Author: hatmaker510
Posted: Sun Aug 14, 2011 6:43 am
Hi Greg,
The first thing I’m going to do is refer you to another thread (http://suboxforum.com/viewtopic.php?p=34268#34268). This other thread includes a link to an NIH article about how to treat acute pain in sub (and methadone) patients. It’s an easy read, and I’d highly recommend you give it a read. Then YOU will have an excellent understanding of how to doctors can treat acute pain in those of us with a high opiate tolerance from being on sub. Many of us have used this paper for surgeries (dental or medical). You might even want to share it with your dentist/oral surgeon.
Also important, make sure your dentist/oral surgeon knows about your sub use AND get your sub doctor and dentist hooked up so they can openly communicate about your proper treatment
Chances are they will use Fentanyl along with something else to knock you out. Because the suboxone will do its best to block the fentanyl. But your docs SHOULD know that. I’ve had fentanyl used that way for an upper GI endoscopy and had no problems whatsoever with them adding fentanyl to the mix. So there will be no negative interaction.
If I were you, I’d taper your dose of 8 mg down a bit over the coming weeks before your procedure. Then stop your dose about 2-3 days before. While you’re doing this, just keep in mind that you may have to adjust this plan if you start to have withdrawals.
You’ll need more than "normal" pain meds following the procedure to get past the suboxone and to reach your tolerance level, now higher due to being on suboxone. This is one of the reasons you want to get those doctors together, so the one writing you for pain meds will know you’ll need higher than average doses of full agonists. In other words, you’ll need enough short-acting pain meds to keep you out of withdrawals.
I hope this helps. I also hope this isn’t too confusing. Ask any questions you may have and I’ll try to clarify.
