Buprenorphine for Chronic Pain Management...

[Bfaith]

...an end to the abyss?

Hello everyone,

I'm new here -and after perusing the forums here have decided to state my plight in hopes of finding kindred spirits who may have knowledge or insight, to help me steer through the ice bergs of uncertainty. The following is a novel, so kudos and NAMASTE to anyone who can get through it all, no less impart some wisdom.

I'm a 33 year old full time working single mother of a wonderful 8 year old daugher - who is being robbed a this point of a healthy and happy mother. I've become an empty shell of my former self and this is why.

I suffer from a debilitating condition called Arnold Chiari Malformation I,  and my symptoms skyrocketed after suffering trauma post mva about three years ago. Chiari; which includes severe neck pain, headaches that you wish you will sleep and never wake from ; they seriously test my sanity, extreme fatigue, dizziness, and a slew of other symptoms - is robbing me of my life, however I am beginning to feel that this pain medication (that I have always taken exactly as prescribed  and have never abused) is causing me much more deficit than benefit at this juncture.

After trying every non narcotic medication out there for pain, I was referred to pain specialist.
Throughout the last three years I have been trialed on just about every opiate medication there is, to no avail - and currenly the last stop on this train trip from hell they put me on Oxycontin/Oxycodone  (and have been on this med/dose for the past year) at a current daily dose of 80mg oxycontin ER with 20 mg oxycodone IR for breakthrough pain. That is an insane 300mg of this stuff daily, even more insane is that it doesnt cover my pain in the least. What could kill a horse does absolutely nothing but keep me from getting extremely ill.This is due to tolerance to be sure, but also not to be under estimated - the pain of Chiari.  Either way it is a very sad and disasterous combination.

[Tuckamore]

This old thread belongs to another poster. For better visibility and responses I encourage you to begin your own thread - telling us about you!

Often these are viewed as inactive - or belonging to the original poster - and therefore few ppl look at these.

Your issues and concerns are important to us. I'll watch for your post.

Thanks,
~Tuck.

[PainIsWorse]

I will put this into perspective from my OWN experience ONLY.  I had a DUII 7 years ago, and as a result, was asked to go to 30 day inpatient treatment as a condition of my sentencing.  First of all, if you are ANY kind of addict or alcoholic, inpatient treatment will likely save your life (if you can afford it).  That is beside the point, however.  I have a Rheumatological Arthropathy called "Ankylosing Spondylitis" which has caused my spine to begin fusing at the SI joint...and now has begun moving up the spine.  It is INCREDIBLY painful, particularly at night and in the morning..and when I checked-in to the alcohol treatment, they informed me that my normal regimen of opioid medicine would NOT be allowed while in their care (which makes perfect sense).  I had never had any issues with my pain meds, as I literally need them daily and do not burden my doctor with early refills. They used SUBUTEX, not SUBOXONE, to ween-me off the opioids...and kept me on the SUBUTEX for the remainder of the treatment to address the chronic pain that is so real in my life.  When I left the treatment center, I was given a one month supply (8mg sublingual/2 times daily) and a letter to give my primary care provider stating that "this medicine can be prescribed for PAIN ONLY" without special certification.  For the last 7 years  I have enjoyed uninterrupted sobriety, AS WELL AS extremely well managed pain from the SUBUTEX sublingual tablets every day.  IT IS VERY DIFFICULT TO OVERDOSE ON THIS STUFF (once tolerant), IT ONLY MAKES YOU "RUMMY" FOR THE FIRST MONTH, AND IT REMOVES ALL CRAVINGS FOR OPIOIDS!!  I have never looked back at hard-core opiates for the obvious reasons that they almost always eventually lead to complications or addiction.  I even go so far as to note that this medicine has helped me stay off the booze, as I no longer need to "self medicate" this pain!!  Now for the bad news:  I just received notification from my doctor that a "drug rep" told him he was illegally prescribing the Subutex for pain...and my doctor has now told me he will be stopping the almost 8 year long RX this month!!  I hope people in the medical community will wake up!  The big Pharma companies are so threatened by Buprenorphine, and the potential it has to replace their trillion-dollar OPIOID empire, that they have stigmatized it using the federal government as a vehicle to make this drug VERY hard to get for chronic pain!  I had a "pain specialist" take me off Subutex a few years ago, to replace it with high-dosage OxyContin, and it was a bit of a withdrawal...so be careful there.  As expected, the OxyContin had varied results, had me wishing I had more of it in a very short time, and did not manage the pain nearly as well as the Buprenorphine!!   So here I am now, facing the very addictive, very problematic powerful opiate routine again soon..and i'm scared as hell about it!  I don't care who you are, if you take high-powered opiates for long-term pain with frequent "spike" pain, you WILL develop tolerance and eventually an overwhelming dependence on the stuff.  It looks like Methadone is in my future...and this is a drug I have watched other loved ones with similar diseases struggle with immensely!  This may seem like a rant, but Subutex subligual tablets have been like a miracle for me...and considering it has been effectively used abroad for decades for chronic pain treatment, I can't help but feel I am a victim to this country's obsession to pump people full of hard-core opioids and ever-increasing NSAIDS.  
Side note:  If you are currently taking opioid medicine, DO NOT TAKE BUPRENORPHINE UNTIL YOU ARE ALREADY IN FULL WITHDRAWAL!!  previous posters are correct, if you take this medicine without first detoxing from opioids, you will be thrown into immediate and irreversible withdrawal...which may be among the most frightening experiences I have ever been through!!  
LET THIS MEDICINE BE USED FOR WHAT IT DOES BEST:  CONTROL PAIN, ABATE CRAVINGS, AND KEEP PEOPLE FROM FALLING INTO THE OPIOID TRAP!!  This is costing us lives folks.  
Yes!  There is a very long, relatively mild withdrawal period when you have to stop the medicine...but compared to the alternative, it's a no-brainer!  If you are someone who just likes the "high" of opioids, then you have MUCH bigger issues to deal with than which is best for what.  I feel extreme sympathy for you friend, as I understand intense and unrelenting pain...I too have been up to 300mg + of oxycodone, only to find myself in the position of a flat-out junkie (when I have worked so hard to remain sober all these years).  Doctors will say what they want, but as you will read throughout the multiverse of internet postings on the topic, ALMOST NO ONE IS WILLING TO PROVIDE this life-saving and effective drug for chronic pain.  Hang in there.  I say "yes"...give the buprenorphine a try!

[Tuckamore]

Will comment at the end of your four-part post.

~Tuck