Opiate managment and half life taper.

[Cora]

One more thing that I wanted to add to my previous post. Buprenorphine for chronic pain is not considered an off-label use. As Ezer said, many physicians currently are reluctant to prescribe it for chronic pain ( does not many any sense to me at all). Again, Butrans is the identical drug and pain doctors readily prescribe that- but my hunch is that some doctors especially pain doctors don't want to get into it because the Sublingual form is most often used with detox and it might raise a flag for a medication audit on the part of the provider. It's honestly the only reason I can think of that would make a doctor hesitant to prescribe.

Cora

[ezer]

Not to be argumentative but Suboxone and Subutex are prescribed for pain in an off-label basis only. The FDA approved Suboxone and Subutex strictly to treat opioid dependence.
http://www.naabt.org/faq_answers.cfm?ID=10

I was on 30mg/day of Percocet (Oxycodone) and switched to a 10 microgram/hour Butrans (Buprenorphine) patch.
The pain relief was exceptional and around the clock. Also on Butrans, there are no highs. You feel completely normal. You simply replace the patch after 7 days. It is much safer than Fentanyl patches. Fentanyl patches are reservoir based and can leak if damaged while the Butrans patch is matrix based like a Nicotine patch.

Buprenorphine is a newer opiate (UK 1972) but it is not "new" therefore has been tested quite thoroughly and is only a schedule III drug in the US.

[Cora]

Ezer,
That is true about Suboxone, but not Buprenorphine.
Not trying to be argumentative either, but the two are easily confused.
Cora

[Cora]

The other thing I want to mention is that "off-label" is often confusing It's done all the time with so many drugs. Compazine is a nausea drug but used for headaches. Seizure meds like gabapentin for chronic pain used to be off-label but now it's approved. Until recently, anti-depressants used for pain was off-label. Trazadone as a sleep medication is an off label use for an anti-depressant. Obviously,some drugs can be dangerous for off label use. Methadone used to be an off-label use for chronic pain but now it isn't. My point I have been trying to make is that if a pain doctor or any doctor who treats pain wants to use Buprenorphine ( not Suboxone) there is nothing limiting them but their own personal practice choices. No legal implications, nothing but their own choice and comfort level and experience. Just trying to clarify.
Cora

[Grammy]

Has anyone use subutex long term for pain--I mean years. I just got off methadone which was great for nerve pain due to apnea. I am going to have another sleep study tomorrow and it will be interesting to see if the apnea is better. I have been off methadone 10mg three times a day for over three weeks and I still feel nauseated most of the time. Interestingly Phenergan seems to help me with the nausea and also the pain. It makes me feel slightly high which is good for me as I am usually exhausted. I have had six reconstructive pelvic surgeries and six failed stim trials so I have been through the mill for 21 years and I can honestly say this condition has completely ruined all of my dreams for a happy busy retirement, I am currently 68 and this started after a hysterectomy when I was 48. The hysterectomy caused severe prolapses and I have so much damage no doctor will do more surgery. My depression is always there and I just find myself in an endless pit. My advice to anyone is do not have a hysterectomy unless it is absolutely life saving. Grammy

[Violet M]

Grammy, you could PM Cora about this medication. She posted about it awhile back and last I knew she was still using it successfully. http://www.pudendalhope.info/forum/view ... 781#p43781

Violet

[ezer]

Grammy,
You should try Butrans patches (same active ingredient as Subutex) that are designed for pain management. They work very well and around the clock.
In terms of pain relief long term, Buprenorphine is like all opiates. You become tolerant and you have to up your dosage. There is no miracle.