[SCarlisle]

II have been on the Subutex since 11/07 and have looked for information regarding the use of Subutex for severe chronic pain: and all I can find is information for someone who has abused or is considered an addict.
I was started on the Subutex due to gastrointestinal issues because my GI tract does not break down medications with coatings or those made for extended release. All the other medications I am currently on have to be a dissolving type tablet or I have to crush the meds. so my body can absorb the medications.
I understand that Subutex is mainly used for those coming off opiates and I had already stopped the major opiates ( MS Contin & Dilaudid) in less than 2 days b/c my body was not absorbing those and I was miserable from the pain I was living with daily which then affected the rest of my life.
Is there anyone who can tell me where I can find more information about the Subutex being used for severe chronic pain, because I will have to have pain medications for the rest of my life due to previous medical/surgical issues which lead to the removal of my left hip joint after 38 surgeries and massive infections, the total hip replacements I had were all (4) removed and I walk without a hip joint at all and use only one crutch to get around and with every step I take, my femur jams into my tail bone which does hurt 24/7 but I have learned to live with pain that 10 years ago I would have considered suicide over but over the time, the pain has gotten easier to live with and I have found other ways such as biofeedback, exercise, and essentially keeping myself as busy as I can so I do not have time to dwell on the pain I am living with daily. In addition, I have already had surgery to correct a C5-C6 disc herniation with a discectomy and fusion, and still have one more disc herniation at L2-L4 and since I had so many infections with my leg, it is too close for comfort for me to have the surgery to correct this. I am trying to live with it as long as I possibly can. I do not want to EVER go thru what I did with my left hip.
Back to my original reason for this post, (BTW, this is my first ever posting, sorry for the lengthy note) but could anyone lead me into the right direction to find more information about the Subutex and even the Pharmaceutical company that is distributing the sub-lingual tablets, however horrible they taste, it works so I will continue to take this drug.
I am glad I have been put on the Subutex and have now gotten a dosage that is controlling my pain and I have now started being able to get back to my life even going back to physical therapy to build back my endurance and strengthening to get as healthy as I can.
Thank you in advance for your help!
Sincerely,
Susan C.

[Cats Meow]

Either the AMA or FDA hasn't approved Buprenorphine for the treatment of CP, but some physicians will Rx it, I think they're not comfortable doing so because it takes extra certification to Rx it for opioid dependency, so they don't bother to read up on it, they can Rx it for pain, but most won't.
Here's some physician resources on Buprenorphine which might answer some of your questions. http://www1.buprenorphinecme.com/PageReq?

It seems to me the cost factor vs. traditional opioid therapy for the long term CP patient doesn't make it cost effective, and it appears Bup has difficulties in the perioperative management of pain as opposed to opiates.
HTH
Cats

[SCarlisle]

Thank you for the link and information. I have actually already had one instance with problems with hospitalization and the Subutex because the hospital did not have it and said it would be 3 days before getting the Subutex so the physician eventually ordered IV Morphine and Phenergan b/c I was in major pain in addition to normal pain issues I had pneumonia and pleurisy. The morphine helped but it did take a few days to get back to the right dosing and actually my physician increased the Subutex to up to 8 mg up to 2 times a day for pain. He wants me to treat the pain and not let it get out of control b/c then it is much harder to get under control. It is hard to take it sometimes because I have been so afraid of becoming an addict after working in the emergency department for 12 years before I became disabled, I never want to have a life like I saw in many patients that in their defense did not become addicts intentionally but were put on pain medications and then at some point their doctors would abruptly say you need a medication holiday and not wean them off but would they would just stop the medications and that is probably the quickest a person will ever become an addict is to do that to them and them be in major pain and it getting worse from withdrawal too. I understand their plight, but do not want to become that patient.

Thanks again,
Susan C.

[mpvt]

Buprenorphene (suboxone,subutex) is a partial agonist like Talwin.It would not do a chronic pain patient such as yourself much good.
Methadone would be the best bet for someone with your type of pain.......Dave