I have neurogenic TOS. My long thoracic nerve is actually severely damaged, giving me a winged scapula. And I am on suboxone (similar to methadone), and have been since I quit heroin, so my tolerance has not dropped at all.
To update, I have made an appointment for a consultation with a pain specialist, who is going to analyze my tolerance I guess. They told me that they deal with addicts or tolerant patients all the time, so I shouldn't be concerned about having pain. Really, however, I have realized that my concern is less about the pain, and more about the withdrawal. Since I cannot take suboxone while taking pain meds (the suboxone blocks the effect of the pain meds), I will have to stop taking the suboxone 3 days before the surgery. I will experience withdrawal on the 2nd and 3rd day, and then they will give me opiates immediately prior to the surgery, stopping the withdrawal. But after the surgery, they will need to prescribe me enough opiates to prevent withdrawal, which is a very large amount (larger than the amount to relieve pain) haha. 80mg of OC might relieve my pain, but I will still experience withdrawal if I do not take my suboxone. I would say it would take around 120mg to match the effect of the suboxone I take, which is very strange because suboxone does not make me high, per se. It prevents withdrawal at the same level a gram of heroin might, while providing the opiate effect of half a milligram of dilaudid. Only way I can explain it is that buprenorphine is a very strange chemical. Needless to say, it will require quite a large amount of opiates to prevent me from going into withdrawal. I am concerned that they will be legally bound to only give me enough that I am mostly pain-free, but not enough to stop the withdrawal, *edit* I wonder if they have ever been in this situation before. I suppose these are really questions for my doctor, but it is so hard to get in contact without paying for an appointment. The medical system in the US is just so unforgiving and devoid of empathy...