Really hoping someone can give me advice on new pain med.-SUBOXONE

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patsy123
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Date Joined Sep 2009
Total Posts : 41
   Posted 10/13/2009 2:15 PM (GMT -7)   
I'm gone to try and make this short and sweet.  My husband has major damage to his lower back (he needs surgery and is not willing to have it till its a last resourse).  He goes to a pain clinic every 2 months and has some kind of injections done in his lower back.  He starting these injections about a year ago and they do give him relief but not for as long as they initial did.  He is a Truck driver so he can not take pain meds till he gets home and by then (usually he works approx. 14 hr days) the pain is pretty bad.  He only takes one vicoden a day and hates to have to even do that.  The Pain Mang. dr. now wants to put him on this new drug that he thinks will really help him.  The name of this drug is Suboxone.  We researched it on line and found out that its used to help people to kick addiction.  His Dr. did tell him to research it and that the FDA has now approved this drug for use in patients with my husbands problems and it suppose to work good.  What I read scarred the crap out of both of us.  This sounds like a heavy duty pain med. 
 
Does anyone have any knowledge or experieces with this drug?  Please, any input would be GREATLY appreciated.

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 10/13/2009 4:39 PM (GMT -7)   
No information on this medication, but I do sincerely hope that your husband is keeping his employer informed of any and all medications he is taking. If he is not and gets into an accident, regardless of fault, I can promise you that he will be left holding the bag. I spent many years driving trucks myself and at one time I was poised to move into the safety department and had completed a lot of additional training.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


BionicWoman
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Date Joined Jul 2008
Total Posts : 243
   Posted 10/13/2009 8:29 PM (GMT -7)   
Suboxone is really not a "front line" drug for pain management and, in my opinion, it's is a huge leap for someone that's maintaining any level of functionality on 1 Vicodin a day. One thing your husband will need to be very aware of is that you don't use Suboxone on an "as needed" basis or just when he's not on the job. It has to be taken exactly on the schedule the doctor gives him, whether he's working or not.

What exactly is the nature of the damage to his back? And what type of surgical intervention has been suggested?
The difference between perseverance and obstinacy is that one comes from a strong will, and the other from a strong won't. ~Henry Ward Beecher


straydog
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Date Joined Feb 2003
Total Posts : 13451
   Posted 10/13/2009 8:36 PM (GMT -7)   
One of our members is on this hopefully she will see your post. Please think about what Bionic told you about how the medication must be taken. Many medications will not work effectively if not taken as prescribed.
Straydog/Susie
Moderator Chronic Pain
 
crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & decreased circulation in both legs. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 16 different daily medications. Intrathecal pain pump implanted June 05.


Hello~Kitty
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Date Joined Jun 2005
Total Posts : 610
   Posted 10/14/2009 3:07 AM (GMT -7)   
Hello Patsy,

AS a Chronic Pain patient with back pain and a patient who takes Suboxone for pain releif, I would recommend NOT starting on Suboxone if he's a truck driver and only takes one vicodin a day. It does have a very potent pain med in it, Burprenorphine which has been around forever, but they use it in MICROgrams for pain relief in other countries for severe pain. This is a BIG jump in pain meds, actually a huge jump. And it does havet he same side effects as any other opiates, atleast to me it does. The drowsiness is still there, even after a year and half of taking it. And lots of people dont find good pain releif with it, I just got lucky with it as it's done wonders for my pain.

Also, what IF (hoping to God this never happens to your husband but what IF?) he's in an accident, and needs emergency pain relief and/or surgery, Buprenorphine (suboxone/Subutex) blocks other narcotics from from working, they have to give a HUGE amount while watching his breathing (full blocking can start around 4-6mgs). This alone can cause issues if he's dying in pain and he gets an ER doctor that doesnt know squat about how Suboxone works and your husband ends up suffering tremendously. It happens all the time, I've heard many horror stories.

But I'm not saying this may not be a good pain med for him, it just might be. It has about the same side effects as other pain meds, but lots of people have reactions to the naloxone in it, but this can be helped by switching to Subutex which is just the Buprenorphine by itself, or spitting out the saliva while sucking on the suboxone. Also the naloxone has no effect (unless your allergic as a VERY tiny amount does pass through the body, but not enough to cause withdrawals as buprenorphine is much more binding then even the nalxone/naltrexone) and it does have a peak dose where taking more will do absoutly nothing else, they say usually that's at 32mg, but some doctors say it can be as low as 6mg, so overdosing on it is very rare.

Also you must remember that it's 25-50 times stronger then morphine, so it's not something to mess around with. They are working on trials on doing a patch of buprenorphine which will be FDA approved just for chronic pain here in the states. I just dont understand why a doctor would recommend this for pain when he's taking just one vicodin a day, But they're the doctor, not me.

But just in case you havent checked this place out yet, go to the NAABT websight which is full of all the information about Buprenorphine you can dream of, and they even can send you a free package of information all about it, it comes in a white folder which has papers with illustrations and a CD to listen to and bruchures, they dont sell anything, they're just there to inform people about Buprenorphine treatment and they have a section on it's use of Suboxone/Subutex for pain.

If I where you, I would defiently get a 2nd opionion if this doctor doesnt offer any other options and just offers Suboxone. Their's so many other better options out there, especially with him driving for a job. Well if you have any other questions, just let me know, I'll be happy to answer anything.

-Carmen

PS, please dont take anything I say over what a doctor says, as I'm not a medical perfessional or have absoutly any training in the medical field. I'm just stating my personal experieince with Suboxone, and as we all know, everyone has diffrent experiences with diffrent medications, what works for me may or may not work for the next person.

Carmen~*~*~Chronic Pain Moderator

DX-Chronic Pain due to two freak car accidents, Pancreatic Divisum,Fibromyalgia, Asthma, Depression w/anxiety, Migraines

Meds- Suboxone 16mg for pain, Cymbalta 60mg, Lyrica 50mg, Imitrex 100mg PRN,Ibprofen 800mg PRN, Ventolin Inhaler PRN, Visteril PRN

 


patsy123
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/14/2009 3:13 AM (GMT -7)   
Hi Jim1969, Yes my husband is very aware of the laws (he has been driving for over 33 years).  That is why he only takes 1 vic when he gets home from work, he then has 10 to 12 hours before he goes back to work.  That is one of our biggest concerns with this new med., can he just take one when he gets home and will it be out of his system before he goes back.  Everything Ive read on this really hasn't given us the answer.  Also, his pain mang. dr. is aware of his work.  I really really really don't like what I've read so far.  Thanks,
 
Bionicwoman,  I wish I could tell you the tech. terms for all the damage he has.  I think it has to do with the lower disc's being pretty much disinagrated with nerves and stuff growing into bones.  I know one of his biggest complaints is his legs and he cant walk far without stopping every few feet and if he stands for more than 5 min. he is in a lot of pain.  The back spec. he saw gave us a tape to watch about the surgery (we watched about a year ago and I can't remember much from it).  My husband is one of the most stuburn people you will ever meet and he just refuses to let them do this surgery.  He said he will wait till he just can't stand it anymore.  I'm sure all the bouncing around in a semi truck doesn't help.  So, I'm thinking what I've read so far on this drug it's not for him.  Thank you all for your input:)

Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 10/14/2009 7:32 AM (GMT -7)   
Suboxone stays in the system for 37 hours, so no, he cant take one and it be out of his system 12 hours later, some people take it this med once daily or once every other day cause it stays in the system so long, but yet the pain relief only last 4-6 hours.

-Carmen

Carmen~*~*~Chronic Pain Moderator

DX-Chronic Pain due to two freak car accidents, Pancreatic Divisum,Fibromyalgia, Asthma, Depression w/anxiety, Migraines

Meds- Suboxone 16mg for pain, Cymbalta 60mg, Lyrica 50mg, Imitrex 100mg PRN,Ibprofen 800mg PRN, Ventolin Inhaler PRN, Visteril PRN

 


patsy123
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/14/2009 3:36 PM (GMT -7)   
I  can't thank  you all enough for your reply's.  We have decided to NOT even think about him taking this med.  The thing that bothers me the most is why would his dr. even want to put him in this kinda of position without trying something else first.  He know's the one vic. when he gets home from work takes a little bit of then edge off for him.  Myself I would think he would try to either add one more vic. or one of something else to see if it helps.  Once again, thanks so much for your responses.

BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 10/14/2009 5:27 PM (GMT -7)   
My suspicion is that the doctor suggested Suboxone because it's possible to skirt the DOT drug testing requirements while using it. At low enough doses (and one would expect a very low dose coming up from 1 vicodin a day), the test would technically be positive, but it would come in below the minimum concentration allowed, so it would be considered "negative."

If your husband never tests a true positive on a drug test, then doctor doesn't have to put himself on the line and go on the official record as saying your husband is safe to drive while using a controlled substance.

But that's just a suspicion.....
The difference between perseverance and obstinacy is that one comes from a strong will, and the other from a strong won't. ~Henry Ward Beecher


patsy123
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/15/2009 6:02 AM (GMT -7)   
Bonicwoman, that could very well be, but my husband did say that the pm dr., told him that the FDA did just approve this drug for use in patients with his  condition so I'm wondering now if his intent is for this medication to help with something other than for pain relief?  He has an appt. with his dr. on Monday (this is when my husband is suppose to fill the perscription and take it for the first time in the office in front of the dr.).  But what were planning on doing is to NOT fill it and talk to him both at that time to see if there is any other med. or options for him.  Also, he does'nt want a paper trail of him ever even filling this med.  Keeping my fingers crossed.

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 10/15/2009 11:37 AM (GMT -7)   
Patsy,
i haven't posted to this thread because I'm not as familiar with suboxone as other members of the forum, but I can say there's no way there won't be a paper trail for any of these medications.

If they're being taken as prescribed, and are safe for your husband to take with his occupation, then an employer should be ok with it, if that's what you're worried about. I'm not saying stuff doesn't happen that shouldn't, but a doctor can't keep this out of his records. Nor if you use your insurance can it be kept from insurance records, pharmacy records, etc.

Are you concerned just because of your husband's employment?

PaLady

jeffro74
Regular Member


Date Joined Oct 2009
Total Posts : 29
   Posted 10/15/2009 12:58 PM (GMT -7)   
This sounds alot like Methadone which is what I take. I have ZERO euphoria from Methadone. I am on 10mg 4 times a day. It has a bunch of crappy side effects. I can't sleep, am constipated, and sweat non-stop. It use to handle the pain fairly well. I think I need to be upped a little in my dosage. Let me give you a little history on Methadone:

It was created by the ****'s in the 30's to help with wounded soldiers pain. They found it was too addictive for treating pain. When the Allies stomped their butts in the dirt America took the "recipe" for Methadone. It was then used for addiction as Suboxone is. Here recently they started using it for its original purpose which was pain relief.

I have to have percocet for breakthrough pain. If your husband only takes 1 Vicoden at the end of the day, I would stay away from the stuff. It Maybe a switch from hydrocodone to oxycodone would be enough to help him.
Jeffro


painsnbody
Regular Member


Date Joined Aug 2009
Total Posts : 30
   Posted 10/15/2009 1:35 PM (GMT -7)   
If you really want the truth about Subs go to drugs.com. And you can read stories from hundreds strugling to get off this med. there are more then a handfull of pain killers out there I would try before subs.
In fact any doctor that would suggest it knowing what he is currently rx'd  is looking for that vacation bonus the suboxone sales rep tried pitching. Thats just crazy!
 
Tell your husband to hang in there. I feel for you both. There are Long acting meds that he could benifit from but can't because of his job. Tough one.
 
I would suggest Lyrica if his problem is anything nerve related.  JM2C
 

Post Edited (painsnbody) : 10/15/2009 2:38:02 PM (GMT-6)


patsy123
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/16/2009 2:45 PM (GMT -7)   
 Hi Carmen, Thank you so very much for taking the time to go in such lengths in your reply.  I agree so much with you about the many other options I think the dr. should try first.  Thanks again. 

OnTheRocks
Regular Member


Date Joined Oct 2009
Total Posts : 117
   Posted 10/16/2009 5:29 PM (GMT -7)   
Suboxone is a combination of buprenorphine (very strong opioid - somewhere between oxymorphone and fentanyl) and naloxone (sometimes called narcan - basically blocks opioid medications from binding to opiate receptors in the brain). It's only been FDA approved to ween opioid/opiate addicts or used as a maintenance drug so addicts don't feel the need to revert to a more dangerous drug. I saw Subutex mentioned above, note that they are NOT the same. Subutex is just buprenorphine while Suboxone is the buprenorphine/naloxone combo.

Anyways, unless your doctor thought he may be acquiring an addiction issue, there's no reason he should have considered prescribing it (unless your husband is actually taking stronger opioids or more than one vicodin/day). This drug is meant to keep heroin addict's cravings at bay, so it's powerful. Even half of a sub-lingual tab would be enough to knock out some one 200+ lbs. with little tolerance (a MAJOR driving hazard). If you have told us the full story, you should consider seeing a new doctor.

uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 10/21/2009 10:48 AM (GMT -7)   
Wow!! You have had a lot of info. thrown at you....I know that taking Methadone was a concern for me about driving...but it really doesn't effect me much... I know other people that took Suboxone for addiction reasons...they were addicted to Methadone...I have recently heard of a lot of people taking it for pain..but I can't say if it works or not. YOur husband is in a very bad situation...being a truck driver and all.. I understand about being worried about the laws...but maybe your husband should consider retiring or having the surgery and after recovery going back to work.. I understand with the economy it's hard to think about being out of work..but what other options does he have? I feel for you and your family....good luck.

<me>
I have been a spectator for so long..Now it's time to participate.......
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/  30 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..Glipizide 10mg. 2X in the morning
Lantus 35 units at bedtime with Solostar Pen                                                                   

 


patsy123
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/21/2009 12:48 PM (GMT -7)   
uniquelyme,  thanks for your input.  I just lost my job at one of what use to be the "big three" so it's kinda hard for him to retire right now.  Were going on Monday to meet with his pain dr, and asking for alternatives for him.  I would think he could at least try something else before going to that extreme.  Fortunetly if worse does come to worse he has the time to retire.  He won't even discuse with anyone the topic of surgery right now.  He says that till he can't function at all is when he might consider having surgery.  I also have several health issues and have had dr., husband and family tell me to fill for disability but have fought it off for sometime now, but maybe it's time to listen.  Thanks again for your concern.
 
"What doesn't kill us, only makes us stronger" (right?)

patsy123
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/26/2009 12:06 PM (GMT -7)   
I'm so confused and totally disappointed.  My husband went to see his pain mang. dr. today to tell him he read up and really educated himself or the Suboxone, ( he was suppose to start in his office in front of him today).  After explaining to him he didn't want to go to this level of medication and also the issues with the legallity of him drive a semi on Suboxone, he told us that it's either Suboxone or nothing at all, and he said no more 1 to 2 vicoden and day because (according to him) vicoden is the number one reason people go to the emeregency room.  I could maybe understand his point on the vic. if my husband was asking him to increase his dose but he didn't.  It was you either go on Suboxone or live with nothing else, no in between.  I ASKED HIM EXACTLY THAT, "ISN'T THERE ANOTHER OPION FOR HIM", AND HE SAID "NO".  He then got up and said to try and find another dr. because he wouldn't do or give my husband anything but the Suboxone.  He was so aragent.  It was like watching a little kid have a temper tandtrum.  Sorry I just had to vent over my anger with this guy.  I guess the next thing to do is look for another Pain Mang. Dr. for a second opinion.  If anyone has any other suggestions, I would really appreciate it.

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 10/26/2009 1:11 PM (GMT -7)   
Patsy,
I don't know for sure (as I said earlier, I don't know much about suboxone) but my hunch is the doctor may - legitimately - be concerned not just for his own liability, but your husband's safety, considering his occupation. I'm not sure you're going to find medications that don't affect your husband's alertness, and that a doctor is willing to put him/herself on the line for. As I said above, there is no way a medical professional can legally or ethically keep this information out of a medical record. No way there won't be a paper trail, and that is as it should be. Medications for pain aren't something to fool around with when it comes to driving, and I know your husband was holding off taking the vicoden until he got home, but the suboxone can't be taken the same way.

It looks to me like your husband has some fairly significant problems in his lower spine, and I know neither of you want to hear this, but driving a truck (the sitting, the jolting, pressure on legs and lower spine) for all those hours is probably aggravating it all. I'm not saying he necessarily needs surgery (I've had a double lumbar fusion, and I still have difficulty standing and sitting) but he may need other treatment, and may need to at least make adjustments in his work. NONE of us ever wants to hear that. I'm still struggling with accepting the changes that have come to my life because of my health issues. But please remember the doctor (and others - pharmacists, etc.) are on the line for what they prescribe, and that PM doctor may be doing the only thing he believes he can safely do. Certainly, you can seek another opinion, but I also think you need to begin accept the realities for the doctors involved in prescribing. I have a feeling you may accept them easier than your husband, as you say he is stubborn. We're all stubborn in our own way when it comes to making major changes in our lives.

You may have stated it somewhere and if so I apologize for missing it, but has your husband ever tried physical therapy, or any other treatments? A good PT can also help figure out what's possible for someone with your husband's occupation - and what's not.

Also - is your husband on any of the anti-depressants that are also used for pain? They tend to be less sedating - some not sedating at all. Might be worth asking your PCP about a medication like cymbalta, which can help with nerve pain.

Just some thoughts. Don't know if they helped or not.

Take care,

PaLady

breathe12
New Member


Date Joined Oct 2009
Total Posts : 16
   Posted 10/26/2009 4:45 PM (GMT -7)   
Hi, I am responding to this thread because of the poor husband who drives a truck with back pain. First of all, i have a bulging disq in my lower back. ALso, over flexible si joint which is where all the nerves run. sitting in a car or plane for more then 5 hours usually leads to my back going completely out. His legs probably hurt, because the nerves in that lower back are connected to everything. As far as his pain Doc, it sounds like either he is not very empathetic or not very good. I used vicodin and or percocet for my back and it was extremly helpful. You can become addicted, build a tolerance, all of the above. However, it sounds like he thinks your husband is an addict???? I just started suboxone today, because the vicodin I have taken on and off for the last 4 years, and lately daily, started to make my anxiety and depression off the charts. I am only using this for a while until my anxiety subsides so my psychiatrist can get me on the correct antidepressent. I have found some exercises that are very helpful, for my book and I have the luxury of not sittingin a car or plane for long periods of time, but 1 to 2 vicodin a day is really not much for chronic pain??? I know everyone is different, but when I take pain meds for pain, i do not feel high, so why can't he take a little to drive???? Anyway, good luck. I agree, maybe he can get the back surgery, that is if you have insurance and he can afford sick days??? thinking of you.
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