Suboxone in Addition to Fentanyl

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skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 3/12/2009 7:14 PM (GMT -7)   
My doc brought up Suboxone today and asked me if I had heard of it. I have read about it with regards to addiction treatment centers and I am sure it can probably be used for chronic pain too (I could be totally wrong here, just my ignorant guess). I told him that I had heard the name before but that I didn't know much about it. He explained that it was used to try and get people off of narcotics but that he would have to research it to find out if it can be used along with Fentanyl. He looked it up in a book while I was there and he said it might have a contra-indicator with Fentanyl. I had to look this one up but it means that it cannot be used at the same time as Fentanyl. He did say that he wasn't positive (some terminology or something that even he didn't understand) if it was a contra-indicator or not but there was at least a warning on it.

From what I understand (and this too may also be ignorance) Suboxone is used to suppress withdrawal symptoms in recovering addicts and that it also blocks the effects of opiates. I read somewhere that even if a drug abuser is taking Suboxone, they cannot "get" anything from opiates while the Suboxone is still in their system. I would assume that this would have a negative impact on the Fentanyl he has me on. Maybe something like canceling out the Fentanyl and blocking it from being effective?!?

If anyone has taken this medication, please post something here. I have been double checking on everything that this doc has written for me and I have had quite a few mistakes on their part so far. He hasn't prescribed this for me yet but he did bring it up. I want to be prepared if he wants me to take this medication. Please let me know if you have any idea if Suboxone could potentially have a negative impact on the Fentanyl I take for chronic pain.


Thanks,


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/12/2009 9:11 PM (GMT -7)   
Skrape,
If your doctor's not sure I would suggest you maybe get a consult with another PM doc (I'm assuming your doc is a pm specialist). You could also get a consult with an Addictionologist, who's a specialist in addiction medicine. I say that not because you're an addict, but because they may know these medications better. A pharmacist might help, but only one that's familiar with both drugs.

Since we're not doctors and can't give medical advice, I'd suggest that a forum isn't a good place to get this type of specific info. There seems to be a lot of people asking questions about medicaiton lately, and a variety of opinions. You need clear facts about these medications, not opinions. Plus someone who has all your medical history. Your doctor should also be willing to consult with another physician himself, so that he knows for sure. I wouldn't take it unless your doctor is certain of what it might or might not do for you. I think you're on the right track about suboxone, but that's purely IMHO, and even I wouldn't rely on that in this instance!

Good luck!

PaLady

skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 3/12/2009 9:53 PM (GMT -7)   
PAlady,

My doc is a doctor of internal medicine. The last time I ended up in the ER they told me to get an internal medicine doctor. They gave me four numbers for docs that were of this nature and covered by my insurance. I value your advice and I will probably ask for another opinion if he wants me to take something like this.

I think my goal here is just to find out if anyone has ever been given this medication for chronic pain and not just withdrawals. I brought up the fact that the Fentanyl (my only pain medication at this point) was giving me withdrawal symptoms on the third day (they're supposed to last 72 hours and only seem to last 48) and that was the point in the conversation where he brought up the Suboxone. I really just want to find something effective for the pain in my back and do not want medications to fight the side effects of other medications. I am sorry if I wasn't clear on this. I have been really emotional and generally not myself since starting the Fentanyl. I do know that no one on here is a doctor, I know that different medications have different reactions for different people. I just want to know if this is a valid medication for chronic pain or if anyone has been treated with this before. I read about Methadone before coming here and had only heard of it being used in rehab clinics and not for pain management. Again this was just my ignorance and not that I knew what medications are used for this type of problem.

I just don't want you to get the wrong idea. I am not relying on this forum for a hard and fast rule about medications, just an idea of what has been used and maybe have worked for other people. I have reason to question some things this doctor has said/prescribed before and I am trying to cover all my bases. I have found a lot of things on HealingWell that I had never thought of before. I value the input.


Thanks,


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


mom9mom
Regular Member


Date Joined Sep 2008
Total Posts : 489
   Posted 3/13/2009 7:39 AM (GMT -7)   
Skrape if you have to double check every thing your DR> tells you its time for a new DR. I know that it is hard some times to find a new DR. but I would have a hard time going to a DR. that I do not trust.Add to that you have to pay him a good amount of money just so that you go right behind him to check his work.
Lost half of my small intestineJan.2008.Ilieostomy for 5 months then reverst in June 2008,Nerve damage to right leg,part of my right hip bone removed Jan. 2008,Cronic pain,hernia,infection in my back called discites,and depression.Gallbladder removed Nov,2008.Surgery to fuse L3 and L4 vertabra Dec. 31,2008.Mother to 9 kids 7 boys 2 girls and 1 stepson.4 grandsons,9 grandaughters.4 of my grandkids I inherited from my twin sister who passed away 6 1/2 years ago from a blood clot after surgery.God has given me my life back after I almost lost it.Even though its a painful and sometimes hard road to walk I take it one step at a time and give thanks to god for every step I take.


Bones And Dones
New Member


Date Joined Feb 2009
Total Posts : 15
   Posted 3/13/2009 8:15 AM (GMT -7)   
If your doc wants to try buphenorphine along with the fentayl, suggest Subutex. Same active ingriedent as Suboxone just no naloxone.(what blocks other opiates opioids from binding to your pain receptors and causes withdrawal syptoms) However buphenorphine is a partial agonist-antagonist opiate(same as darvocet). Meaning in will bind with some receptors and not others. Fentanyl is strictlly an agonist opiate, meaning it binds to all three of your pain receptors. Personally, I don't think I would recomend this. If it breakthrough pain is what your doc is trying to avoid, I would suggest hydrocodone or oxycodone. Both are agonists opiates and are often used for BT pain along with other longer acting opiates or opioids. This is not medical advise only opinion and should NOT be used as such!

Momcares
New Member


Date Joined Feb 2009
Total Posts : 16
   Posted 3/13/2009 8:34 AM (GMT -7)   
Skrape,
My daughter's WC carrier wants her to try the Suboxone treatment-she is on MS Contin for her chronic pain-I have done a lot of investigation into this drug. First please go to the suboxone website which is http://suboxoneheretohelp.com/safety/Default.aspxor or www.suboxone.com. One thing that I must tell you is the manufacturer of Suboxone (ReckettBenckiser) says:
 
Appropriate use of SUBOXONE
Do not use SUBOXONE or SUBUTEX for conditions for which they were not prescribed. Patients with a clinical need for analgesia should not be transferred to a SUBOXONE regimen. SUBOXONE is not indicated for pain management.
 
I called this manufacturer-at  1-877-782-6966. The representative was very nice but since Suboxone is not indicated for pain management and has not been approved by the FDA for use of pain management she was not able to talk to me about it. Understand,Suboxone is used to get people off of narcotics both illegal and prescribed.  Off label use is not illegal but she recommended that the doctor who prescribes it be certified to use it, since your doctor doesn't know that any narcotics that may be taken along with Suboxone may cause serious side affects-he surely must NOT be certified! Please use the information on these websites to make your decision-my daughter would not be able use anything but over the counter pain killers if she was this drug.  Please be very, very careful.  Momcares

My daughter has been in chronic pain for seven yrs after a work related injury that caused neuropathy pain in her thoracic vertebrae area. She has tried physical therapy, she has had 3 failed neural stimulators surgeries 2 which were implanted directly into her spine, morphine pain pump that was infected during implant -caused her to go septic and needed to be remove-took a year to heal.On Bipap w/ oyxgen. Doc has tried neurotin, lyrica, hydrocondone,methadone, percocet, etc. all with serious side effects, now on MS Contin 30mg 4x daily for pain and morphine 15mg for break through pain and proxac 40mg for depression, worker's comp wants her to try Suboxone-been through too much,not sure it won't cause severe adverse reactions and pain doc doesn't think it is a good idea. Tired of fighting it all. Momcares.


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13451
   Posted 3/13/2009 6:49 PM (GMT -7)   
Skrape I hope you get on board and read the above post from MomCares. I think that answers your questions about the medication. I know the others have suggested getting another dr but they don't remember the hassle you have been thru recently, thats why they say change. By the way, we do have one girl on it here and she had to be tapered off of her other pain meds before being put on the stuff. She swears by it as a pain killer, but quite frankly I don't think its one I would ever care to take. Just my opinion only. I think you should print off the info about this medication and take it with you to the next dr appt and give it to him so he does not try to push this medication off on you. Sure hope you are doing ok. Susie


Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 3/13/2009 7:53 PM (GMT -7)   
I think I'm one of the very few, if any other, on here that takes Suboxone. I wanted off of pain medication all together, thats why I'm on it, but in the process I found that it helps my pain wonderfully. I get mine from an addiction specialist. And as far as I know, you arnt suppose to be able to take any other narcotic with Suboxone, including fentanyl, but I could be wrong, I'm not a doctor. It's not FDA approved for pain, but Bupernorphine the main ingredient is coming out with patches meant just for chronic pain, so bupernorphine is indeed a narcotic pain killer, but right now Suboxone and subutex is the only ones I know about thats being used in the US. I know alot of doctors are starting to use it off label for pain control cause they love the fact that people cant abuse or build a tolerence to it, and they even sometimes, very rarely use it for depression. And on another forum I go to thats just for Suboxone/Subutex users, theres a few people that had to withdrawal off of fentanyl to be put on Suboxone/Subutex. But my favorites things aobut it is the fact that you dont have to wait more then 15 minutes for it to take effect, and that I can skip a dose or two before it starts to wear off since it has such a long half life. well in case you need more information, the NAABT has a websight and a forum with lots and lots of information on Suboxone.

-hellokitty
I have Migraines, Pancreatic Divisum, Severe lower back pain (possibly turned to arthiritis from lack of treatment), Fibromyalgia, Asthma, Depression w/Anxiety/panic, had glallbladder stones at 14yrs old, gallbladder removed at 15yrs old, 2 severe car accidents in '05
Meds: Suboxone 8mg 3xday for pain, Cymbalta 60mg @ night for depression & Fibro,
Lyrica @ night for Migraines and Fibro, Treximet as needed for Migraines,
Ventolin Albuterol Inhaler as needed for Asthma Attacks.
Chocolate as needed daily
Been on Diability since I was 22 for Migraines and chronic Pancreatitas but going to college Spring '09 to be a nurse
"Some days I just wish I was a missing person!"
"I'm not spoiled, I deserve all my stuff"  -Happybunny


skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 3/14/2009 9:31 PM (GMT -7)   
I want to say thanks for all of the information that you all have given me in regards to this concern. I also want to thank Susie (straydog) for keeping up with me so well! There were other posts about breakthrough medications and I want to try and briefly explain the exact situation a little better:

I saw my family doc for my back pain for almost 18 months. I had a failed epidural/spinal injection procedure in 11/08 and I saw my doc three times in four weeks for the problems I was having afterwords (I was completely incapacitated and in ungodly amounts of pain). I told him at all three visits that I was taking more pain medicine than what he prescribed because I was in so much pain and I wanted him to know exactly what the problem was and why I felt the need to take more. This is also why I saw him almost every week, I wanted to make sure he knew that I was still having problems with this failed procedure. He did not tell me not to take the extra medication (I wouldn't have done it if he had said not to) and when I ran out early that month, he asked me to leave his practice. I was very confused and upset when this happened. I believe this was a misunderstanding (maybe he wasn't listening to me or didn't understand me when I said I was taking more pain meds) but it has caused me a great deal of grief.

*** The following is all just my speculation. Because of this previous issue with my old doc, I believe this new doc does not want to prescribe me oral pain medication. I think he feels that the Duragesic patches (Fentanyl) cannot be abused. He asked me to discontinue the Norco that I was on for breakthrough pain and I destroyed all that was left of that Rx (about 2 weeks worth). I have been on the patches only for the last 4 1/2 weeks and he doesn't seem to want me to have anything for breakthrough pain. I have been pretty stressed that I have no recourse when the pain gets really bad but I will not ask him to give me anything in addition to the Fentanyl. I am very aware now (I was not before) of how I appear to doctors. This experience has taught me a great deal about the way I am perceived. If I give a doctor ANY reason to doubt me, bad things may happen.

I am only posting this to try and clear up any confusion about my lack of BT meds and in the hope that this may prevent someone else from enduring what I have for the past couple of months...


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours

Missing Key Value : en-US, 736

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