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Starting Subutex Today... Is this Dose high? Other important Questions.

Ok, today I am switching from OXY to BUPE for long term pain management.  I saw the Doctor for the final time this morning to pick up my script and I am suppose to take 8mg tabs FOUR time per day.  From what I've read, this seems like a hefty dose.  The Doctor said that is a normal dose for pain management and that the stories I've been reading on the forums were most likely people using Bupe for addiction reasons, which is why they are taking a lesser dose.  

This Doctor has a dual degree in Neurology and I.M. and is published all over the place, but that doesn't mean he's perfect. I wanted to get some input from others on this board that have ever used Bupenorphine as a substitute for other Narcotics.  HERE ARE MY QUESTIONS:

Is this too much?  

Should I expect ill side effects?  I have an ulcer (yet another reason I chose to seek an alternative to Oxy/Hydros) as well as the sudden onset w/d symptoms get when I'm late for a dose, they make me semi non-functional.


(I have a spinal Neuropathy which causes intense pain, limited range of motion, etc in my shoulder/upper back) due to a botched surgery from a Quack Doctor that severed and/or damaged my suprascapular, spinal accessory and long thorasic nerves). As far as more background:  I've never abused Narcotics by taking more than prescribed or digested them in a manner other than swallowing them with water.  I see that it's used A LOT for addiction.  CAN ANYONE RECOMMEND ANOTHER ANALEGISIC OTHER THAN BUPE/OXY/HYDRO/ULTRAM?  (I want to keep my options open in the future).  I am a raging alcoholic apparently and a chain smoker, so I guess I'm lucky I never got the urge to abuse narcs.  I only hope it stays that way.  (Been on them for 7 years now).

20 Responses
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Avatar universal
Have you tried Lyrica or Neurotin? They are both non addictive medications used in treatment of neuropathic pain. I worked in Neurology for awhile doing nerve conduction studies ( I'm sure you've had one to confirm your never damage) Those inconjuction with pain killers or alone have been shown to help treat patients with severe nerve damage.

Helpful - 0
Avatar universal
subutex causes head pain and some what vomiting i wouldn't recommend it
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Avatar universal
I am currently taking 8mg of subutex daily.  I recently found out that I have hepatitis C.  I am now on treatment to try and get rid of the hep C. I just found out that my white blood cells are low.  Do you think or do you know if subutex can cause low white blood cells.
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182493 tn?1348052915
buprenorphine is the opiate in both Suboxone and Subutex,  both have the ability to block other opiates, it is not the naloxone in the Suboxone that causes withdrawals or blocks that is just used as a precaution against IV users
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Avatar universal
i understand now, well i think anyway. i've been away and read some info.
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Avatar universal
I'm really confused now cos i always thought subutex had a blocker in eg naloxone or something similar i know people on it and they always been told it has blocker in it and not to take it to close to taking opiates as it will cause withdrawals. I always thought suboxone and subutex were same and now confused. I'm going to go read some info now to see.
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Avatar universal
yes you did miss something hun...read her last paragraph in her original post...i am just concerned.
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Avatar universal
Where did I ever hear that FLbella had an alcohol problem?.........Did I miss something?
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Avatar universal
32mgs daily for pain is appropriate...and if you have an ulcer you need to stop drinking, that will damage your stomach lining quicker than suboxone or subutex...is your doctor aware of your alcohol abuse?   i dont think you are supposed to drink on sub...i would be honest and tell your doctor about this drinking problem you have...
Helpful - 0
233181 tn?1235183152
Subutex is only used in the induction process. It is done this way so you will not experience any side effects as you may be transferring with opiates still on your system and may have scored on the (COWS), which stands for clinical opiate withdrawal scale, Would you say you were in mild withdrawal when you started the subuex? If you scored 5-12 this indicates only mild wthdrawal. To be one the safe side with a low score subutex is most often prescribed for the induction phase he had used suboxone8/2 which is buprenorphine with 2mg of naloxone. But the drug is taken sublingually less than 2% of the naloxone actually enters the blood stream. It is in the drug as a diversion factor for anyone crazy enough to try this drug interveiniously as it would cause withdrawal in a matter of minutes. I am a pain patient that takes the same dose as you with the addition of Lyrica or neurotin, 300mg every 12 hours for nerve and an emergency medication should I have a severe pain attach. It is strong enough to over ride the Bupe/nx. I have only had to use it once in the 7 months I have been on suboxone which has really improved my quality of life overall. So give it a try. Try not to listen to the people who claim you trading one drug for another addiction, Yes the Bupe is addicting by the way. But has a relatively mild withdrawal profile. Some may disagree as they may have had a painful withdrawal with the medication. But it works for me and many others that take it for pain management. You just taper very slowly when the time comes.------NOAH
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Avatar universal
Just wanted to say, Thank you for you bold honesty about your addiction...you are asking for help, but I hope you know that you are helping others by asking your questions, and we all get to hear the forum answer....you are all good people, but sometimes we need others to be bld for us....and we get out answeres....Thanks LFbela for your courage.........
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199177 tn?1490498534
she is NOT on it for addiction she is taking it for pain management there is a difference.
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Avatar universal
Yes, I did.  The little white capsules with the two yellow bands.  

I tried it once and vomited uncontrollably.. thought that was just misfortune and tried it again 2 weeks later and threw up again.   Something in that does not agree with me.  It must be close to the Bextra forumulation, but there is probablly some insignifigant filler in there that disagrees with me.

Is there anything else out there with the same story?
Helpful - 0
Avatar universal
Hugs  Lurker.  I appreciate it.  It seems that there is a fine but very defined line between Pain Management users and Addicts.  (All in the same boat in the end) but it seems as if a few addicts assume that if you take pain killers, you are an auto-in for being addicted.  Being dependent on pills to sit upright and walk isn't the same as taking them for fun.  (My 2 cents).  I guess a few ppl rubbed me the wrong way. Make fun of my alcoholism.... because I am a an alcoholic, but don't claim to know everything about me.  Ya know?

Either way, I am super glad to hear that sub helps you because I am not depending on it to help me and my pain is unbearable.  I almost offed myself last year because I couldn't take it....  I sought help for that little issue, now it's not just one day at a time, it's one hour at a time.  

You are a success story, you should share it more maybe?   Us chronic pain sufferers feel displaced sometimes.  I feel like I don't belong in some forums simply because I don't understand.
Helpful - 0
222369 tn?1274474635
Have you tried Celebrex? It's an NSAID similar in action to Bextra and Vioxx. Just an option since you said Bextra worked for you.
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Avatar universal
I am taking Suboxone for chronic pain and an addiction problem which is why my doc started me at that dose too.  For pain management, they do use higher doses.  However, I'm only taking 12-16mg per day, not 24 as prescribed and I'm not having any pain or problems.  He told me I could take up to 3 per day but to use as little as I could get by with for pain.  They do prescribe the Sub (either with or w/o nalaxone) for pain management and it is at the higher doses.  Good luck
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Avatar universal
Maybe I'm confusing everyone.  It's subutex without naloxone and it's for long term use for pain management in place of the oxy's. (My choice, I requested to be taken off the oxy's...Bupe was the Doctors Idea since I've tried everything else.  He is a Neurologist). I'm an alcoholic chain smoker, I've never ran into addiction problems with pills...YET (knock on wood).  I've never even taken more than prescribed.  I do have a problem with the medications hitting a roof and just not relieving pain anymore though which just sucks. The Doctors keep adjusting the dosage and/or switching medications every year or so.  I've tried:  Oxycontin, Percoset, Percodan, Ultram, Vicodin, Tylox, Bextra (taken off market which is a shame, it's a non-narc that worked pretty well in combo with T#3) Oxycodone, Darvocet & Feurocet (sp?) (some of these are just generics of others or contain aspirin instead of Tylenol).

I am seeing a surgeon this week to see if there is something they can do to alleviate some of the pain so I don't need as many pills to get by, but a surgery gone wrong is what put me here (in pain) in the first place.  I'm a little leary but I'll go in with an open mind and listen.  

I don't know how you guys can do it.  What do you do if you are in agonizing pain and must take something?
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Avatar universal
I just started Subutex too, and I was told to do 8mg per day.  However, the Dr. also said to split it in half the first time and wait an hour and see if 4mg worked.  But I only needed it to take away the withdrawal symptoms, and I don't have any real pain.  4mg worked for me, but it couldn't hurt to start with that, and then just take the full 8 if you need to.  
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Avatar universal
This is the third person here at the forum with the same dose prescribed by their doctor.......8mg tabs 4 times a day........

I guess this is a reasonable amount of suboxone to take for a heavy addiction........
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Avatar universal
Your the third person now on the same dose so I guess it is not that big of a deal.....but if I were to guess you must of had a pretty heavy habit going into this........

If I were you I would follow your doctors directions right to the letter..........and only consult with him as far as your medications........

Good luck but I do hope you have a taper planned to eventually stop using the suboxone did you talk to your doctor about that or is it just dealing with your addiction and W/Ds trying to get off your narcotic addiction........

Good luck
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