Suboxone in Addition to Fentanyl

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

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

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!

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

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