Transitioning from High Dose Opiates to Suboxone for Chronic Pain

Take it. It changed my life. It returned life to me.

Exactly the same thing happened to my husband with suboxone. It was a nightmare of months of trial and did not control his pain. He finally was able to back on the opiate that managed his pain and he is the clearest on in his head. Then recently he needed a spinal cord stim removal surgery of a paddle lead, which requires a reverse laminectomy as it fixed to the spine to avoid migration. 2 weeks post op the pain clinic decided he had hyperalgesia. He was not near recovered from the surgery just needed more time. They did not taper slowly using the DHS guidelines of 10% per month for those on long term opiates and dropped his dose 33% in 1 month. He never failed any urine tests or missed any appointments. There was no reason to put him through that. He is now in bed too much due to lack of pain relief He has pressure sores on his heels and ankles. The dose he is on is not adequate for pain relief. We still do not know if he can ever get back to the opiate dose that worked for him. He has absolutely no life.

Hi Nettegirl,
I am so sorry to hear about your husband’s plight regarding his pain meds, ( insufficient dosage of opioids). After using opioids for 34 years, I have experienced about every problem possible in getting them and continuing to get them. It’s either a physician issue, pharmacy or insurance problem etc.
By far, the biggest hurdle has always been and remains on the physician prescribing side of things. Unfortunately, after having a doctor willing to assist me be able to confidently rely upon him or her, they move, close their practices, retire, become disabled or pass away etc. Trying to find a new physician and or related pain clinic to continue to assist me has pretty much become impossible.
I only have the physician I have now due to a mutual personal relationship with another doctor who assured my current doctor that me, Phil, is a straight up guy and you can trust him. This is after I had spent 3 months contacting various pain clinics throughout California and had 3 individual, personal meetings to review my files and discuss my case in hopes that they would take me on. All I got was a “RESOUNDING NO!”
My recommendation to you is to take the next step like I did. Find a “Palliative Care Physician” who may be in a better position to more adequately assist you and your husband. Firstly, I got mine because my current doctor is 76 years old and who knows when he might retire, move or no longer be able to practice medicine? Again, a sudden loss of his services would be catastrophic and life threatening to me.
So, I also currently consult with my Palliative Care Physician who counsels with me about recovering from my Prostate Cancer and the other health challenges and related disabilities which require my need and use of opiates. He also prescribes me some other helpful medications to manage my overall health challenges.
The most important requirement is to find a physician who is empathetic to you and your husband’s needs and is willing prescribe the appropriate amount and daily dosage he needs to lead the best quality of life he can. This can be an ongoing search and I know how difficult and heartbreaking it is to be held hostage in this situation.
Unfortunately, all of the younger and newer doctors these days won’t even broach the subject and really will not be of any benefit at all.
They lack the knowledge, empathy and experience to have any idea regarding what chronic pain or acute chronic pain is or how to manage it for the long term. What it is and how to effectively treat it.
Their personal policy on the issue is simply, “I do not and will not prescribe any opiates under any circumstances!”
Apparently, the general stand on this subject is based on the assertion that “Opiates don’t do anything to cure or make the patient improve of feel better!” Therefore, they are of no benefit!!!!!
Nothing could be more WRONG!
Firstly, there are a number of diseases, illnesses or physical injuries where there are no cures or effective treatments available to measurably cure or heal their medical maladies. However, having to continue to fight and deal with chronic pain everyday on serves to make the entire situation worse, punishes the patient and ruins the patient’s overall quality of life.
So…….in fact, Opiates do provide a great deal of benefit simply by managing the very uncomfortable chronic pain. The fact that no treatments including opiates are going to cure or measurably improve the patients level of recovery is a non starter and completely irrelevant.
FACT: when a patient’s pain is more adequately managed and improved by a reduction in severity it most DEFINITELY DOES improve the overall health, wellbeing and quality of life. That is a huge improvement over doing nothing or not providing the patient with the adequate dosage of pain meds, (opiates) to better manage and enjoy an improved overall quality of their life.
How could any physician really believe this to be of NO BENEFIT to the patient,
The simple fact that it can significantly reduce the amount of overall suffering should be more than sufficient enough evidence to provide adequate pain relief through opiates to the patient.
Unfortunately, the inappropriate prejudice and outright dis information against opiates are causing patients to unnecessarily suffer and die.
I’ve been in a position a handful of times where I came as close as a person could come to taking their own life due to the out of control pain and suffering I could no longer endure.
I spent the better part of 20+ years home bound and bedridden due to the incredible severity of my disease states and associated total disabilities!
All I can suggest is that you keep searching for an empathic physician and or Palliative Care Specialist to assist you.
Best wishes,
Good luck and
GODSPEED,
Phil

Ten or so years ago, I was on high doses of narcotics. I took four 80mg OxyContin and four 30mg OxyContin daily. More if I could swing it.
Did it help pain? Mmmm not really. I grew tired of nodding off for a second or two at dinners with friends, or parties.
Finally I took a week and went cold turkey. It was not at all easy.
Once I got the crap out of my blood & system, I didn’t know what to do with myself. A friend suggested Suboxone and I’ve been on a low dose since. I started with 16mg/day weaning down to two mg. Upon my request, I have been maintaining at 4 mg. I feel great. I travel. I love time with partner & friends.
Suboxone helped enormously with putting my life together.
Btw, I’m 76.

This more info on the topic: https://www.va.gov/formularyadvisor/DOC_PDF/CRE_Buprenorphine_for_Chronic_Pain_MAR_2024.pdf. Hope this helps.

is this ldn?

???

First of all, your pain management doctor should wean you off opiates. My doctor very gradually decreased my foster of Percocet. What's the rush? When I was first given Suboxone I was taking 1/2 strip 2 X a day. I believe that's 8mg but I don't remember for sure. With that dose I was a walking zombie. I couldn't drive for fear of nodding off. I just about fell on the ground while feeding my horses because I had nodded off. I couldn't handle it. In stead I started taking the same daily dose, but split into 3-4 doses instead of 2. That was much better. It did help a little with my pain. I'm also taking Gabapentin. I should say that my psin is due to me shattering some of my vertebae and bone shards had penetrated my spinal cord. I'm in pain 24/7. Nothing I've tried has helped as much as Percocet- Gabapentin combination. I also take Cymbalta because it helps a litte with back pain. I was also taking Subutex for a while. It's Buprenorphine sublingual same as Suboxone only it doesn't contain Naloxone.

Does the suboxone help stop the pain?

A little.
I’ve grown accustomed to my pain. Generally constant pain is blocked out.