Maximum Dose Of Suboxone/subutex & Chronic Pain (Page 2)

What is the maximum dose of suboxone or subutex when you have severe pain?

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I just started using the subutex film after developing an allergy to the patches. I have been on one form or another of suboxone for over a year for my chronic back pain. Prior to finding suboxone, I was at the end of my rope after six years of blinding back pain . I only take 1 mg per day. I had gone through several nerve ablations about 30 cortisone injections, accupuncture, massage, physical therapy, etc. I also use a TENS unit. Prior to injuring my back I was very fit and competing in rowing. I had to endure many doctors telling me that my problem was weak core strength, a psychological problem, or phantom pain syndrome. I do not have much patience with people who do not have chronic pain giving me advice on how to manage it. Subutex is a lifesaver and can be used to treat pain effectively with the proper monitoring program. If you are in chronic pain, don't let anyone tell you that the drug is only used to treat opiate addiction.

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Hello, I am the director of the P.A.I.N. INSTITUTE and I have treated more than 1500 patients over the last 10 yrs. You can find a great deal of info at my website, painandaddiction.com and on youtube "kcal channel 9 2 part program on suboxone." Also, I have written an explanation as to why this drug is so unique and could prevent major procedures and surgery in opiate dependent patients who are detoxed first. The following facts are true:
1. Subutex/Suboxone is a great pain killer in those individuals who have been dependent or addicted to opiates first. If you take buprenorphine and have not been on opiates, it is likely to make you ill.
2. 45000 people in pain die from opiate overdose every year. No one dies from buprenorphine. That's right no one dies unless you add Intravenous valium or the like. Motrin like drugs kill 150000 people every year from gi bleeds, liver damage, kidney damage, etc. Imagine, NO ONE DIES FROM USING SUBUTEX because it is virtually impossible to overdose and stop breathing, (plateau effect on respiratory depression)
3. If you use max 32 mg sublingual buprenorphine as directed, you WILL NOT GET HIGH. In fact everyone says they feel normal.
4. Naloxone is inert sublingual. Therefore, theoretically, the effect of SUBOXONE SHOULD BE THE SAME AS SUBUTEX, SINCE NALOXONE IS ONLY THERE TO PREVENT IV ABUSE OF THE DRUG. THAT BEING SAID, CLINICALLY, I HAVE NOTED SUBUTEX IS A SLIGHTLY BETTER MEDICINE IN HELPING THE OPIATE DEPENDENT PAIN PATIENT HAVE BETTER PAIN CONTROL.
5. In a study that I presented in BARCELONA AT THE WORLD INSTITUTE OF PAIN IN 2004, I studied 17 patients who were going to have spine surgery but were addicted to opiates. They were detoxed with buprenorphine first and incredibly 16 of 17 were able to cancel scheduled surgeries because the pain that was caused by the hyperalgesia due to opiates resolved. This amazing fact while even I had difficulty believing it, has been replicated multiple times. So I say to anyone contemplating surgery, spinal cord stim implant, etc, what have you got to lose, get off of your opiate with subutex. This must be done with buprenorphine, tapering by itself does not work because it has to do with the complex changes at the mu receptor.
6. Ortho surgeons do not want this to be true. think about all the cancelled surgeries!! Also, what a savings for our country and all the people who are prevented from becoming crippled from fusions and surgery.
7. Buprenorphine is a very unique drug, at low doses, less than 1 mg it is a full opioid agonist like morphine. but in doses greater than 4 to 6 mg it is an opioid antagonist and by filling in the opioid receptor it changes our perception of pain. truly unique.
8. Buprenorphine is misunderstood and addicts and many doctors like DR. DREW aren't really interested in the truth. In fact had DR. DREW given it to mike starr or some of his other patients during intervention they would be alive today. The fact is that the forces of the pharmaceutical industry, methadone clinics, society of addiction medicine, and drug rehab centers, do not acknowledge the truly important nature of this agent as has been discovered in europe and australia. unfortunately, its all about money. imagine how many billions of dollars are made with the revolving door at rehab clinics and the large number of people on methadone.
8. Add to this the number of surgical implants and procedures like spinal fusions and all the epidural injections etc. People are basically treated with unecessary procedures rather than a simpler more common sense approach.
9. I know most of you are wondering, who is this guy? Do I dare believe what he is saying? Actually, you are a fool if you don't. I am not saying that BUPRENORPHINE is the be all that ends all. but I am saying, why not try it, you've really got nothing to lose, and everything to gain. The cost is cheap compared to everything else.
9. Now other people will say, oh but you are just substituting another evil opiate, so why bother? Well the reason is, that it is not just an opiate because of its unique pharmacology. And if you can't get high, and won't ever escalate beyond the average dose of 1/2 tablet 4 times daily, and you can't overdose or die, and your quality of life is great, isn't that what medicine is supposed to do??? Surgery is not a fix. The complication rate is staggering, and most end up on pain medicines anyway in the end. 2 norco become 12 norco in 2 years. Buprenorphine never increases, in fact most decrease. I am a diabetic and have high blood pressure. I take medications every day. In a sense aren't I dependent on medications. I can tell you right now I will never be free of medication. I do know that my quality of life is good and I will live a long while. Buprenorphine should be viewed the same way.
10. I am all for less medicine. If you can do it, then do so. But if your are going to end up battling addiction, then you are only fooling yourself.
11. Read my website. Open your mind and understand that in the U.S, we have the best medicine that money can buy, the problem is that most consumers buy the worst medicine. Our system is broken and it is greedy and unfortunately the addiction societies are not helping.

RICK CHAVEZ, M.D.
BOARD CERTIFIED, AMERICAN BOARDS OF ADDICTION MEDICINE, PAIN MEDICINE, AND FAMILY MEDICINE. FORMER ASSISTANT CLINICAL PROFESSOR OF FAMILY MEDICINE, UCLA GEFFEN SCHOOL OF MEDICINE.

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Someone told me that snorting Subutex does not affect loratabs from still working on you ,I dont believe this to be true because I thought it killed the effects of opiates

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In all sincerity, thank you.

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You DON'T MIX any other drugs with Suboxone! You must not be prescribed this medicine because you wouldn't be asking this kind of question. So NO, no other drug will work if you snort subs!!

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You CAN get your life back. Find a doctor in your area who is able to prescribe suboxone. You will not regret it!

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Dr Chavez, I respectfully disagree with your overall evaluation of Suboxone. After 40 years of heavy opiate use, I was put on 32 mgs Suboxone daily and told I would need to take it for the rest of my life. After four years of Suboxone use, I could no longer accept that it (the Suboxone) was responsible for my "good" feelings and not my own brain's endorphins. I spent another two years on Suboxone, but titrating, getting down to zero. Three days after I got off I went into full-blown withdrawal that lasted for 23 days. 23 days!

I'm now free of all drugs (finally!) and my feelings of joy and elation are MINE. A number of addiciton doctors have told me that very few of their patients who are taking Suboxone can get off. I'll be very interested to see what the medical community is saying about Suboxone in 5-10 years. I have a feeling it will no longer be seen as the "magic bullet" that so many now portray it as being.

Lee (now free)

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Apply for pre-existing condition insurance. It covers suboxone and the copay is only $4.00!!! Search for it online. I'm pretty sure it's offered in TX, although I live in SC but I'm thinking I saw TX was one of the states where it's offered.

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The ceiling of suboxone is 24mg. I know this for a fact. The info came from SAMHSA!

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you have know clue about subs...it is a powerful narcotic that in small doses is great for detox. When takin in high doses of 24mg or higher it is great for pain releif without the high of other opiates...do some real research and stop going on what you think you know. The ppl who say it does'nt work for pain really mean i camt get off on it....if its not good for pain then why do other countries use it in er's like we use hydro morphine....ppl like you are the ones who cause the need to control these meds....now of we could only control the dumb info you pass on we'd be good...

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Thank you....i hate ppl who say its not good for chronic pain...i take it over oxy and any others cause of how well it works compared to the older opiates...i think the ones who say it doesnt work for pain are the low dose detox users...and thats just because its a narc with no euphoria or high....im just glad ppl like you know what tgere talking about....cause mis information can really hurt ppl...

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I am happy you got help and your life back god bless you i know what your goung through i have so many health problems. I pray i can get through them especially with five kids! Stay strong hun:)

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OK. This seems like an appropriate forum to ask this question. .seeing as though there's many people with suboxone experience here. Im a pain patient thqt had dehabilitating chronic migraine disease since age seven. I am now 37. Went through about every preventative med on the market and had to resort to fioricet with codiene and vicodin. I would periodically get migraines so unmanageable and be so dehydrated i would need the er..who were always great and inderstanding..thank god! Started feeling poopy on all the pain meds and dr kept raising my dosage. Felt poopier. Asked for more professional help and decided to try subutex. First 3 months i felt great and took only tylenol for the moderate head pain. No more puking either! Then....started to get worse..had a cpl er visits because sub not working like it did initially. (I mean severe pain for days!!) Now...i have moderate pain all the time. My joints ans back and everything hurt. The severe headaches are bqck more often..and more often then goimg to emergenxy..i dit them out for 24-72 hours...excruitiating!! 3 wks ago i developed severe lympedema in my neck amd base of head. I sleep for ten minutes at a time..am in constant pain and am on my third antibiotic..which is not working. My doc will do absolutely nothing. I think he forgets i am a pain oatient and not an addict. I called for motrin 800 or toradol (which i have done before) and am given valium?!?!?! Anyway, clearly my 2 mg 3-4 x's a day isn't working. I also read that increasing the dose for pain patients accomplishes nothing and I am on the top dose for pain..which I would not want to go any higher anyhow..knowing last time I went to er dilaudid did not work. .the toradol finally calmed it down for two days..then back to no sleep (even with 5 mg Valium! ) I do not understand why a Dr would not give me an nsaid...also..have people tapered off to other drugs for awhile then went back on the sub to feel better again? I know most say u cannot gain a tolerance to this Med...but I KNOW I have!! Help please: (

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you scar me

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Tell me what do some of you think about methadone for pain management?

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to fireman625. what you wrote about the sub pills not working as well because they cause to much saliva is the dumbest thing i have ever heard. the med. is still entered into your bloodstream. how much do you think that dilutes it.no matter how much spit your mouth produces your still getting the same dose of medication.think about it for a few minutes.that is absolutely untrue.it even sounds stupid!!!! the only way the amount of spit would have anything to do with the effectiveness of the medication is if you wre spitting while the tablet was still being dissolved and absorbed.actually the more saliva the more it helps the tablet dissolve and be absorbed into your bloodstream. the same goes for the films. it actually says to take a drink and make sure you dont have a dry mouth before taking the medication. these are serious issues and if you dont know what your talking about KEEP YOUR OPINIONS TO YOURSELF!!!!!!if you dont believe me ask a dr. if too much saliva inhibits the medication from working properly!

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I have been taking suboxone for 6 months..It gave me my.life back too..think.about it , if you are struggling with opiat addicition..its worth it!!

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Subutex is the best pain killer in the market not Subaxone is not 100% pure like Subutex the doses are between 2-3 -8mg a day I take 3 and cero pain and non addictive and not more abusing the Oxycontin etc.

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I want to know what the average dose is for subutex not suboxone for severe pain?

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I want to know what the average dose is for subutex not suboxone for severe pain?I just want to know what people have been subribe?

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