Chronic Pain Support Group

Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not...

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MarkL 04/26/2011

I'd like some input on Suboxone for pain management. I was at my PMD yesterday. I was telling him that the oxy ir 15's I've been taking haven't been working that great.I also take a small dose (15mg) of MS contin before bed. I have Meralgia Paresthetica (a form of neuropathy). I've been waking during the middle of the night with significant pain and then it seems the oxy's don't always allow me to get on top of the pain. I was actually hoping he would increase the MS contin dose or change it to oxycontin as that seems to work the best. He suggested thinking about switching to Suboxone. I have a number of reservations to this idea but one in particular. Suboxone is not currently cleared for chronic pain in the US. I believe that in order to get suboxone, it would have to be said that there are abuse issues. IS that correct? It is not the case and my concern is that if I am prescribed this under the guise of abuse, I will have certain career issues. I currently maintain a "secret" clearance and am the "listed" person on our companies explosives permit. I sign certifications that say I am not addicted to narcotics. I think you can see the possible dilemma. The ATF can get their hands on my prescription information. Can anyone shed some light on this problem?
Thanks,
Mark

deleted_user 04/26/2011

I don't know the answer to your questions but hopefully your doctor can tell you how the med is scripted. Have you told the doctor about your concerns? I don't think it is standard for the ATF to watch all meds you are on. If they did I would think the oxy would have already sent up a red flag. If it has I can see your concern about the suboxone and what could be assumed.

MarkL 04/26/2011

Thanks for the reply. As far as the oxy +morphine scripts go, they can't really hold that against me as I am legally prescribed this for pain. My concern about the suboxone is that the only "legal" way it is prescribed is for abuse/addiction issues. As far as them finding out, you wouldn't believe the background checks the ATF and DoD do for my clearance and the explosive permit. It is truly a new world since September 11 2001.

deleted_user 04/26/2011

After reading the info about this drug and the issues that others on this board have had with it, I would not touch the stuff. It is not for CP.

I took the advice of a PM one time using off label meds. Then I had to be in hospital. They refused to give me the meds. I went thru withdrawal. It took several days to get the AMA signed so I could get out. I found a new PM who is strick about using drugs.

Hope you find some help.
Sunny

deleted_user 04/26/2011

A bad idea imo...this is a combination drug designed for addiction where the second component is an opiate antagonist. The purpose is to make the person feel ill/lousy if the balance between the pro and anti opiate components is off.

MarkL 04/26/2011

@CC
Can you shed some light on the prescribing requirements? Is it true that it should only be prescribed when addiction/abuse is indicated?

deleted_user 04/26/2011

If the drug has not yet been cleared for off label usage, then I would definitely discuss your concerns with your doctor, and I would strongly consider requesting another medication. I don't know if they have to right the reason on the script, but if this medication is known at this point as an "addiction only" medication, then with your clearance and background issues I believe this could be a problem if they found out and probably isn't work the risk.

Just an opinion, though, I have no experience with this drug or with having a clearance in this situation.

deleted_user 04/26/2011

There is actually a Member Group on this site called

"Suboxone Support Group". You can type it in the search box.

If you post the same thing there, you could get more answers too.

deleted_user 04/27/2011

I take suboxone for pain and it is great for me. I had alot of side effects with opioid treatment and this works for me. The problem I am having now is that my RX insurance do not want to pay for it because it is prescribed for pain. That is my only big complaint as of right now.

I say go for it what is the worst thing that can happen you have to switch back, I think we try lots of different meds to find the right combination but when people come to suboxone it gives them pause because of the original use of it. They do not want that stigma of it and I say phooey on that if it works who cares what is involved

lladyfairhair 04/27/2011

It has helped me the most out of anything I have tried.

BUT... IMHO... I would save that for the very last possible option due to your career.

Due to the current diagnosis code- I think there are way too many ways for things to go wrong.

I see your dilemma. I dont think you should risk it unless you can pay for it out of pocket.

deleted_user 04/27/2011

I forgot to write that on my RX authorization it is written for pain use. That is why i am having alot of trouble but doctors have to write what it is given for even if it is not given for the original use of the drug it is attended for.

deleted_user 04/27/2011

I just came off of Suboxone. I was prescribed this for chronic pain by a doc that mostly treats addiction patients. I was unaware of acute pain issues that were going on during this year period. It took almost six months to be scheduled for shoulder surgery. My acute pain level would flare to 7,8,9 and 10 levels. Nothing could be taken to relieve this pain as the Suboxone blocks any other pain meds. I can honestly say that I had a year from HELL.
We are all different and medications effect us all differently. I am only sharing my bad experience. I had one experience where I had to go to urgent care. I was treated like a drug seeker even told that they couldn't assist me. My doctor was out of town and I was told,"thats what you all say". Awful experience!

deleted_user 04/27/2011

Well from my expereince wit Suboxne it is great if you want to get off the painkillers. But it is not worth crap for pain management. In my opinion your Dr. is trying to trick u into taking it because he thinks he are hooked. I have had some bad expereince with pain management Dr.s. When I went to them and said the drugs I was on weren't working, thought I was talking them too much And was just drug seeking. All I was seeking was to control the pain and they just did not do a good job. They wrote this in my recond and now I have a very hard time getting narcotics. They have me on Cynbalta and Lyrica. It helps some but I still have that toothache feeling in my hip and lower back. I amm going to anther pain Dr. but he has all that info and he so far will not prescribe anything. I get shots in my hip and they help for a coulpe of months. I have another coming up May 9th. I hope this helps. The paim Mamagement people are very senstive because of the goverment is stickiong their nose in their business. So it makes it very hard on everyone. They just don't wont to help with peoples pain It's a shame but it is what it is. Sorry for the spelling.Thanks hurtinginconcordnc

deleted_user 04/27/2011

I really dont think the doctor is trying to trick you they have to write down a diagnosis when prescribing. Suboxone works for pain management.

Hurting I dont know your situation but there has to be more to it doctors generally do not alter records and put in false information that is really going on the paranoid rail of thinking. Did you try the suboxone for pain or did you readily discount it all together and just want pain meds that may be why he had a red flag. When my doctor said it worked for pain I was all for it I had many side effects from opiates and just wanted something to work no matter what it was and what it was used for before.

deleted_user 04/27/2011

Suboxone does work for pain management. But the problem for you will be getting your insurance to pay for it. Right now, the only thing Suboxone is FDA approved for is opiate addiction treatment. Any other use(as in pain management) would be off label. 99% of insurance companies will not pay for off label use.
And with your clearances, they have,and do pull your prescription records. If they see Suboxone being prescribed, because of the only FDA approval. I think they will come to the conclusion that you were/are addicted.
Ask your Dr about BuTrans patches if you want to go the buprenorphine(active ingredient in Suboxone/Subutex) route. It is a patch that is worn for 7 days at a time. BuTrans has been used in Europe for a long time in pain management. Buprenorphine is actually 50-100 times stronger than morphine when administered transdermally(patch). It is dosed in mcg(micro grams), not mg(milligrams)

I would be VERY cautious if you were to go with the Suboxone/Subutex. And for you to pay out of pocket would be very costly. I believe the Suboxone is about $7 per pill and the Subutex is around $4 a pill.

BBB

deleted_user 04/27/2011

I forgot to add. If you take the Suboxone/Subutex. Make sure to carry a card in your wallet. When we have patients come into the ER that are on buprenorphine, they need to be given a MUCH larger dose of pain medication in order to over ride the buprenorphine. I have seen 3 patients now come in that couldn't tell us they were on buprenorphine because they were unconscious. And when they came to in horrific pain, it took us a while to get their pain back under control. Just something else to think about.

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