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Suboxone and Surgery

Discussion in 'Detoxing From Buprenorphine/Subutex/Suboxone' started by KimG, Feb 8, 2004.

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  1. KimG

    KimG Guest

    Can someone please tell me how long it takes for Suboxone to get out of your system? I have been on it for about 6 months. Doing well, up until now. I am taking a relatively low dose. About 12 mgs a day. The problem is I am having surgery in three days and I don't want to suffer. I was told by the prescribing physician that everything would be fine...just to tell the surgeon I was taking Suboxone. Well, that's all fine and good for him, he isn't the one about to be cut on. I don't want the painkillers to NOT work! I feel confident that I can handle taking the painkillers for a few short weeks after the surgery without becoming an addicted fiend again. Anyone, who has been through a similar situation please respond!!!! HELP! I am scared. Thanks.
  2. Crystal

    Crystal Well-Known Member

    I could be wrong...but I don't think pain killers WILL work while still taking the sub. In fact, that high of a dose that your on..I'm SURE it wouldn't work.
    If I were you...I would try to post pone and get yourself off the sub. before surgery. Better safe then sorry.
    If you look around, someone else posted about this same subject and if I remember right, others were giving her info/advice about waiting a week or so.
    Hope you can get this all figured out before you go under the knife.
    NOT to scare you or anything...but please....check around before doing so.
    GOOD LUCK and keep us posted, ok?

    Communicate,Validate and Appreciate!
  3. Bup4pain

    Bup4pain Well-Known Member

    12 mg a day is really not a LOW dose, as it is high enough to be a full blocking dose for full agonist opiates.

    Bupe/Sub has a 37 hour 1/2 life.

    12 -6 mg = 6 mg (after 37 hours
    6 -3 = 3 mg after 74 hours that's 3 days
    3 - 1.5 = 1.5 mg after 111 hrs that's 4.6 days

    They say at around 4 days opiates wills tart to exert their full force. I would shoot for a week.

    ALL of us here are wondering what the process for a person who is on BMT ( on sub maintenance) in the event of an emergency and has the need for severe pain control, like a car accident.

    If your MD tells you what drugs (Stadol??) they give or the process to push the sub off the receptors PLEASE let us know!

    Many here have the same question.

    The Idea of suffering in agony for 4-5 days before you will respond to pain control therapy is one reason *I* got off the bupe, and is a valid reason to NOT be on BMT. A fire fighter, Policeman, construction worker, farmer, or any other HIGH risk job for injury would be a reason to NOT be on buprenorphine.
  4. JaH

    JaH Well-Known Member

    Why not just continue with the suboxone after surgery?

    The active ingredient in Suboxone is Buprenorphine HCL, .3 mg of which in injectable form is supposedly equal in analgesia to 10 mg. of morphine. If that's not enough, they can always give yhou more, since the risk of overdose with buprenorphine is practically nil.

    Remember, buprenorphine has been used as a strong pain medicine for many many years -- only recently has it been used for detox.

    There's no reason why it wouldn't work for you.
  5. spring

    spring Administrator

    12 mg is NOT a low dose.

    2 to 4 mg is a low dose.

    There used to be a guy who posted here, name was Dan P. He was on liquid bup (Buprenex) for pain management for years. He often mentioned how he would take percs for breakthrought pain. It never made any sense to me how the percs could help relieve pain if they were being blocked by the bup. (????) There are many things I still don't understand about bup.

    ~~~Do the right thing and risk the consequences~~~Spring~~~
  6. Bup4pain

    Bup4pain Well-Known Member

    JaH.. FYI Bupe will NOT give a person who is on BMT pain relief the same way it will for an opiate naive person. The 10 mg Morphine equivalence is in an opiate naive person. (including buprenorphine)
  7. JaH

    JaH Well-Known Member

    Good point, Bup4pain. Although I should add that the same is true for regular opiates -- i.e., that they're less effective if you've already been using them.

    For example, my knee replacement surgery is now scheduled for February 27. And although my doctor has been giving me some Vicodins for especially bad days, he wants me to go without any pain meds for the two weeks prior to surgery because that will lower the dose of pain meds needed after surgery.

    Anyway, even if Bup maintenance lowers the effectiveness of Bup for post-op pain relief, it should still give at least some relief, right? Isn't it just a uqestion of how much more is needed?
  8. Bup4pain

    Bup4pain Well-Known Member

    JaH... th problem is that Bupe has a ceiling. In the opiate naive person the pain controlled may be adequate at .3 mg IM and a 2nd dose of .3 mg IM may help, but after a point the ceiling is reached.

    NOW in a non bupe naive person they have already adapted to the drug. They get little to no pain relief and the higher doses do nothing. At even higher doses it reverses it's self.

    Bupe is absolutely USELESS for pain control Post Surgery for a person on BMT, especially at the doses used here in the states!

    Bupe is titrated up to doses where the opiate effect becomes eliminated (so ya can't get a buzz or more importantly pain control from the bupe), and the BLOCKADE effect is maximized. How nice of the AMA and the Government.

    This is directly from the 8 hour course. They recommend higher doses so a patient can not spike the dose and get any buzz. At low dose if you spike the dose you MAY get a little head from it. Doing this is short lived as you will become accustomed to the spike and it will do very little.

    I think Stadol will work with bupe MAYBE, as it is a partial agonist like bupe. However since the bupe has such a high affinity for the receptors the Stadol may not work either. I wish a MD would comment on the issue of pain control for people on BMT!

    It is one of the HUGE disadvantages of Bupe. (the blocking action)
  9. JaH

    JaH Well-Known Member

    Thanks for setting me straight (as it were) on bup and pain control.

    This is a complicated question, clearly. Kim better talk to her doctor about it.
  10. KimG

    KimG New Member

    I guess it has all worked out in the end. My surgeon just cancelled the surgery because I have come down with some type of cold or flu. I haven't had any Suboxone since Sunday. I can't tell if I feel crappy or if I am having any withdrawl or not because I am sick with this cold. The nurses are going to call me with a new surgery date soon. I plan to be Suboxone free when I go under the knife. I want plenty of meds and I want them to work! If all goes well, I won't even go back on Suboxone. I know I sound optimistic but I am very much relieved. I appreciate everyone's advice. I thank Suboxone for getting me where I am today. But it's obviously not such a good thing to be immune to painkillers in the event of an emergency. Just something to think about.
  11. Apheana

    Apheana Well-Known Member

    Goodluck! I myself am heading under the knife soon and was told by my addiction doc that bup could be given to me IV after surgery for pain. I knew that after being on BMT that it would be useless and so I worked extra hard to get off of it. I found that being on and off of pain meds now using bup for a day or two here and there helps me break free from the meds and I do not have W/D. I noticed if I only use it for no longer than 2 days I feel almost fine and dandy but without the bup I had W/D like stomach cramps and stuff. I guess the fact that I dont have cravings anymore make it bearable for me to take pain meds and get back off of them right away. I havent taken anything longer than a week and the thought scares me to death. So good luck and beware of W/D. My drug of choice was OC and perks so pain meds bring me W/D. Goodluck with the surgery!

    ***Live, Laugh and Love***
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