Transitioning from High Dose Opiates to Suboxone for Chronic Pain

Posted by faithgirl30 @faithgirl30, Nov 25, 2020

Hi! My name is Melanie and I’ve been on high dose opiates for the last 5 years due severe degenerative arthritis in my neck. I’ve undergone 5 spinal neck surgeries in the last 4 years, the last of which was October 2019. I am now fully fused between C2-T2 and have rods in the back of my neck for stability that run the full length of my fusion. I suffer chronic daily headaches and have just undergone the first round of Botox for headaches and cervical dystonia. My pain specialist and surgeon agree that I will more than likely suffer long term chronic pain for the rest of my life. They have recommended that I make the jump from high dose dilaudid to suboxone to manage chronic pain, which is an off-label use for suboxone, but which has been shown to successfully manage long term chronic pain.

I am writing to find out if others have made the jump successfully to suboxone, and if so what your transition from opiates to suboxone was like? I have been nervous about this transition, because it requires that you go cold turkey off of opiates and enter into full blown withdrawal before it’s safe to start the ramp up onto suboxone. So, if you have made the jump, what was the withdrawal process like for you, and has suboxone been effective in managing your long term chronic pain? Would you recommend others make this move? Why or why not?

Interested in more discussions like this? Go to the Chronic Pain Support Group.

Hello
I know your post about Suboxone is old , but I am wondering how you got on . I am interested in if the Suboxone helped your pain after you transitioned from dilaudid . I am in a similar situation. I am not worried about the process just if Suboxone was effective or not for pain .

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I was prescribed Suboxone for pain without opiate medication or withdrawal. After researching it I am afraid to take it! Does anyone have any advice or experience with Suboxone ? I could use suggestions

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Hi @caun3508, I moved your discussion and combined it with a discussion titled "Transitioning from High Dose Opiates to Suboxone for Chronic Pain" - https://connect.mayoclinic.org/discussion/transitioning-from-high-dose-opiates-to-suboxone-for-chronic-pain/.

I did this so you could read the experiences of members like @alh123, @stlr21, @clutch, and @jenniferpruitt, who have all discussed being on suboxone.

@caun3508, do you have a particular concern that worries you the most about this medication? If you are comfortable sharing, what is causing your pain?

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This is about my own Suboxone use, but a bit of history about my pain first. I had never used opiods before for pain. I have severe pain in my fingers, especially my thumbs, bilaterally due to osteoarthritis. I have exhausted all surgical options with the exception of fusion of multiple joints an ddo not want to fuse my joints yet. (Various injections provided no relief). One of my physicians recommended a trial of Suboxone to improve quality of life. I thought I was "allergic" to all narcotics as I would get hives from things like codeine or oxycontin. Nonetheless I gave low doses of Suboxone a try. It works well for me. I have been taking generic Suboxone 2mg/0.5 mg sublingual film for 2 years. It takes the edge off the pain and so far I have not had to increase the dose. For pain, it is advised to take it in split doses instead of once per day. I cut my film tab in half and take it a total of two whole film tabs per day. It does not seem to have many side effects and I have no itching from it.

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@JustinMcClanahan

Hi @caun3508, I moved your discussion and combined it with a discussion titled "Transitioning from High Dose Opiates to Suboxone for Chronic Pain" - https://connect.mayoclinic.org/discussion/transitioning-from-high-dose-opiates-to-suboxone-for-chronic-pain/.

I did this so you could read the experiences of members like @alh123, @stlr21, @clutch, and @jenniferpruitt, who have all discussed being on suboxone.

@caun3508, do you have a particular concern that worries you the most about this medication? If you are comfortable sharing, what is causing your pain?

Jump to this post

From web.md title of definition of Suboxone should allay some of your fears.

Suboxone for Opioid Use Disorder
Find out how suboxone reduces opioid cravings, helps manage withdrawal, and prevents overdose or relapse.

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Hello there,
I truly empathize with the amount of pain you are experiencing and the daily challenges involved with trying to manage it successfully. I say “manage successfully” because I don’t know of anybody who suffers from severe chronic pain or acute chronic pain that gets rid of all their pain or neutralizes all of their pain. I’ve been successfully using opioids for over 30 plus years to manage a number of types, places and sources in my body that contribute to my ongoing, severe chronic pain. I’ve tried just about every pain management medication and protocol there is, (excluding anything surgically planted inside my body).
Firstly, a stronger Opioid isn’t always better or more effective for successfully managing your chronic pain. Finding the right medication and or combination of medications and dosages are extremely important.
Secondly, I did and continue to do a lot of research about opioid medications. Putting aside all of the subjective feelings, attitudes and beliefs etc. Opioids exist for a reason. “THEY ARE EXTREMELY EFFECTIVE IN MANAGING SEVERE CHRONIC PAIN WHEN NOTHING ELSE CAN PROVIDE EQUAL OR BETTER EFFICACY!”
In my quest to find the best pain management protocol for myself, I included trying SUBOXON as an alternative to my regularly prescribed Opioids. You are correct in describing it as an “Off Label” pain medication. FACT: SUBOXON is an OPIOID.
Its initial and primary use was to assist people with an Opioid Usage Disorder to assist them to reduce or get off of the opioids they were taking all together. FACT: Not everybody who has used or continues to use Opioids has a OUD! FACT, most long time Opioid users have a Opioid Physical Dependence issue. Although different, similar to a diabetic who is physically dependent on their insulin,
I was assured by the physician who initially prescribed Suboxon to me that it would be as equally effective and provide the same efficacy as my OXYCODONE. That proved to be totally inaccurate and not truthful for me. It provided me very little pain relief and I found it to be woefully ineffective for my pain management requirements.
Even worse, when I told him the truth about my experience and requested to go back to my Opioids he refused to prescribe them to me. It was bad enough that his initial comments about the efficacy were not true and misleading. Even worse, was his refusal to prescribed me the previous Opioids I was on that had been very effective and worked well for me.
This entire situation exacerbated my pain and created a very real and almost impossible situation for me to find another physician who would prescribe me my Opiates.
Keep in mind that there was nothing in my medical files or history that stated or even in the slightest way suggested that I had ever abused my Opiate medications or had ever taken them inappropriately.
FACT: Suboxon”MIGHT” be effective for some patients as an alternative choice to there current Opioid medication but there is absolutely NO GUARANTEES that it will be. If the physician feels so confident that they will be as effective than I would expect them to write a letter stating so and a guaranteeing me that he or she would prescribe me my previous Opioid medication if the Suboxon did not work out as well as they had promised.
Like many controversial subjects in life, about 50% of the people will support it and about 50% will not. I found this to be equally true when it came to the subject of prescribing Opiates to manage severe chronic pain. Like many people and or positions taken on a subject, they will innately already have made specific decisions about something without researching it adequately or utilizing FACTS and RESEARCH to arrive at their decision(s).
PAIN and PAIN MANAGEMENT are very personal situations. Everybody experiences pain differently. There might be some people who share some common or similar experiences regarding pain and the levels of severity they feel etc. However, one must be free to investigate and try whatever they find to be the most efficacious solution for themselves.
Best wishes and good luck.
GODSPEED

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@philipsnowdon

Hello there,
I truly empathize with the amount of pain you are experiencing and the daily challenges involved with trying to manage it successfully. I say “manage successfully” because I don’t know of anybody who suffers from severe chronic pain or acute chronic pain that gets rid of all their pain or neutralizes all of their pain. I’ve been successfully using opioids for over 30 plus years to manage a number of types, places and sources in my body that contribute to my ongoing, severe chronic pain. I’ve tried just about every pain management medication and protocol there is, (excluding anything surgically planted inside my body).
Firstly, a stronger Opioid isn’t always better or more effective for successfully managing your chronic pain. Finding the right medication and or combination of medications and dosages are extremely important.
Secondly, I did and continue to do a lot of research about opioid medications. Putting aside all of the subjective feelings, attitudes and beliefs etc. Opioids exist for a reason. “THEY ARE EXTREMELY EFFECTIVE IN MANAGING SEVERE CHRONIC PAIN WHEN NOTHING ELSE CAN PROVIDE EQUAL OR BETTER EFFICACY!”
In my quest to find the best pain management protocol for myself, I included trying SUBOXON as an alternative to my regularly prescribed Opioids. You are correct in describing it as an “Off Label” pain medication. FACT: SUBOXON is an OPIOID.
Its initial and primary use was to assist people with an Opioid Usage Disorder to assist them to reduce or get off of the opioids they were taking all together. FACT: Not everybody who has used or continues to use Opioids has a OUD! FACT, most long time Opioid users have a Opioid Physical Dependence issue. Although different, similar to a diabetic who is physically dependent on their insulin,
I was assured by the physician who initially prescribed Suboxon to me that it would be as equally effective and provide the same efficacy as my OXYCODONE. That proved to be totally inaccurate and not truthful for me. It provided me very little pain relief and I found it to be woefully ineffective for my pain management requirements.
Even worse, when I told him the truth about my experience and requested to go back to my Opioids he refused to prescribe them to me. It was bad enough that his initial comments about the efficacy were not true and misleading. Even worse, was his refusal to prescribed me the previous Opioids I was on that had been very effective and worked well for me.
This entire situation exacerbated my pain and created a very real and almost impossible situation for me to find another physician who would prescribe me my Opiates.
Keep in mind that there was nothing in my medical files or history that stated or even in the slightest way suggested that I had ever abused my Opiate medications or had ever taken them inappropriately.
FACT: Suboxon”MIGHT” be effective for some patients as an alternative choice to there current Opioid medication but there is absolutely NO GUARANTEES that it will be. If the physician feels so confident that they will be as effective than I would expect them to write a letter stating so and a guaranteeing me that he or she would prescribe me my previous Opioid medication if the Suboxon did not work out as well as they had promised.
Like many controversial subjects in life, about 50% of the people will support it and about 50% will not. I found this to be equally true when it came to the subject of prescribing Opiates to manage severe chronic pain. Like many people and or positions taken on a subject, they will innately already have made specific decisions about something without researching it adequately or utilizing FACTS and RESEARCH to arrive at their decision(s).
PAIN and PAIN MANAGEMENT are very personal situations. Everybody experiences pain differently. There might be some people who share some common or similar experiences regarding pain and the levels of severity they feel etc. However, one must be free to investigate and try whatever they find to be the most efficacious solution for themselves.
Best wishes and good luck.
GODSPEED

Jump to this post

Hello to you all, please excuse all of my previous misspellings of SUBOXON instead of SUBOXONE. You misspell
it once and it threads through the entire piece.
Thanks,
Phil

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