Suboxone For Pain? It Depends On Circumstances

Suboxone is an effective medication for treating addiction to opiates. Many people wonder, “Can I take Suboxone for pain?” Here’s an example: You’re in a medication-assisted treatment program, and you anticipate an upcoming surgery. Or, you expect to deliver your baby, or you may wonder what would happen if you were in an accident and needed treatment for pain. What is the relationship between your treatment program and Suboxone for pain?

Why Suboxone For Pain May Not be a Good Idea

When people are in pain, they will do anything to not experience the pain. And that may mean mixing medications, even though that’s not a good idea. If you mix Suboxone with alcohol or benzodiazepines such as Xanax, the combination could be fatal. Additionally, the National Alliance of Advocates for Buprenorphine Treatment (NAABT) doesn’t support the use of Suboxone for pain. The NAABT website includes a letter from the Drug Enforcement Administration to a Dr. Heit, who asked about prescribing Subutex or Suboxone for pain. The letter states that the use of sublingual buprenorphine “is not prohibited under DEA requirements.” However, there may be a problem with scheduling and dispensing the various buprenorphine formulations.

Because the liver metabolizes buprenorphine (a primary ingredient in Suboxone) so slowly, it is less efficient than other pain medications. The slow processing may lead for people to take more buprenorphine which can lead to an overdose.

When Suboxone For Pain is Appropriate

When you’re in a medication-assisted treatment program, doctors monitor your use of Suboxone. Talk with your buprenorphine doctor about using buprenorphine or Suboxone for pain. For example, the doctor for a woman anticipating a C-section delivery may increase the dose of Suboxone a small amount for the days immediately after the procedure. When we say small amount, we mean maybe from a typical 8 mg to a temporary 12 mg. However, it is absolutely something that must be done in communication with your doctor, regardless of the reason for anticipating pain.

NAABT Recommendations

The NAABT makes the following recommendations for handling pain during surgery:

  • Your doctor can continue your regular Suboxone treatment and gradually introduce an increasing dose of a pain medication. You may need a higher-than-normal dose in order to break through the effects of the naloxone.
  • Your doctor can order your Suboxone dose to be taken as a divided dose. Instead of one 8mg film daily, you would take half the amount twice per day. This may well help with your pain—but it’s not a guarantee.
  • Your doctor can halt your Suboxone therapy 72 hours ahead of your procedure. Once the procedure has passed and the analgesics you took are out of your system, you can resume Suboxone therapy. You will need to undergo the induction period once again.
  • Your doctor can switch you from buprenorphine to methadone at a small dose—30 or 40 mg—so that your pain is managed and you also do not experience withdrawal symptoms.

Possible Options For Treating Pain

You may simply have an elective surgery or dental surgery and you’re in a maintenance program with Suboxone. Again, before you take any type of medication, you must talk with your doctor. Acetaminophen and ibuprofen are two different categories of over-the-counter analgesics. However, aspirin, ibuprofen, and naproxen are all categorized as non-steroidal anti-inflammatory medications, and so they cannot be taken together. Ask your doctor if you can take one of them along with acetaminophen to help you deal with pain.
Other methods for managing pain without medication include massage therapy, gel packs, acupuncture, relaxation techniques, or physical therapy. Many people also work with a hypnotherapist to learn techniques that help them relax or put themselves into a different state of mind. The American Psychological Association is an advocate for hypnosis for the relief and control of pain.

Keeping open communication with your buprenorphine doctor is the best way to get the pain relief you need without putting yourself in danger.

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Additional Reading About Recovery

Suboxone and Xanax – A Deadly Combination – BAART Boyle Heights

How Opioid Addiction Can Affect Marriage

Suboxone Treatment: What to Expect

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