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    pain management
    mudderjen posted:
    long story short...need TKR on right knee, have cervical fusion with lots of headaches and pain associated with this. Treated with various modalities including meds, PT, many injections of every kind and surgery. I am not currently taking narcotics but have taken in the recent past. I saw a new Dr. for pain management and he asked me if I saw more than one Dr. for meds...yes...and then why...because I was not being listened to or taken seriously and I was in severe pain and still am. I have not taken any pain meds in several weeks and am in alot of pain. With that in mind he gave me a med and said it would help. Suboxone. Well, I found out it is for treating addiction and withdrawal and I am not going thru withdrawal. Is this a valid treatment for pain like arthritis and cervical joint pain with severe headaches? or do I need to find a different Dr.? Is this also addictive? thanks
    Anon_1421 responded:
    Pain management doctors do not want a patient getting pain meds from anyone but them, in fact you usually have to sign a contract stating you won't get pain meds from anyone but them, and if you do get meds from another doctor, you will be dismissed as their patient. It sounds like your doctor thinks you are drug seeking-but he also sounds like a jerk. I doubt he will prescribe any pain medication for you. If I were you I would try to find a doctor who would listen and treat your pain seriously.
    Anon_160307 replied to Anon_1421's response:
    I have read some posts across the web from chronic pain patients that switched to Suboxone and are getting good pain relief from it. It is the same medication in the Butrans patches if you ever researched those or were prescribed those. I personally have never tried it and I don't think it would do much for the pain that I have.

    It does have ceiling effect, after a certain dosage, taking more won't provide additional analgesia. It also produces no sense of well being or euphoria so it is really benign medication when compared to pure opioid agonists like oxycodone, morphine, and oxymorphone.
    annette030 replied to Anon_160307's response:
    They seem to use it much like they did methadone years ago. They say it does not cause as much addiction as the older opioids do. But that is less than 2% according to all the medical studies I have read. I do not worry much about side effects with such low percentages.

    There is Suboxone with an anti-addiction medicine, Naloxone, incorporated in the pill, and Subutex, just the pain med by itself. The pain med in both these pills is Buprenorphine. It is classified in my drug hand book as an opioid, and is used to treat moderate to severe pain as the labeled use, and an off label use for treatment of opioid addiction. Suboxone, with naloxone in it, is used for opioid addiction or dependence treatment per this book also.

    I have never had the high or sense of euphoria or well being that some folks say they get from opiates. I don't think any drug is totally benign (for everyone taking it) over a lifetime of use, we will see.

    As a nurse and just an old person, I have seen many drugs come up and be advertised as having no side effects and being the only drug that works for a specific problem, then after a few years, it either has been proven not to be that great, or is actually recalled. Talwin was one that was used for pain. Quaalude for sleep was advertised as being totally "non-addictive", not true, now it is illegal in the US to even possess it.

    I will not switch to any meds until they have been widely used for at least five years to see if there are any side effects from longer term use. Right now I am on methadone, old, cheap and it works well for me, I will stick with it for now.

    Take care, Annette
    David Maine, MD responded:
    It is hard to comment on this without full details. That being said, Suboxone is a combination of Buprenorphine and Naloxone. Buprenorphine can be a good pain reliever. Suboxone as you know while can be used for pain is typically used to detoxify from opiates without becoming ill with withdrawal symptoms. They are also used in the long-term maintenance of opioid dependency. Suboxone is a "partial opiate" that partially work to block pain receptors and thus can be an attractive option for long-term chronic pain management in those that are high risk. I hope that helps. Ultimately, you will need to have this discussion with your doctor to better understand his/her reasoning for using this as part of your pain treatment plan. Good luck.
    mudderjen replied to David Maine, MD's response:
    Thankyou Dr. Maine...I appreciate the time you have taken to comment on my question. I don't like having to look for Doctors that may or may not treat me. I would just like to have one listen to me, and then treat me within the limitations I have and respect me. More often than not, they have been condescending and write what they want in the records. For instance, I do not drink, smoke or do drugs. I have told them that due to the severity of my pain, I have gotten meds from another Dr. What they wrote in my records is that I drink socially, smoked in the past but not currently and take drugs. I was offended because now this is in my records and if you don't check your records, Lord knows what is in them! I am clearly upset, but you can't unring a bell!
    annette030 replied to mudderjen's response:
    A GI surgeon I saw many years ago said in my medical file that I had had my gall bladder surgically removed, not true, etc. I don't even have a scar that would be appropriate for a gall bladder removal, lol. There were several things that were inaccurate. I don't even remember HIS name now. Probably I will never find that record anywhere.

    It is allowable by HIPAA laws that you write a note to be included in your medical records as an addendum correcting any inaccuracies. If you think this will follow you, you might consider it.

    Take care, Annette
    dogluvrrr replied to annette030's response:
    How can I go about finding out who to speak to about correcting inaccuracies in my medical records? I really need to take care of this and may be why I am having some problems with some of my doctors. Thank you!
    annette030 replied to dogluvrrr's response:
    Sorry, I have not been on line for several days, I responded to your other post.

    Take care, Annette
    mudderjen responded:
    ne mudderjen posted: I am trying this new pain Dr. that has me on Suboxone now for 3 weeks for neck pain (fusion) , knee pain and migraines. The first week the headache was a little worse so he put me on double the amount. The headaches now are severe but not as frequent. I am fearful that if I have to go to the ER for interventional treatment, they won't be able to control the pain because of the suboxone. Now he wants me to add another film, triple the original dose. I don't want to but feel that he won't help me so I don't know what to do. Yesterday, I had to take 2- 100mg imitrex and a zofran along with nasal toradol and I finally got it under control. With triple, I am literally afraid of getting another headache and not being able to get rid of it.
    I started a different discussion but can't find it again to ask this.
    copy and psted from a different discussion...started by me because I couldn't find this one...sorry
    annette030 replied to mudderjen's response:
    Have you seen a neurologist who specializes in headaches? I think perhaps this doctor doubling to suboxone dose due to your migraines just doesn't sound right. I believe that most pain meds can cause rebound headaches which can be a worse problem than you started out with.

    Take care, Annette

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