Subutex? Anyone tried this for pain? How effective is it?

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Danimal
Regular Member


Date Joined Mar 2009
Total Posts : 80
   Posted 4/24/2009 1:07 PM (GMT -7)   
My husband and I are interested in having children in the not too distant future. I met with a maternal/fetal specialist and he mentioned that studies seem to indicate that subutex has less of withdrawal effect on newborn babies. I'm interested in this (I currently take methadone and morphine) but would like to know if anyone on here has tried it and how effective it is in managing pain. I wouldn't want to switch if it's not that great of a pain reliever.

Thanks!

Danimal

Author of Chronic Stimulation- a blog about living with chronic pain and a neurostimulator

Come visit me at: http://www.chronicstimulation.blogspot.com/

Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 4/24/2009 2:38 PM (GMT -7)   
I do Suboxone which is Subutex but the Suboxone has Naloxone in it nd the Subutex doesnt. The main ingredent in it is Buprenorphine and I find it to be a wonderful painkiller but some people dont. And a baby can still go thru withdrawals with Subutex as they can with any narcotic pain killer but with Subutex/Suboxone it's not as bad and alot of time the baby doesnt have any withdrawals, it's always diffrent. I can find some information for you on Suboxone/Subutex and withdrawals in newborns if you would like me to, theirs a websight I visit by NAABT that has alot of information on it. The thing about this med is that you HAVE to be in withdrawals to start it and you have to be on 30mg on methadone for atleast 2 weeks before starting it, I did it and it wasnt that bad, I went from 180mg of methadone down to 30mg pretty easily. It is a very very strong pain killer, and the Subutex is also dissolved under the tongue like the suboxone I take, but it's a lemon-lime flavor but I thought it was pretty nasty, but you get use to it. It has a peak effect of 32mg, so anything higher wont do anything else for you in pain releif. but let me know if you wnt that information.

-hellokitty
26 years old, single mother of 2 children, 7 year old girl and 9 year old boy
DX-Lower back pain, Arthiritis, Migraines, Raynald's Phenomenon, Depression, Anxiety/Panic Disorder, Bipolar Disorder, Pancreatic Divisum, Chronic Pancreatitas, Fibromyalgia
Meds- Suboxone 16-24mg daily, Cymbalta 60mg, 100mg Lyrica, Ventolin Albuterol Inhaler, Advair, Imitrex 100mg, Ibprofen 800mg, Phenergan 25mg, Hydroxizine 25mg, Biofreeze
Surgeries- Gallbladder removed 1998, Stent in Pancreas 2003, marsupilized bartholin gland cyst, countless upper GI scopes and ERCPs
Pets- 3 degus named Pricilla, Aster, and Shorty, one female rat named Sassy, one male rat named Squeeky who's brother died on 4/18/09 and was replaced by a baby female Guinea pig name Rosalina, a baby black emperor scorpian, and a corn snake named Precious
"Never go to a doctor's office whose plants has died."
 
 


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 4/24/2009 5:26 PM (GMT -7)   

 

I got this informationat www.suboxone.com 

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.

Suboxone is an opioid and an effective pain medication. It has been used for this purpose for many years -- mostly used in its injectable form. Suboxone is now available in the United States as an oral medication. It is fifteen times more potent than injected morphine. The medication is different from other opioids so the client usually feels more "clear headed" when taking Suboxone. An evaluation for chronic pain management will be made by the Program's physicians to determine if Suboxone is the appropriate medication for treatment.
Suboxone is the first oral medication that has been approved in the U.S. that physicians can prescribe in their offices to people who are dependent or addicted to opioids such as pain medication, heroin, or methadone. Suboxone is an effective medication for opioid addiction that does not require daily or weekly visits to a clinic. Suboxone blocks the effects of other opioids. This eliminates cravings and prevents withdrawal symptoms such as pain and nausea. Patients can be maintained on Suboxone or go through detoxification .
 
 
Me.<!-- InstanceEndEditable --><!-- InstanceEndEditable -->

 I hate Boats!!!!
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night
                                                                    

 


Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 4/24/2009 6:33 PM (GMT -7)   
Here is some info I got from the NAABT (National Alliance of Advocates for Buprenorphine Treatment) websight.
 
What is Buprenorphine??
Buprenorphine ('bu-pre-'nôr-fen) (C29H41NO4) is a semi-synthetic opioid derived from thebaine, an alkaloid of the poppy Papaver somniferum. Buprenorphine is an opioid partial agonist. This means that, although Buprenorphine is an opioid, and thus can produce typical opioid effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone. At low doses Buprenorphine produces sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. The agonist effects of Buprenorphine increase linearly with increasing doses of the drug until it reaches a plateau and no longer continues to increase with further increases in dosage. This is called the "ceiling effect." Thus, Buprenorphine carries a lower risk of abuse, addiction, and side effects compared to full opioid agonists. In fact, Buprenorphine can actually block the effects of full opioid agonists and can precipitate withdrawal symptoms if administered to an opioid-addicted individual while a full agonist is in the bloodstream. This is the result of the high affinity Buprenorphine has to the opioid receptors. The affinity refers to the strength of attraction and likelihood of a substance to bind with the opioid receptors. Buprenorphine has a higher affinity than other opioids and as such will compete for the receptor and win. It will "knock off" other opioids and occupy that receptor blocking other opioids from attaching to it. If there is enough Buprenorphine to knock the opioids off the receptors but not enough to occupy and satisfy the receptors, withdrawal symptoms can occur; in which case the treatment is more Buprenorphine until withdrawal symptoms disappear.

In October 2002, the Food and Drug Administration (FDA) approved Subutex® (buprenorphine hydrochloride) and Suboxone® tablets (buprenorphine hydrochloride and naloxone hydrochloride) for the treatment of opiate dependence. These are the only buprenorphine based products approved to treat opioid dependence (addiction).

Suboxone, contains both buprenorphine and the opiate antagonist naloxone. Naloxone has been added to Suboxone to guard against intravenous abuse of buprenorphine by individuals physically dependent on opiates. If misused by injection, the naloxone will cause immediate withdrawal in opioid dependent people, however when taken sublingually, as indicated, the naloxone is clinically insignificant. 

Are there other uses for Buprenorphine?
The Food and Drug Administration (FDA) has approved Buprenex® ( an injectable formulation of buprenorphine) (Buprenex PI) to treat pain. However, by law, Buprenex cannot be used to treat opioid dependence(addiction), even by DATA-2000 wavered physicians. Buprenorphine: Considerations for Pain Management (study)

Buprenorphine has also been found to relieve refractory depression, but this particular use has never been approved by FDA. Refractory depression is depression that has not responded to other treatments. Some patients, who suffered from depression in the past, have experienced relief of symptoms on buprenorphine. (Bodkin,1995)

FDA has approved Subutex®( buprenorphine) and Suboxone® (buprenorphine/naloxone) to treat opioid dependence (addiction). However, neither Suboxone nor Subutex has been approved by the FDA for the treatment of depression or pain. Thus any use of Suboxone® and Subutex® for pain or depression is considered an off-label, unapproved use of these medications.

The D.E.A. articulates policy on the use of buprenorphine for pain and other off-label uses of buprenorphine products under DATA2000. Letter to Doctor Heit

Clarification: Buprenorphine is intended for the treatment of pain (as, Buprenex®) and opioid dependence (addiction) (as, Suboxone® and Subutex®). In 2001, 2005,and 2006 the Narcotic Addict Treatment Act was amended to allow qualified physicians, under certification of the DHHS, to prescribe Schedule III-V narcotic drugs (FDA approved for the indication of narcotic treatment) for narcotic addiction (up to 30 patients/physician at any time, 100 for those who meet certain criteria) outside the context of clinic-based narcotic treatment programs (Pub. L. 106-310). Suboxone® and Subutex® are the only treatment drugs that meet the requirement of this exemption (not Buprenex®). Source: DEA

Can someone switch from methadone to buprenorphine?
It is best to SLOWLY reduce your therapeutic dose of Methadone to 30 mg a day or less for at least a week, before discontinuing it completely for at least 36 hours before starting Buprenorphine. You MUST be in mild to moderate withdrawal before you take your first dose of Buprenorphine. If you are doing well in Methadone treatment it may not be advisable to change treatments at all unless you and your doctor determine it is in your best interest.

It is VERY important to follow these guidelines and prevent precipitated withdrawal.

What the experts say (PCSS mentors)

NAABT Precipitated Withdrawal sheet (including COWS)

What if I need pain medication for surgery, or acute pain?
You will still be able to be treated for pain with elective dental or surgical procedures. Your doctors should speak with each other about the plan. They will likely stop your Buprenorphine medication, at least 36 hours before the procedure, and then when you are ready to go back on Buprenorphine you will need to be re-induced, which means stopping your pain medicine, experiencing mild withdrawal (for a very short time) and restarting your Buprenorphine.

And here are some links to information on buprenorphine and pregnancy/birth-

http://www.ncbi.nlm.nih.gov/pubmed/18283247?log$=activity
http://www.suboxoneassistedtreatment.org/47.html
http://pediatrics.aappublications.org/cgi/content/full/122/3/e601

 

I hope this information helps. I'm not taking credit for any of this stuff cause I didnt write it. But I only posted some of the importnt stuff like for pain pregnancy.

 

-hellokitty


26 years old, single mother of 2 children, 7 year old girl and 9 year old boy
DX-Lower back pain, Arthiritis, Migraines, Raynald's Phenomenon, Depression, Anxiety/Panic Disorder, Bipolar Disorder, Pancreatic Divisum, Chronic Pancreatitas, Fibromyalgia
Meds- Suboxone 16-24mg daily, Cymbalta 60mg, 100mg Lyrica, Ventolin Albuterol Inhaler, Advair, Imitrex 100mg, Ibprofen 800mg, Phenergan 25mg, Hydroxizine 25mg, Biofreeze
Surgeries- Gallbladder removed 1998, Stent in Pancreas 2003, marsupilized bartholin gland cyst, countless upper GI scopes and ERCPs
Pets- 3 degus named Pricilla, Aster, and Shorty, one female rat named Sassy, one male rat named Squeeky who's brother died on 4/18/09 and was replaced by a baby female Guinea pig name Rosalina, a baby black emperor scorpian, and a corn snake named Precious
"Never go to a doctor's office whose plants has died."
 
 


crste
New Member


Date Joined Apr 2009
Total Posts : 3
   Posted 4/24/2009 10:26 PM (GMT -7)   
someone please help me. im tryn to get off methadone with no medical help off of 60mg and soma, oxycodone.
my body in such spasms. i need some guidance. i have degenertive disc disease, fibromyalgia, arthritis. no drs care. canttake anymore.

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 4/24/2009 10:36 PM (GMT -7)   
Crste,
I want to welcome you to the chronic pain forume of Healing Well. We aren't doctors here, though, and can't give medical advice. I would never recommend trying to withdraw from these drugs without medical guidance. It can be dangerous. If nothing else, you may need to go to the E.R.

Why is it you want to stop these medications without medical help? Please, at least call your local E.R. and tell them your symptoms and let them decide if you need to be seen.

PaLady

Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 4/24/2009 11:12 PM (GMT -7)   
Crste,

I dont know about Soma, but for the oxycodone, all you can do for withdrawals from that is time, you wont die from the withdrawals but you will wish you where dead. The symptoms peak at about 3 days and lasts for up to 7-10 days for oxycodone and quite a bit longer for methadone, the withdrawls from that can be months, even one lady I know was still having withdrawals after a year, it really stores up in your bones and fatty tissue. Then their's paws which can last for a year or more, which will be the worse part of it from what I hear, the depression from the paws is suppose to be terrible. And you will need some kind of counciling, group, or/and 12 step meetings no matter what, that will the most important part.?? But all I can tell you to help with opiate withdrawal is to drink ALOT of water even if you dont feel like it, take alot of hot baths, take ibprofen for pain and aches, and stay away from caffiene, which can make withdrawals worse. And if you can find a doctor, ask for some clonidine, the pills not the patches, that will help you with alot of the symptoms, and sometimes benzos (klonidine, xanax, valium, ect) can help but take as little aas possible or that can cause a whole new addiction problem which can be deadly if stopped all of a sudden. This is all I can think of, and of course their's Suboxone treatment which can cost alot (I know it did for me) and you can find a list of approved doctors at suboxone.com. Also why are you not under a doctor's care? where you getthing these meds from a doctor?
-hellokitty


26 years old, single mother of 2 children, 7 year old girl and 9 year old boy
DX-Lower back pain, Arthiritis, Migraines, Raynald's Phenomenon, Depression, Anxiety/Panic Disorder, Bipolar Disorder, Pancreatic Divisum, Chronic Pancreatitas, Fibromyalgia
Meds- Suboxone 16-24mg daily, Cymbalta 60mg, 100mg Lyrica, Ventolin Albuterol Inhaler, Advair, Imitrex 100mg, Ibprofen 800mg, Phenergan 25mg, Hydroxizine 25mg, Biofreeze
Surgeries- Gallbladder removed 1998, Stent in Pancreas 2003, marsupilized bartholin gland cyst, countless upper GI scopes and ERCPs
Pets- 3 degus named Pricilla, Aster, and Shorty, one female rat named Sassy, one male rat named Squeeky who's brother died on 4/18/09 and was replaced by a baby female Guinea pig name Rosalina, a baby black emperor scorpian, and a corn snake named Precious
"Never go to a doctor's office whose plants has died."
 
 

Post Edited (Hello~Kitty) : 4/25/2009 12:17:34 AM (GMT-6)


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 4/25/2009 12:38 PM (GMT -7)   
 
Crste,
I understand about wanting to stop taking Methadone, for whatever reason.  I recently went from Methadone 120 mg. a day to MS Contin (Morphine) 120 mg. a day...What a disaster!!! First off I had to deal with withdrawls!!! Almost from the get go.  Then I had to deal with Pain... For me Morphine isn't as effective for pain as the Methadone was.  After only one week I went back to the Methadone.  I couldn't deal with it.  I don't know if it was the withdrawls or the actual pain that was the worst...whatever it was, I had to go back..
 
May I ask WHY you want to get off the Methadone if it works?  I know, for me, I will most likely take Methadone for the rest of my life....and that's okay for me.  It might not be okay for others. I am not giving in to the pain, I have just resigned myself to the fact that the pain will always be a part of my life, and if I want any kind of a life, I have to take something...
 
Not everyone feels that way, and I applaud anybody that can go through this without taking anything... And....trying to come off of ANY Opiate by yourself is trouble waiting to happen.  Not only are the withdrawls awful, but you have to worry about other health problems...like seizures, depression, and added pain.  So, please talk to a Dr. about it, they know how to handle these things...
 
Me. 

 I hate Boats!!!!
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night
                                                                    

 


Danimal
Regular Member


Date Joined Mar 2009
Total Posts : 80
   Posted 4/25/2009 4:50 PM (GMT -7)   
Hi Hello-Kitty:

Thank you so, so much for all of this information. After reading it, the whole idea makes me a little nervous when there is no guarantee that the subutex would be a better pain reliever for me than methadone. Both my maternal/fetal specialist and my pain doc, who works with high risk obs, have said that it's ok to stay on methadone if I'm pregnant. Of course, I cringe at the idea and feel guilty about it but they've tried to alleviate my anxiety.

Anyway...I really appreciate you going to the trouble to post all of these sites and this info!!

Best,
Danimal

Author of Chronic Stimulation- a blog on being young and living with chronic pain and a neurostimulator

Please come and visit! http://chronicstimulation.blogspot.com/
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