Help. I used heavy narcotics for chronic pain for 12 years. I won't EVER touch it again. I only have to think of the hellish month of withdrawal I went through and what life was like before to even keep my mind from going that direction. I currently use 1-2mgs. Of suboxone tape, as needed, but still at least once or twice a weeks. So far no problem. Here's the problem... I will be having my knee replaced in 12 days. I want to use suboxone to treat the pain of this horrible surgery. Is this possible? How much can you take at one time? When they did my first knee, as a habituated pain patient, they gave me 40 mg oxy pills! It has been 14 month since I had anything more than 4 mg of suboxone a day, but will suboxone cover the pain of a knee replacement? Thanks, Harmony
Suboxone and surgery. Will suboxone cover the pain of a knee replacement surgery?
Question posted by Hrmnee on 8 Dec 2011
Last updated on 2 May 2017 by kelmore
3 Answers
They r sawing your knee. U r gonna be screaming in pain. Take the pain meds then switch over
Great answer cetterferge. In addition to what she said I would contact your sub doc and let him/her direct you to how you should proceed. And yes if u do have to take the pain pills you must have someone in your support group help to keep you accountable. You also might want to ask your surgeon to prescribe Toradol which is a super strength NSAID. The only thing is that u can only take them for 5-7 days in a row due to irritation of the stomach lining. Sometimes right after surgery NSAIDs will increase bleeding in the first and second postoperative days. Again this is a question u must discuss with your surgeon and your sub doc to formulate a pain control plan.
Good luck and I hope that everything turns out ok for you...
Thank you for your support and suggestions. A friend recommended a nerve block and the toridal is an excellent suggestion. It is a Miricle drug as far as I am concerned, and then can give it IV while I am in the hospital for those 4 days. It is good to know that more is not necessarily better with the suboxone. THE PROBLEM is that unless I stop the suboxone, today cold turkey, it will still be in my system preventing me from being able to take pills. I heard that you willing into opiate withdrawal if you take ANY opiod within a week of taking ANY suboxone? Does anyone know if that is true, or not. I would rather just stay on the sub for the entire treatment of the knee pain and then taper off as soon as I am able. Aso, I have to be careful of heavy duty anti inflamitories are they give me esophegeal spasms (feels like a heart attack). Currently I only take tylonol and 1/5 of a stripof Suboxone daily.
Hi Hmnee... it is not true that you will go into WD if having taken suboxone in a week and stop and then take an another opiate... quite the contrary.
Also re: the Toradol... even if you get it IV it still has the same effect on the gastric lining... so please be careful about that. It is a really super drug for pain. Too bad you can only take it for 5-7 days in a row due to the possibility of GI lining damage... please take it with Pepcid or protonix or Prevacid... something like that to protect your tummy.
Good luck to you with your surgery. I would get the advise from your sub doc also... be well...
So , I have never been able to find out, how long does it take suboxone to leave the brain after your last dose? In 2004, while I was still very dependent on nacotics to treat my nerve pain (at that time I was being prescribed, oxyconitin and oxycodon) I had a big surgery, I was really scared the night before, so I couldn't sleep the entire night before the surgery. When I got to my room post op, I was,of course, exhausted, a stupid nurse, not reading my chart and not realizing I had a high tolerance, thought because they gave me such a big dose of morphine after the surgery (understanding my tolerance), decided that because I was so very, very tired that I was ODing, so she gave me narcan, and then went off shift. I went into full instant withdrawal and had a seizure. If it wasn't for my room mate getting a doctor, I might have died.
So, yeah, I get nervous at the idea of mixing an anti narcotic drug with a narcotic (although this would be the opposite way around.) I did experience withdrawal syptoms last spring when my Dr. Accidentally prescribe a codiene cough suryp to me when I had phenumoia. It wasn't fun, but it went away the next time I to some suboxone (unfortunately, it took me three days to figure out what was wrong!) duh. So, again, the question, how long does suboxone stay in the body and what is the fastest way to taper off of it? Just curious, in case I need to use this route. I do hope I can get through it with only the suboxone. Thanks, Harmony
Dear H... since suboxone or buprenorphine is an opiate that is not "up regulating" it does not sprout extra receptor sites... so... after you take the last dose it has to go through its half life distributions without having to get rid of extra receptor sites... Remember it has a long half life so not only is your body getting rid of the last dose but also some of the other doses. The way half lives go is that... let's use 10 mg to make it easy to understand. In 72 hours or so... half of the 10 mg will be gone... then in another 72 hrs half of the 5 remaining mgs will be gone... and so on... until all gone. Another thing u must consider, and this is variable,is that buprenorphine is very lipophilic (fat loving)... so if you have a lot of body fat it will stay in your system longer... conversely if you have little body fat it will stay around less... so as u can c it is variable...
Other opiates are what I said earlier... up regulating drugs... the brain produces more receptor sites over time when taking the drug on a regular basis... this can occur in as little as two to three weeks... of course the less time on them the less the WD symptoms will be. Anyway... these extra receptor sites start begging to be occupied, hence physical tolerance has occurred. Depending on how long and how much u were on will dependon how fast the body's reticuloendothelial system reabsorbs these vacant receptor sites... my sub doc says that we are all different and variable... I have not been able to get a documented piece of literature describing this... my sub doc is supposed to have something for me to read next week when I go to my appointment. I know Thor is anxiously waiting for this also.
Re: the negligent and ignorant nurse that gave you the narcan... how absolutely incompetent and stupid... u could have died from hypoxia from the seizure.
To answer your other question... buprenorphine is what is called an agonist/antagonist drug... meaning that it does have agonistic (pain relieving) properties along with antagonistic (reversal) properties. The best way to understand this is to imagine the opiate oxycodone sitting on your mu receptor site doing it's thing. It is sitting there very content when all of a sudden buprenorphine comes along and is a stronger bully and kicks it off... you have a reversal of the oxycodone but since the bupe has some of the same properties it is able to open the receptor site's door to produce the desired effect on the body although perhaps not as well as the oxy. The bupe has a much higher affinity for the mu receptor site so it will kick off any pure opiod... even morphine and fentanyl and the most potent of all... sufentanyl... with the exception of pure opium which is not even available for medically prescribed purposes... but it would most likely knock that off also. This is why you can reverse the respiratory depression of a pure opiate with an agonist/antagonist drug without fully reversing everything... like with the nurse who reversed you with the narcan and sent you into seizure activity... unbelievable... hospitals can be scary...
I hope some of this clarifies some things for you... be well and good luck on your upcoming surgery...
Amazing, I consider myself well read and intelligent, but I didn't know anything about the things you just shared in that email! Wow! So, interesting! So, I was on high doses of Oxys for 7 years, then methadone and 10 mg oxy for break through pain, for 5 MORE years. Then, after trying to wean myself off of the methadone for two years, I gave up and went cold turkey, thought Ibwas going to die and fell like hell for a month. But, for the last 14 months, like I said an average of 4 mg perweek of suboxeone, but that is all. So, knowing my history and all the billions of MU receptor sites my brain produced, do you think I should just dealing with the pain with just suboxone or tempt yo use and stop using opiates in regards to this surgery.
Dear H... I am so sorry but this is only a question that you, with the help of your suboxone doctor, can answer. I can only give you information that I know and that has been shared with me by my suboxone doc. You are facing some serious situations that can only be decided by you and your doctors... I am so sorry I cannot help you answer this. If you do have to go back on pain meds temporarily you will need a good support group to keep you accountable... you may even have to have one of your support group have possession of your pain meds and ration them out for you... this is also a consideration. I will keep you in my prayers that you will make the best informed decision in regards to your upcoming surgery.
With kind and heartfelt regards...
My opinion is yes. I've been through many surgeries and will simply never take another pain pill, period. I've been on Subox. through everything, and now down to 1 mg. I know everyone will have a different opinion, but I've seen my entire family go through some nasty operations, including heart bypass surgery with NOTHING but 800 mg Ibuprofen, occasionally! I found it amazing. So, I will never fool myself into thinking I need another pain pill, although I was always convinced I needed one before I went through the nightmare of getting clean/sober. Also, the more the better doesn't work for Subox., so if you choose to go that route, I would never take more than ~ 8 mgs. If you choose pain pills, let someone else hold them because, I assure you, if you let that option in again, you WILL get addicted again. Once in your system, you will forget the withdrawal nightmare! That's my experience. Good luck and stick to your statement of "I will never touch it again"!
BTW, my first knee replace was the most horribly pain thing I have ever been through. With my neck and back surgeries, I just felt SO much better than before the surgery that it wasn't a big deal. I was really impressed that you have had surgeries w/o narcotics of any kind! Wow! How did you survive the first 48 hrs, always the worst. I would love to hear how you did it without narcotic!
I used the Ibuprofen, and slept alot! I learned from watching my folks both go thru major surgeries, too, without anything but tylenol in their 80's!! I was ashamed after that! HaHahahah. Don't feel bad if you need to take narcotics. I just know that I would have to have someone else hold them. I had too many hard falls many years ago! I really don't want to face it again. But, that's just my experience. Maybe you won't kid yourself like I did so many times! Good luck! You'll do fine, whatever you choose. Jillian
P.S. I was also on 2mg Subox.
Related topics
suboxone, opiate dependence, pain, withdrawal, knee joint replacement, surgery, chronic, narcotic
Further information
- Suboxone uses and safety info
- Suboxone prescribing info & package insert (for Health Professionals)
- Side effects of Suboxone (detailed)
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