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Does Intake Of Suboxone Help In Pain Management?

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Posted on Mon, 2 May 2016
Question: Wondering the pain relief ability of Siboxone films. I have been off of narcotics for 17months and on Suboxone 2mg. But I have a herniated disc I irritated and also spondalothesis. If I choose surgery, what are my pain med options?
doctor
Answered by Dr. Dr. Matt Wachsman (1 hour later)
Brief Answer:
the main thing to know is that suboxone has limits.

Detailed Answer:
It is a partial agonist. Here's what that means. Drugs work by binding to a spot like hitting a socket. They can light up the socket BUT they can also hit the socket and BLOCK it. Beta blockers block stress hormones. anti-histamines block histamine. narcotic blockers (naloxone... one part of suboxone) block narcotic action. BUT the other drug in suboxone is buprenorphine. It is NEITHER a full activator NOR a full blocker. It is in the middle. It's actions have limits no matter how much of it you take it can only be the equivalent of about 30 mg of oxycodone per day. This is more than zero and less than 100. And the equivalency charts are very very wrong in that everyone has different responses to different narcotics. They are never equivalent. The numbers are averages but nobody has that exact average in the equivalency chart.


I can safely say that 16 mg of suboxone a day is usually the maximal effective dose and more does not do much more in most people. And I can safely say that the pain effect is more than zero and less than 100 mg of oxycodone per day. If someone needs 100 or more mg of oxycodone per day, they are not going to be happy on suboxone. If they are on about 30 mg, they mostly are going to be ok on it. I suspect that there is less addiction to suboxone. Along with that there is, I suspect, less gettting used to the dose and less needing more and more if one is on suboxone.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (9 hours later)
Today i feel much better. . I believe that it is not necessary to rush into surgery if you can bare the pain and I you don't experience any foot drop, severe numbness in your legs or loss of blatter control.
I think that's where I am. I will slowly start some exercise etc....
I will continue to take my regular dose of suboxone2mg
I did want your opinion on what post-op pain meds I could take if I had to have surgery. Ultram? Toridol?
doctor
Answered by Dr. Dr. Matt Wachsman (46 minutes later)
Brief Answer:
two points.

Detailed Answer:
First, sciatica MOSTLY is up and down with long periods of not that much pain. Neurologic problems such as foot drop are a reason to get surgery and pain control isn't.

Second. Suboxone blocks other narcotics. One has to be off of it a good 24 hrs minimum before using any other narcotic. Then, which one to use is tricky. Toridol is a strong aspirin like drug. It is a bit bad to use aspirin when there is a risk of bleeding. Otherwise it isn't going to interact with a narcotic nor with a narcotic blocker. Ultram will interact with suboxone. And narcotics will also. 2 mg of suboxone is NOT the highest effective dose and increasing it is one option for increasing pain. So,
Suboxone at higher dose
Substituting another narcotic with a wash out period for suboxone
An aspirin like drug
A nerve blocker like amitryptiline
are about all the options.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (4 days later)
Would it be of benefit to see a chiropractor for herniated disc and spondalothesis of L 3-4, L4-5?
doctor
Answered by Dr. Dr. Matt Wachsman (3 hours later)
Brief Answer:
Varies

Detailed Answer:
people have different responses to it mostly 66th e y are positive this is a very c o ommon context for chiro practy
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Does Intake Of Suboxone Help In Pain Management?

Brief Answer: the main thing to know is that suboxone has limits. Detailed Answer: It is a partial agonist. Here's what that means. Drugs work by binding to a spot like hitting a socket. They can light up the socket BUT they can also hit the socket and BLOCK it. Beta blockers block stress hormones. anti-histamines block histamine. narcotic blockers (naloxone... one part of suboxone) block narcotic action. BUT the other drug in suboxone is buprenorphine. It is NEITHER a full activator NOR a full blocker. It is in the middle. It's actions have limits no matter how much of it you take it can only be the equivalent of about 30 mg of oxycodone per day. This is more than zero and less than 100. And the equivalency charts are very very wrong in that everyone has different responses to different narcotics. They are never equivalent. The numbers are averages but nobody has that exact average in the equivalency chart. I can safely say that 16 mg of suboxone a day is usually the maximal effective dose and more does not do much more in most people. And I can safely say that the pain effect is more than zero and less than 100 mg of oxycodone per day. If someone needs 100 or more mg of oxycodone per day, they are not going to be happy on suboxone. If they are on about 30 mg, they mostly are going to be ok on it. I suspect that there is less addiction to suboxone. Along with that there is, I suspect, less gettting used to the dose and less needing more and more if one is on suboxone.