My prescribing doctor says that the 32 mgs of Subutex I take uses all my pain receptors, so adding or replacing Subutex with stronger pain meds may not address the higher level of pain after an operation. Meanwhile, because I have that high level of chronic pain, stopping the subutex beforehand would be hard. In general, I worry about an unpremeditated rush to surgery and how to deal with that eventuality. Would adding percocet help? I don't believe it would send me into withdrawal, as one idiot pharmacist insists. A detailed analysis of the way buprenorphine works, alone or in combination with other pain medication would be helpful.
There have been some hurt feelings expressed by new members ( and old ones as well) toward the responders, so please imagine my voice as soothing, calm and polite. Subutex and suboxone both contain bupenorphine but the way it is processed under the tongue keeps it from being as effective for pain as bupenorphine administered in a different way that is used to treat pain most people with chronic agonizing pain do NOT get the relief they seek from subutex or suboxone and you are right, you would not go into withdrawal by adding percocet, but its effects would be blocked. Those who KNOW they are going to need surgery should wait until the acute pain phase following surgery has passed before being started on subutex or suboxone. I think you mentioned an unforeseen surgery, and in that case, the percocet would work if the subutex is stopped and then the percocet is added or other opiate. I did also see that you said stopping it would hard because of the pain now. Would you please let us know why you have pain, (injury, failed surgery, chronic pain condition) not because I am being nosy, it may help me trouble shoot this possible dilemma. Subutex is not usually recommended for chronic pain because a) it isn't designed for that purpose b) it blocks all other opiates, therefore eliminating the effectiveness of any opiate. It is very long acting and even on just 8mgs, it would stop opiate withdrawal symptoms, and block opiates for 2 to 4 days after the last dose. At 32 mgs, it will block them for at least 5 days, it slowly recedes off the brain receptor sites, the opiate will only work after that has happened. Methadone is usually the better choice for long acting pain control, but not knowing anything about the reason you are in pain, I am not sure if you were not offered methadone instead of subutex. I hope you will feel comfortable adding why you have chronic pain and how well you feel the subutex is working on your pain. Subutex is effective for some, including those who have fibro, but it usually does NOT afford those in chronic agonizing pain the relief they seek, and it wasn't really designed for that type of pain. Hope this info helps. Patti
This is why we have this site and talk to each other. It's understandable about having this fear of pain and a distrust of doctors. I have different health problems and meds, but I get freaked out thinking about an accident, as that's when it goes wrong for me. At times I don't like modern medicine too much, and I get very anxious. basically, if you think about someting before it happens people accuse you with being obcessed, if you don't think about beforehand-you're in denial-so no matter what you do-it's wrong. The thing that's not wrong is to talk to us here. We do understand, think kind thoughts, and try to help each other. good luck- let us know what's going on. You can talk to us any time.
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