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Is Suboxone good for pain relief?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
I have been on percocet and morphine for 6 years for intractable pain. Needless to say i have become addicted and the opioids no longer are effective for pain control. My doctor is weaning me from the opioids and putting me on suboxone. I have read that suboxone is not for treatment of pain, she says it is. I can not take neurontin any longer because I have been in kidney failure 4 times in the past year. I also have pancreatic insufficiency and heart failure with COPD.
Posted Mon, 3 Mar 2014 in Brain and Spine
Answered by Dr. Preeti Parakh 3 hours later
Brief Answer: Yes, it has analgesic effects. Detailed Answer: Hi, Welcome to Healthcare Magic! Your doctor has correctly informed you that Suboxone will help in pain. In fact, buprenorphine, which is the active ingredient in Suboxone, was first marketed as a pain killer only. It was only later that its benefits in people with opioid dependence were noticed and it began to be used for that as well. The other point that I wish to make is that please do not expect too much from Suboxone. It does have analgesic effects but I do not feel it will help you to the same extent as morphine and percocet. Since you have developed tolerance to opioids and buprenorphine is also an opioid, some of that tolerance extends to buprenorphine as well. However, since other medicines are no longer working for you now, it does make sense that you go on Suboxone. It may not be as good an analgesic as morphine but it will certainly be safer than morphine for you. Hope this clears up things for you. Please feel free to ask in case you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry
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Follow-up: Is Suboxone good for pain relief? 1 hour later
Thank you very much. Is there anything else that you could suggest I ask my doctor about to add to the suboxone? My pain on a scale of 1-10 is usually at 6-7. within about 30 minutes of a dose my pain is at a level 6, by the time I am ready for another dose it is 7 or 8. I am unable to walk and I sleep in a recliner because I can not lay down. I am worried that the suboxone alone will not be effective. Thank you again, I look forward to your response.
Answered by Dr. Preeti Parakh 2 hours later
Brief Answer: As below. Detailed Answer: Hi, I too fear that Suboxone alone may not be sufficient for you. I guess because of your history of kidney disease, your doctor would not be willing to advise non-opioid analgesics as well. Please discuss this with him if he would consider allowing a minimal use of other analgesics like naproxen, ibuprofen etc or not. The other option is the use of steroids. These can even be injected inside the joints directly if joints are painful, and provide excellent pain relief for a few weeks. These are indicated in arthritic joints. If oral medicines are not an option, ask your doctor for ointments containing analgesics which are applied locally. There are also other methods like ultrasound therapy, acupuncture, acupressure etc which, if accessible to you, may help you. Relaxation exercises and meditation are also known to help. I hope you get well soon. Best wishes. Dr Preeti Parakh MD Psychiatry
Above answer was peer-reviewed by
Follow-up: Is Suboxone good for pain relief? 6 hours later
My doctor says the suboxone claims to cover over 95% of pain receptors. Are you aware of any studies that bear this out? She has also suggested adding Lyrica in conjunction with the suboxone. What is your opinion of this course of therapy for pain relief? Also, after a period (and please indicate how long) could I return to use of percocet and morphine? When it was working it was the best pain relief I had ever experienced. My spirit and soul are becoming weary from suffering the severe intractable pain. I do see a psychiatrist for depression and being treated with 40 mg of Lexapro daily. Thank you in advance for your help.
Answered by Dr. Preeti Parakh 3 hours later
Brief Answer: As below. Detailed Answer: Hi, Yes, it is common knowledge that buprenorphine has a very high affinity for opioid receptors. In fact, this is the basis of its success in opioid dependence treatment. If people on Suboxone take heroin, they are unable to get a high because buprenorphine has a very high affinity for opioid receptors and does not let heroin or other opioids bind to them. There is plenty of research in support of this. Lyrica can be started if you have neuropathic pain. It works very well in reducing neuropathic pain and can be combined with Suboxone. Regarding returning to Percocet and morphine, you must remember that buprenorphine is also an opioid and has cross tolerance with other opioids. When you stop buprenorphine, you will have the same withdrawal symptoms as with other opioids. You will need to wait for buprenorphine to leave your body completely before you start any other opioids. Even then, your body will show at least some, if not as much as previously, tolerance to morphine and Percocet. Usually a period of more than three months is needed for receptor densities to change. I understand that you have many reservations about starting Suboxone. In my opinion, you should go for it thinking that you have nothing to lose. If it doesn't help you, you can always return to your previous regimen. Best wishes. Dr Preeti Parakh MD Psychiatry
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Follow-up: Is Suboxone good for pain relief? 1 hour later
Dear Dr. XXXXXXX Parakh, Thank you SO much for all the information. My doctor has been my doctor for many ears and I have confidence in her, but I wanted so further answers from another source. I appreciate the completeness of your answers and the concern that you offer along with it. I will take your advice and "go for it". You are right I have nothing to lose. I have no illusions that I will get better. I have been sent home from the hospital this last time with in home nurses, physical therapy and occupational therapy and an aid. I also have a nurse practioner for case management and they are keeping me comfortable. May the Creator bless and keep you. Sincerely, Professor XXXXXXX XXXXXXX Bonacci (Retired)
Answered by Dr. Preeti Parakh 19 minutes later
Brief Answer: All the best! Detailed Answer: Dear Prof Bonacci, Many thanks for your kind words. I am glad that you have access to occupational therapy, physical therapy and good nursing care, in addition to a good doctor. I really hope that things get better for you. In the last few decades, there have been so many developments in the health sector and now there are many options to choose from. For example, if Lyrica is not of much help, then there are other medicines that can be tried. A few years ago, one did not have much of a choice. I hope that you too will benefit from the expanding knowledge and eventually things will get better. But for that, you will have to take the risk of trying new medicines. And I am sure that you will have the courage to do so. All the best! Dr Preeti Parakh MD Psychiatry
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