[dennyfan]

My pm doctor has suggested trying suboxone for pain control. I am leary tosay the least and at this point have declined and said I would need to think about it. Here's why. First I would have to come off all my other pain meds cold turkery for three days. That means I will be in pain & may very well go into DT's. Then I will start the Suboxone. It "Will" make me sick he says. Proably for as long as a week. So I will be sick & in pain for over a week. Okay it gets better. He also siad this has about a 50/50 chance of working for me. Now for those it works for it is supposed to be great "But"!!! Now one of the side effects is that opiods are blocked from working with this medication so say your in an accident they can't give you anything else to help you because you are taking this medication. Now if it doesn't work for pain control for me I will have to wait several days for it to come out of my system to go back on my old meds. This could mean 2-3 weeks of pain & being sick. Now am I crazy or does this sound like its not worth it. Has anyone else tried this medication? Did you have any other side effecs with it? Frankly I am scared to try it. I am going to get a second opinion from my gp about this medication. Any help would be appreciated. Thank you.
Denny

[loretta]

Hi Denny, Sounds like a good idea for a 2nd opinion. I have never heard of this med before. Hope all works out well for you. Loretta

[CZZ74]

Originally Posted by loretta jewell

Hi Denny, Sounds like a good idea for a 2nd opinion. I have never heard of this med before. Hope all works out well for you. Loretta

Ive never heard about it? Im going to look it up, more comments later. CZ

[DianaA]

Dennyfan, CZZ74, Mslday,
I spoke with my doctor today about the Suboxone. Here are as few sites.
If you just put in the search for " Suboxone for pain Uk", Canada, Australia, US etc, you will get some information to be able to make a more informed decision. A lot of meds were used for something different in the beginning, Botox is just one of many. Which by the way is now also beginning used for pain treatment. It was first used by optomologists. When used in withdrawal, Suboxone, they found was giving the patients pain relief as well, with less side effects.

http://www.suboxonedoctor.com/articl...ain.html<br />1UCLA School of Medicine, Los Angeles, CA, 2The Pain Institute at Little Company of Mary, Redondo Beach, CA, and 3Friends Research Institute, Inc., Los Angeles, CA


Presented at 3rd World Congress, World Institute of Pain, September 21-25, 2004

“Pain Advances in Research and Clinical Practice,” Barcelona, Spain.



AIM OF INVESTIGATION: Managing opioid dependent patients with chronic pain is challenging and hampered by limited treatments. We explored buprenorphine sublingual tablets (BUP) for treating 65 opioid-dependent patients (34 male) with chronic severe pain at a multidisciplinary pain management center in Redondo Beach, CA.



METHODS: Patients received medical and psychological assessment at entry. Open-label treatment included maintenance or medically-supervised withdrawal using BUP over varying periods of time, urine drug screening, on-going pain assessment using a

0-10 rating scale, monitoring of adverse events and centralized case management. Concomitant medications were prescribed according to medical and psychiatric disorders. Patients averaged 47 years old (range 18-87), 6.4 years of opioid dependence (range 0.25-30) and prior treatment attempts for opioid dependence had been unsuccessful. To control pain, all patients used prescription opioids (legally and illegally) and 5 also used heroin. Pain ratings at initial evaluation averaged 6.5 ± 0.2 (SEM). Common comorbid disorders included depression, anxiety, and musculo-skeletal maladies. All patients had stopped using opioids before starting BUP 2 mg and BUP 8 mg tablets, two to four times per day, were prescribed according to patient need. Maintenance doses averaged 14.7 ± 1.1 (SEM) mg/day and maintenance is ongoing in 81% of patients.



RESULTS: Average pain ratings declined to 2.9 ± 0.3 (SEM) on maintenance BUP, and ongoing medical and non-substance abuse-related psychiatric problems were stabilized.



CONCLUSIONS: BUP therapy safely and effectively managed opioid-dependent Pain patients with comorbid chronic severe pain and reduced their pain ratings. Additional controlled research is needed to evaluate BUP for treating these opioid addicted patients.

http://www.patient.co.uk/showdoc/30002448/
http://painandaddiction.com/4abstracts2162006.htm

There is alot more info out there. When you do a search on Medicine you have to go further into the search. The drugs companies with their money will have all of the first few pages. If there is say..1 of 7777000 go to page 20.
Hope this helps! Having RSD since 1989, I am totally open to research any avenue but surgery.....Tried that and it didn't work... Subcutaneous Upper Thoracic Radio Frequency Sympathectomy.
All the best
Diana

[dennyfan]

Thanks for the help everyone. But I got not just a second but a third opinion as well. bOth my others doctors said not to do this. One said the only time this should be tried is when someone is stable on opiod medication but is having problems wih side effects. The other doctor told me he didnt think the suboone could ever be adjusted high enough to handle my pain control. So doctor number one is over ruled by the other two doctors. I trust them more anyway.
Thanks Denny

[Mslday]

Originally Posted by dennyfan

My pm doctor has suggested trying suboxone for pain control. I am leary tosay the least and at this point have declined and said I would need to think about it. Here's why. First I would have to come off all my other pain meds cold turkery for three days. That means I will be in pain & may very well go into DT's. Then I will start the Suboxone. It "Will" make me sick he says. Proably for as long as a week. So I will be sick & in pain for over a week. Okay it gets better. He also siad this has about a 50/50 chance of working for me. Now for those it works for it is supposed to be great "But"!!! Now one of the side effects is that opiods are blocked from working with this medication so say your in an accident they can't give you anything else to help you because you are taking this medication. Now if it doesn't work for pain control for me I will have to wait several days for it to come out of my system to go back on my old meds. This could mean 2-3 weeks of pain & being sick. Now am I crazy or does this sound like its not worth it. Has anyone else tried this medication? Did you have any other side effecs with it? Frankly I am scared to try it. I am going to get a second opinion from my gp about this medication. Any help would be appreciated. Thank you.
Denny

Hi Denny, I don't know anything about suboxone but a quick look on google brought me to the FDA site about it. I'd list the link but I'm still too junior to include links in my postings so below is the copy of the text from that site. A second opinion is always wise. In my humble opinion if you are having serious withdrawal symptoms from going off your meds this may be very beneficial and help you to keep your pain under control as simply going through withdrawal from addiction medications could make your rds much worse. I really feel for you and wish you all the best with this adjustment of medications. Be gentle to youself. MsL

1. What are Suboxone and Subutex?

Subutex and Suboxone are medications approved for the treatment of opiate dependence. Both medicines contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence.

2. Why did the FDA approve two medications?

Subutex contains only buprenorphine hydrochloride. This formulation was developed as the initial product. The second medication, Suboxone contains an additional ingredient called naloxone to guard against misuse.

Subutex is given during the first few days of treatment, while Suboxone is used during the maintenance phase of treatment.

3. Will most prescriptions be for the Suboxone formulation?
Yes, Suboxone is the formulation used in the majority of patients.

4. How are Subutex and Suboxone different from the current treatment options for opiate dependence such as methadone?

Currently opiate dependence treatments like methadone can be dispensed only in a limited number of clinics that specialize in addiction treatment. There are not enough addiction treatment centers to help all patients seeking treatment. Subutex and Suboxone are the first narcotic drugs available under the Drug Abuse Treatment Act (DATA) of 2000 for the treatment of opiate dependence that can be prescribed in a doctor’s office. This change will provide more patients the opportunity to access treatment.

5. What are some possible side effects of Subutex and Suboxone?

(This is NOT a complete list of side effects reported with Suboxone and Subutex. Refer to the package insert for a more complete list of side effects.)

The most common reported side effect of Subutex and Suboxone include:

cold or flu-like symptoms
headaches
sweating
sleeping difficulties
nausea
mood swings.
Like other opioids Subutex and Suboxone have been associated with respiratory depression (difficulty breathing) especially when combined with other depressants.

6. Are patients able to take home supplies of these medicines?

Yes. Subutex and Suboxone are less tightly controlled than methadone because they have a lower potential for abuse and are less dangerous in an overdose. As patients progress on therapy, their doctor may write a prescription for a take-home supply of the medication.

7. How will FDA know if these drugs are being misused, and what can be done if they are?
FDA has worked with the manufacturer, Reckitt-Benckiser, and other agencies to develop an in-depth risk-management plan. FDA will receive quarterly reports from the comprehensive surveillance program. This should permit early detection of any problems. Regulations can be enacted for tighter control of buprenorphine treatment if it is clear that it is being widely diverted and misused.

8. What are the key components of the risk-management plan?
The main components of the risk-management plan are preventive measures and surveillance.

Preventive Measures include:

education
tailored distribution
Schedule III control under the Controlled Substances Act (CSA)
child resistant packaging
supervised dose induction
The risk management plan uses many different surveillance approaches. Some active methods include plans to:

Conduct interviews with drug abusers entering treatment programs.
Monitor local drug markets and drug using network areas where these medicines are most likely to be used and possibly abused.
Examine web sites.
Additionally data collection sources can indicate whether Subutex and/or Suboxone are implicated in abuse or fatalities. These include:

DAWN—The Drug Abuse Warning Network. This is run by the Substance Abuse and Mental Health Services Administration (SAMHSA) which publishes a collection of data on emergency department episodes related to the use of illegal drugs or non-medical use of a legal drug.
CEWG—Community Epidemiology Working Group. This working group has agreed to monitor buprenorphine use.
NIDA—National Institute of Drug Abuse. NIDA will send a letter to their doctors telling them to be aware of the potential for abuse and to report it if necessary.
9. Who can prescribe Subutex and Suboxone?
Only qualified doctors with the necessary DEA (Drug Enforcement Agency) identification number are able to start in-office treatment and provide prescriptions for ongoing medication. CSAT (Center for Substance Abuse Treatment) will maintain a database to help patients locate qualified doctors.



10. How will Subutex and Suboxone be supplied?

Both medications come in 2 mg and 8 mg strengths as sublingual (placed under the tongue to dissolve) tablets.

11. Where can patients get Subutex and Suboxone?
These medications will be available in most commercial pharmacies. Qualified doctors with the necessary DEA identification numbers will be encouraged to help patients locate pharmacies that can fill prescriptions for Subutex and Suboxone.

[Coffeebean]

I don't know much about suboxone but I do know that my husband's son-in-law was detoxed off of all of his pain (and bipolar) medications and then placed on this drug for pain relief in his back. This was all done under medical supervision as an in-patient in the hospital. He was in for almost two weeks and still it took another month for him to feel better. This poor guy was on all sorts of meds, including a daily pain patch, lots of Lyrica, Ativan and Vicodin without much relief. Now, he takes just Prozac, something for the bipolar condition and this medication and feels 100% better. He was ready to end it all due to pain and now he is riding a bike and taking walks with his wife. He still struggles daily with fatigue and some minor pain issues, but he is really so much better it is amazing.

I just wanted to add what little I know because this was done under close supervision in the hospital. A second and third opinion may be well worth the time and effort.

[DianaA]

Hi Denny,
I wrote a post about this a while back. My therapist suggested that I ask my doctor for Suboxone. It generally is used to wean people off opiates. But is currently being presecibed for pain relief. I beieve there are some major advantages over opiates. But, as with all medications...Do your research!
All prescription meds seem to effect everyone differently. I have heard though, that it is working well for a few of my doctors patients. My suggestion: do your homework and be open to the possibility even if it is a new use for this med. Keep us informed. All the best
Diana

[dennyfan]

Diana, Its not what it was used for in the past that bothers me. It is the way that they want me to start using it. Three days with zero pain meds will be hell. And may go into DT's without dropping slowly off my medications. Which wuld just draw out my high pain longer. ANd then they told me this medication "will" make me sick in the beggining for a week or so. So I will be sick & in pain. And on top of that they only gave it a 50/50 chance of working. Those arent great odds. If it doesnt work it will take several days for this medication to get out of my system before they can change me back. And if you read coffeebeans post her son in-law was hospitialized to do this changed. Thats huge. And bascially we take the same kinds of medications. That really scares me. What did you think after reading that? I would appreciate your take.
hugs, Denny

[Millerprof]

Does this med have any similarity to low dose naltrexone? Naltrexone in high doses is used for addiction. In lower doses may help stimulate the immune system.