[At Sea]

I have major chronic pain and several health issues at the moment. Brain tumor, migraines, back pain with lots of spasms. I have been going to a pain specialist in lubbock who gives me HC 10 or 7.5 mg 2 x per day and also facet injections, epidural steroid injections and nerve burning. I have been going to her for over a year with no relief. The last time I went was 3 weeks ago and she did 8 facet injections in lumbar and now my entire back has been spasming to where I can't bend, twist, reach or stand straight up without my back spasming. I called their office and they said to take an extra HC during the day. Did that with no relief.

I had a follow-up with my neurologist who treats me for the migraines. He noticed how bad I was in my back and asked me the regimen the pain specialist was doing.

I told him all the above and he offered to treat me for the back pain also. He took me off Flexeril (5 mg that I take 3 x per day) and put me on Tizanidine 4 mg (directions are to take 1/2 to 1 tablet 2 x per day and then take 1 or 2 tablets at bedtime)

yesterday and he gave me Suboxone (8 mg-2mg tablet R-B) Take 1/2 tablet under tongue 2 x per day for pain

I've been on this forum alot and haven't seen anything about Suboxone being given for pain.

He did say that he was using it off label and their is controversy over giving it for pain - but he feels that the lortabs aren't the right medicine for my pain level, and that the injections she is giving me obviously isn't the entire problem with my back and she seems to be drugging it or shooting it without trying to go outside the box that she's in to help me get pain under control to live a fuller life.

He said that Suboxone was given at a lower dosage to be used for peoples addiction coming off of drugs. And that Suboxone given at twice the amount has been shown to give really good pain relief.

He does not feel that I'm addicted to the other pain medicine, just that I have been off and on it for so long (since 2002) that it isn't working any longer and I'm having too much break through pain.

So really my question is has anyone heard of this.... Using Suboxone for pain. I'm to take my first dose at 2 pm (he said to wait 18 hours after I took my last lortab before I start it because it will throw me into withdrawals if I take it earlier)

Also if anyone has information on the muscle relaxer Tizanidine 4 mg like did it work etc.

I would appreciate anyone's experiences also with either drug.

So any information would be greatly appreciated.

[Robert_325]

Buprenorphine, the main ingredient in suboxone is an opiate. It seems to help some with pain and not others. Considering the amount of opiates you have been taking and how getting off them would benefit your system I think doing the suboxone is worth a try. It doesn't really help me with pain but it does help some. Hopefully you will be one of those people too. The dose you are at is more of a detoxing dose than a pain dose but let's see how it works for you Please keep me posted how this works. God bless.

[jillg]

Hi I also take suboxone for pain. Like many others on this site I have a terrible back. I was on oxycodone for 2 years at 30 mgs a day and after about a month or 2 it really didn't relieve much pain, but I would be sick if I didn't take it. I just started the sub about 3 weeks ago and it works very well for my pain a lot better than the oxy, will see if it continues to work at the same amount of mgs. I take 12 mgs usaully -16 if it was a really bad day. I tried the 8 as Robert suggested and felt good for a day or 2 then after 3 days at 8mgs I really was hurting and had to go back to 16 and I have been trying to take less like 12. My prescribed dose is 20 but I really wanted to keep it lower than that. I am trying to take the same mgs everyday to keep my body chemistry level so I feel really bad inside when I take the 16. I go to the Dr. on the 23rd so will see . Let me know how you are doing , I am really happy to have found someone else who is using sub for pain management.

Thanks,

Jilly Bean

[Robert_325]

Originally Posted by jillg

Hi I also take suboxone for pain. Like many others on this site I have a terrible back. I was on oxycodone for 2 years at 30 mgs a day and after about a month or 2 it really didn't relieve much pain, but I would be sick if I didn't take it. I just started the sub about 3 weeks ago and it works very well for my pain a lot better than the oxy, will see if it continues to work at the same amount of mgs. I take 12 mgs usaully -16 if it was a really bad day. I tried the 8 as Robert suggested and felt good for a day or 2 then after 3 days at 8mgs I really was hurting and had to go back to 16 and I have been trying to take less like 12. My prescribed dose is 20 but I really wanted to keep it lower than that. I am trying to take the same mgs everyday to keep my body chemistry level so I feel really bad inside when I take the 16. I go to the Dr. on the 23rd so will see . Let me know how you are doing , I am really happy to have found someone else who is using sub for pain management.

Jilly Bean

Jill ... you know that I am a huge advocate of getting on buprenorphine to get past opiate detox w/d symptoms and then getting off as soon thereafter as is possible. That is why I always hammer on people to take such a low dose so it will be easier to get off.

But I have always maintained that there are a very small % of patients who need to remain on suboxone/subutex for an extended period of time for whatever reason. It could be that you need to use it longer for pain management especially if it works for you. I would still caution you to stay as far away from the high doses as you can. I promise you will be glad you did down the road. I'm serious about that. NO WAY I would ever go over 12mg and preferably less. God bless.

[jillg]

Originally Posted by Robert_325

Jill ... you know that I am a huge advocate of getting on buprenorphine to get past opiate detox w/d symptoms and then getting off as soon thereafter as is possible. That is why I always hammer on people to take such a low dose so it will be easier to get off.

But I have always maintained that there are a very small % of patients who need to remain on suboxone/subutex for an extended period of time for whatever reason. It could be that you need to use it longer for pain management especially if it works for you. I would still caution you to stay as far away from the high doses as you can. I promise you will be glad you did down the road. I'm serious about that. NO WAY I would ever go over 12mg and preferably less. God bless.

Oh I know , I really am working on getting back to 8 mgs,and for me it does help with pain and I am testing myself to make sure this isn't a mental thing too because that can very well happen. Today was a good day and I only took the 12 and I am hoping that or should I say ,I will continue that for 2 days more and then drop to 8 . I think my levels have been to up and down . The first day the Dr said to take 20, so I did and the next day I went down to 16 and then 8 for 3 days and then 12 and then 16 and now 12 soooo phew... Once I get to 8 I am going to stay there. I know when I started the sub I was not in wd yet and I took 20mgs and dropped in 2 days to 8 during major wds,that was tough and working 2 jobs,totally sucked. I'm not in wd so I am working back down to 8. I need you Robert , to keep on me and check up on me . I am so afraid of my building tolerance to this med so can you please keep on me? Please, I know I won't slip if you and Melinda or anyone checks on me, I wouldn't want to dissappoint anyone, especially people who take their precious time to guide me. I try not to let myself down too. My boyfriend never asks me,it's like he is afraid to offend me, which I understand. Thanks for all your support and friendship.

Jilly Bean

[melinda7.5]

Hi jilly bean
dont worry robert will take good care of you,
some times i dont know how he takes care of all of us, but he sure seems to do a good job at it.LOL
and if you ever want to talk you know me im on here all the time.some times i just leave it on while im cleaning or somthing and when i walk by i check to see if anything is going on. (I need to get a life) LOL...
how was your day?
Melinda

[jillg]

Originally Posted by melinda7.5

Hi jilly bean
dont worry robert will take good care of you,
some times i dont know how he takes care of all of us, but he sure seems to do a good job at it.LOL
and if you ever want to talk you know me im on here all the time.some times i just leave it on while im cleaning or somthing and when i walk by i check to see if anything is going on. (I need to get a life) LOL...
how was your day?
Melinda

Hi Melinda, my day was long and I am so tired what a long week. I am so happy to welcome the weekend.

How was your day? Did you have a nice day off? You have a life and it's very important one, being a supportive cyber angel is not easy. I leave mine open too, this is better than AA in some way because there's always someone to talk with,the only thing is you can't see anyone, but you don't have to get all dressed up to discuss things. I need your help too this is pretty hard, my pain has been tough but I do feel the sub is helping a lot better than the percs and my family respects me again. I get to babysit my bro's children again too,which killed me when I lost that priviledge back in June. I just found out last night at my shop when my bro's family came in for haircuts, we talked and he asked me to start watching the kids again and I gladly accepted.

I don't know how Robert takes care of all of us but what a great job he does. This is his calling in life and I think it's yours also to help others in need. Both of you are wonderful at it. So maybe addiction was meant , so you guys could see where your true purpose to life lys,you know what I'm trying to say. Everything happens for a reason,even if we don't understand at the time, God always has a plan. I believe you 2 were meant to help in this way.

Well talk to you soon I hope,I need you to keep on me, I don't want to become addicted to anything else besides soberiety.

Your Friend,

Jilly Bean

[melinda7.5]

Hi jilly bean
I did have a great day off today,I hope you have one tomorrow,I know this is scary,I was really scared when i went thru my w/d, but you will get thru it.
And you will never have to look back.and you will be a much stronger person.
Thank you for the nice things you said,but i think you are an angel to.
any time you need me just let me know,you will be sorry you told me to check on you. ttyl,melinda

[Robert_325]

It isn't a matter of staying on you. You have to take the amount of sub that is right for you. It's just that when we start out going to some guy who programs us into thinking we need more than what we really need we fall into the trap and automatically go for the higher amount. That is what we are accustomed to doing, taking the most we are told we can take. It's not a pass or fail thing unless you quit and permanently relapse. its just important to get to the least effective dose and stay there, whatever that dose is. I can't say what it is for you at this point. If you feel w/d and have to take a little bit extra, do it. Just take a sliver, but not 4-8mg. Try 2mg first. That is just my suggestion. Try the 2mg and give it an hour. It will be easier on you down the road if you do it this way now. I won't vanish from the forum. You will get through this. Just have faith. God bless.

[At Sea]

Thanks for writing in. I was thinking I was the only one out here who was prescribed Suboxone for pain. I googled it earlier today and only found sites that you had to read through a bunch of stuff to see what they were talking about and then it never answered my question so I decided to post.

I am shocked though at the difference in the amounts we are taking. My doctor only has me taking 4 mg 2 x daily. And I do realize everyone is different as is every doctor, it just seems like a huge difference, to me that is.

So do you mind if I ask you something? You said in your earlier post,

"The first day the Dr said to take 20, so I did and the next day I went down to 16 and then 8 for 3 days and then 12 and then 16 and now 12 soooo phew.... Once I get to 8 I am going to stay there."

So my question is, is that how your doctor told you to take it? I don't know how all this works so I'm just asking. My doctor just told me to take 4 mg twice a day, and he also changed my Flexeril 5 mg to Tizaidine 4 mg which is a muscle relaxer.

I think from reading some of the posts on the forum that there is a lot of tapering down when it's used for addiction after a few weeks (more or less) but I didn't think it was done that way for pain management. And I guess the second part of the question would be if you (or your doctor) planning on tapering down and eventually get off the Suboxone? And if yes, are you/your doctor planning on another medication? Depending on what your answer is on the first question, the second question may not need an answer. Did I make that confusing enough?

It sounds like you've gone through a lot with your family with trust issues. And WOW! What a way for your brother to say "We love you and we trust you and we want things to be the way they used to be, only better!" Okay, he actually said can you babysit? But I think it's more of the first part what I wrote. From what I read earlier, that must have been a huge step for him. And not mention what an awesome, fabulous, tremendous, uplifting moment for you when they asked you to babysit. That had to make you feel like "Today is a good day."

Well I'm off to bed, it's almost 4 am. But I wanted to give you a shout out.

Just hang in there and I look forward to hearing how things are going. Keep me posted.

At Sea

[jillg]

Originally Posted by At Sea

Thanks for writing in. I was thinking I was the only one out here who was prescribed Suboxone for pain. I googled it earlier today and only found sites that you had to read through a bunch of stuff to see what they were talking about and then it never answered my question so I decided to post.

I am shocked though at the difference in the amounts we are taking. My doctor only has me taking 4 mg 2 x daily. And I do realize everyone is different as is every doctor, it just seems like a huge difference, to me that is.

So do you mind if I ask you something? You said in your earlier post,

"The first day the Dr said to take 20, so I did and the next day I went down to 16 and then 8 for 3 days and then 12 and then 16 and now 12 soooo phew.... Once I get to 8 I am going to stay there."

So my question is, is that how your doctor told you to take it? I don't know how all this works so I'm just asking. My doctor just told me to take 4 mg twice a day, and he also changed my Flexeril 5 mg to Tizaidine 4 mg which is a muscle relaxer.

I think from reading some of the posts on the forum that there is a lot of tapering down when it's used for addiction after a few weeks (more or less) but I didn't think it was done that way for pain management. And I guess the second part of the question would be if you (or your doctor) planning on tapering down and eventually get off the Suboxone? And if yes, are you/your doctor planning on another medication? Depending on what your answer is on the first question, the second question may not need an answer. Did I make that confusing enough?

It sounds like you've gone through a lot with your family with trust issues. And WOW! What a way for your brother to say "We love you and we trust you and we want things to be the way they used to be, only better!" Okay, he actually said can you babysit? But I think it's more of the first part what I wrote. From what I read earlier, that must have been a huge step for him. And not mention what an awesome, fabulous, tremendous, uplifting moment for you when they asked you to babysit. That had to make you feel like "Today is a good day."

Well I'm off to bed, it's almost 4 am. But I wanted to give you a shout out.

Just hang in there and I look forward to hearing how things are going. Keep me posted.

At Sea

Hi there, I just started the sub 3 weeks ago and I was told to take 20 mgs a day, way to much in my eyes. .I have to find out on my next appointment what the over all plan is going to be. Only psychiatrists prescribe sub around here in MA, not a pain management specialist. I am seeing the orginal Dr on the 13th and another Dr. at a treatment center on the 23rd I hope the second one works for me because he takes health insurance and the first one is a cash cow only, so I don't have a lot of faith in his prescribing that why I lowered my dose, I knew that 20 was totally way to much,but I had a perc in my system when he said to start it and he knew I did ,which in result led me in to full blown wd's for about 2 weeks . I was vomiting for 3 days and had headaches the worse I have ever had and this past week was the dizzies and hot and cold sweats, so I am hoping I am through the woods. I am on 12 mgs currently and working my way down to 8mgs,I know from reading a lot of posts that less is more with sub, so we kind of have to retrain our thinking. Where with the straight opiates the more you take the better you feel kind of ,with sub you only need a little and you're better off on less in the long run. I look forward to hearing what both docs have to say.

Thank you about the family stuff, I was on cloud nine. I have a very successful brother in work and in family life and to lose that for4 months really was tough on me and embarassing. They all see the change in me for the better and are willing to give me another chance. Don't get me wrong the children were not in danger, I was just very hyper and talked a lot it looked and sounded immature so now that I'm back to the real me and the kids have always loved their auntie so much,they said ok lets give her another chance,which I am very greatful for and will not take it so lightly this time.

Let me know how you are feeling.

Jilly Bean

[melinda7.5]

Hi At Sea
I was thinking about you today and was wondering how you were feeling...
talk to ya later,melinda

[DGahan]

Hey, new member here. I was just reading through but I felt like I should tell you about my experience with suboxone.

I am taking suboxone because I am a recovering heroin addict. The highest daily does I've been on is 8mg. I know that you're taking it for pain, and I would definitely not recommend doing this, especially at the dosage you are on.

I have taken both methadone and suboxone before to get off heroin. When I was in rehab (in-patient), they gave suboxone ONLY to people who planned on not taking it during their stay there (which was 7 days at the most). If you planned on staying on a subs or methadone after you left rehab, they would always give you methadone.

Why? Because even though the w/d symptoms are long and pretty bad on methadone, suboxones are worse.

When I was on Methadone(10mgs a day at the end but started off at 40-50mg daily), the w/d symptoms were not that bad if I were to miss taking a dose for half a day, or even a whole day. But now that I'm taking subs, there is NO WAY I can function without taking all my doses. If I miss a dose, I start yawning, get tired, feel restless, and get hotflashes within an hour or two at the max. If I still haven't taken my dose, the bone/muscle pain starts kicking in, anxiety and upset stomache.

The thing is though, I'm only on 3mgs a day (1mg when I wake up, 1 around 4-5 and 1 at 11-12pm). At such a low dose, I still feel very severe w/d effects missing only one 1mg (I cut the 2mg pills in half) dose! It is unbelievably annoying, as I ALWAYS have to make sure I have my dose on me, or else I would have to drop anything I would be doing at the time and go home to take my dose.

I have also tried quitting suboxone. I couldn't go lower than 1mg a day and the only way I was able to quit was by actually using a small amount of heroin daily for a week or so, taking less and less daily.

Also, in terms of pain relief, methadone was a much better pain reliever IMO than suboxone. Before this read, I have never heard of anyone taking subs for any other reason than for opiate (heroin, oxycontin) addiction.

Honestly, the only reason I would recommend anyone to take suboxone is for opiate w/d's and to also not take it more than a month, ideally 2 weeks max.

Lastly, staying on subs can become very expensive. All the doctors I've been to or asked never accepted any health insurance for suboxone "maintenance." Apparently no insurance company covers this and the usual fee to go to a doctor just so he can write you a 1-month prescription of suboxone was at the least $200 and some even charged as high as $500 per visit! Cash or debit/credit only, by the way.

And since the company that makes suboxone still has a patent on it, the pills are very expensive . Two pharmacies told me that they themselves buy it at $5 a pill, no matter the dosage amount (2mg pill costs the same as an 8mg pill), which to me is ridiculous. So on average I am spending about 400 dollars a month total for a 5-minute trip to the doctor and the prescription. Oh yea, I'm also pretty sure that none of the insurance companies cover suboxone prescriptions as well (at least they didn't a year ago when I actually had insurance).

I know your situation is different than mine, but I thought I'd share my personal experience with subs. Sorry for the really long post, by the way. Also, if you have any questions, feel free to ask. Good luck to you with your back pain problems.

[Robert_325]

Each of us have our own experiences to an extent with most any drug we take. We are all a little different. I would never question anyone's personal symptoms. You have made a couple of general comments directed basically at everyone however that I must question.

First I agree that suboxone/subutex should be taken for as short amount of time as possible. It should ideally be an amount of weeks rather than months. And the 8mg dose you mention on is in line with the way subs should be dispensed rather than the higher doses so commonly prescribed. It is unusual that you would experience w/d symptoms just being late on taking a dose when you are taking suboxone three times a day. With the long half life of suboxone your symptoms are not the norm. Your case is an exception to the rule. It's just not necessary normally to dispense suboxone three times a day.

Methadone is a great pain medication for someone who is going to be on pain meds for life or a very long time. It is much safer for the body than lots of the fast acting pain meds that are loaded with apap. It should be used as a last resort medication however as it is not intended for short term use at all. And no doubt that for most people buprenorphine is not a good pain medication. The way it works on our receptors just doesn't permit us to get much pain relief.

You stated that w/d symptoms from suboxone are worse than methadone. That might be the way it works in your situation but once again, that is NOT the norm at all. It shouldn't be stated as a general rule that suboxone w/d is worse than methadone for everyone as that just isn't the case. You mention the problems you have with suboxone at 1mg or less. It is tougher tapering down at micro doses. The taper process needs to be done properly and if done so in MOST cases it can be done fairly easily. Again that is a general rule. Your case or some other individual cases might be different but I am talking about generalities that are true for the majority of people. There are lots of people on this forum who have done this successfully myself included.

While very few insurance companies are approving prescriptions for maintenance doses of buprenorphine, most major insurers are covering the medication for short term use. Subutex/suboxone has become much more accepted by insurers over the last couple years. When there is a problem with not being able to use insurance it's usually due to the requirements of the attending physician and not the insurance company.

It's good to hear that you are being successful with getting off the heroin. Congratulations. Thanks for sharing your experiences. I understand after a lifelong dependency to opiates how difficult STAYING clean is. If it has taken methadone for you that is great. Whatever it takes is what we need to do. Keep us posted how your recovery is going. We are here if we can help. Good luck and God bless.

[jillg]

Originally Posted by Robert_325

Each of us have our own experiences to an extent with most any drug we take. We are all a little different. I would never question anyone's personal symptoms. You have made a couple of general comments directed basically at everyone however that I must question.

First I agree that suboxone/subutex should be taken for as short amount of time as possible. It should ideally be an amount of weeks rather than months. And the 8mg dose you mention on is in line with the way subs should be dispensed rather than the higher doses so commonly prescribed. It is unusual that you would experience w/d symptoms just being late on taking a dose when you are taking suboxone three times a day. With the long half life of suboxone your symptoms are not the norm. Your case is an exception to the rule. It's just not necessary normally to dispense suboxone three times a day.

Methadone is a great pain medication for someone who is going to be on pain meds for life or a very long time. It is much safer for the body than lots of the fast acting pain meds that are loaded with apap. It should be used as a last resort medication however as it is not intended for short term use at all. And no doubt that for most people buprenorphine is not a good pain medication. The way it works on our receptors just doesn't permit us to get much pain relief.

You stated that w/d symptoms from suboxone are worse than methadone. That might be the way it works in your situation but once again, that is NOT the norm at all. It shouldn't be stated as a general rule that suboxone w/d is worse than methadone for everyone as that just isn't the case. You mention the problems you have with suboxone at 1mg or less. It is tougher tapering down at micro doses. The taper process needs to be done properly and if done so in MOST cases it can be done fairly easily. Again that is a general rule. Your case or some other individual cases might be different but I am talking about generalities that are true for the majority of people. There are lots of people on this forum who have done this successfully myself included.

While very few insurance companies are approving prescriptions for maintenance doses of buprenorphine, most major insurers are covering the medication for short term use. Subutex/suboxone has become much more accepted by insurers over the last couple years. When there is a problem with not being able to use insurance it's usually due to the requirements of the attending physician and not the insurance company.

It's good to hear that you are being successful with getting off the heroin. Congratulations. Thanks for sharing your experiences. I understand after a lifelong dependency to opiates how difficult STAYING clean is. If it has taken methadone for you that is great. Whatever it takes is what we need to do. Keep us posted how your recovery is going. We are here if we can help. Good luck and God bless.

Hey Robert how are you doing? I was really glad to read your post here ,as I got really scared about the wd's this person was discussing. Don't get me wrong it's good to know other people's experience on this. I can't wait to discuss all this new information with the new Dr. at the sub clinic. As he only deals with addiction and works at a suboxone clinic at the rehab I chose to recieve treatment. I was lucky to get help on my own, and not by the law so I was able to pick a clean, and very nice rehab, as nice as they can be I suppose. I have so much more info about sub than when I started on it because of this site. So naturally I have a lot more questions now. Well I hope all is well with you and look forward to reading your future posts. How is the center you want to open coming along? I hope everything is running smoothly, and I wish we had one around here. The church I go to is the main church involved with the prisons up here. Thanks for all your help and advice in all your posts.

Jill