. I guess, from what I read, to not stop the drug and tell my foot surgeron to give me a heavier dose of meds. I hope they can knock me out.

speck91854 (and others):

Suboxone does not interfere with MOST anesthetics. An anesthesiologist has a number of choices of general anesthetics (regional anesthetics using local anesthetics injected into areas to make things numb are not affected by Suboxone either. The problem you will have will be with the pain meds (opiates) post surgery. Suboxone will block most pain meds for about 24-48 hours after the last dose is taken (the more sub being used, the longer it will take to leave the opiate receptors where it binds and allow reg opiates to bind there and have an effect). The only opiate that can knock suboxone off the opiate receptors is fentanyl, and many doc's just won't prescribe something that strong (perhaps really strong doses of other pain meds would work, but again most doc's won't prescribe the large amounts necessary to "overcome" the blocking effect of the sub). My advice is to start tapering off the suboxone a few weeks before the surgery with the goal of being completely off for at least a week before surgery (yes, this will be hard) and like I said, yes pain meds will generally work 24-48 hours after the last sub dose, but you really don't want to go into the surgery in suboxone withdrawal, which typically lasts about a week after the last dose (with days 3-5 being the worst). Also you may want to go the website of the manufacturers of suboxone where I've heard they have info for doctors relating to how to treat individuals pain meds who are on suboxone. Maybe you could print some stuff out and show him/her.
Hope this helps. Good luck with the surgery.

Hello yzernan MY name is STEAMER and read your artical just today so you may never read this but hey it woke me up I need surgery second on my back-got stenosis 2and 4 bith sides down below. Was on oxys but forgot to take a few times and almost died-in coma grossmont hos . for 10 days. Woke up0 on 16 methadone a day--10s- well it took me 3 years to get to 6 and finnally put myself in nut house for 3 days and got me off it and 5 others.My mind is almost back been on saboxon 8mg a day cut in 3 peices. Well i was sick on methadone for 3 years after I got to 6 and lost 40 lbs and I new I was dieing-no docs help. I waiting a6 months mew doc to take me off well he didnt the hospital did and I saw him same day and he said i would die without suboxon and been on it for 6 months still have withdrawles from methadone-wired up and no sleep-I didnt sleep for years-maybe 4-5-4 nights wired awake then sleep 2-well your artical the first one I have read and bot what a wakeup that there will be a problem and glad I caught on to it. I see sub doc next wedsday and my doctor for everything else the ssame day and will find out what time it is iwith both of them and mmmme with suboxon and they will say whatever but will come down to docs in hospital.I want off suboxon-been addict on oxys and forgot didnt overdose under dosed and then try the good meds for pain and then get off tham again-I just dont like the nerve pain I will have after stenosis surgery will be bad but I have to able to walk thanks good day STEAMER













:D :D

I just joined this forum and am not sure how to post myself. I'm glad you shared your situation. My personal situation is simililar to yours in that I have been wiening off 8mg of suboxone daily prior to my surgery. (been on Subox for about 2 years.) When I found out I needed stomach surgery I knew I should wein off of subox and made a goal to be Subox Free at least at least 2 weeks before surgery. Now, 9 days away, withdrawal has hindered THAT goal several times. I'm down to 2mg daily. Yesterday I didn't take any despite the 2mg leaving me feeling a bit "our of sorts", but not in full blown withdrawal. I didn't research or ask my doctor for advise and after reading what MOST doctors advise, I am glad I didn't or I would have likely only stopped 2 day before surgery. Today I couldn't get out of bed for work. Because of the aching in my legs I thought MAYBE its the suboxine so I took about 1mg (just guessing-as I chip off a piece of an 8mg tablet. After about an hour,I was able to function again. THEN I decided I better google the question, "HOW long do you need to be SUBOXONE FREE before surgery that require opiate pain relief". My question for you is, you were already in Suboxone withdrawal when you had surgery, right? Then 5 after surgery (10 day suboxine FREE from wiening down to .25 mg daily for weeks) you still were suffereing withdrawal? Did you resume suboxine after the 4 days you were on Lortab? Now that I have only 9 days to go and today I took suboxine, I am VERY worried. I will keep researching for an alternative pain med (I'm guessing Dilaudid is NOT an opiate as a few writers indicated it offered some relief). THANKS for sharing.

I know this post comes in late but in case someoen else gets this post on a Google search result, I had been on 8mg Suboxone for a year ad had to have a ulner nerve transposition in my right elbow. My addiction Dr told me to be off Suboxone for 4 days prior to surgery. I met with a pain specialst who recommended Fentanyl 50's for 3 weeks. I was in a lot of pain even with the Fentanyl 50 so she bumped me up to Fentanyl 100's which worked perfectly.