Suboxone

[Barbj55]

I have lived with chronic pain of the neck and right shoulder for 20 years. I just recently started to take Suboxone for chronic pain. Has anyone ever taken this medication and what was your experience. I like the medication, but I am having extreme constipation with it. Is this a common side effect. I've always had constipation when I was taking opiates but not as severe as with Suboxone.

What has your experience been with this medication. Thank you for any help and better understanding of this drug you can provide.

Sincerely,
Barbara

[Mark N]

Barbara, I haven't taken the medication but I have terrible constipation with my medication. I have found that Miralax does a great job with getting over the constipation. Constipation isn't something to mess with or to suffer through as that is what caused Elvis's death as it caused his stroke. I suffered terribly because I followed my GP prescription to take more fiber. Unfortunately many of our meds cause low motility which slows our bowels very much and adding fiber makes it much worse.

You can find Miralax or one of the other ones that have Polyethylene Glycol in it.

[tortoisegirl]

I have heard a lot about Suboxone but haven't tried it as it doesn't seem a good fit for me, between the dose "ceiling" (after a certain dose more doesn't help pain more...I believe the conversion says I'm over that already) and that you can't take much of anything for breakthrough pain on it (I have a lot of pain variation). Some folks really swear by it. Seems like a good option for starting out on (or if you aren't too tolerant), have pretty constant pain, etc. How is your pain doing?

I definitely second the Miralax (and its generics). Costco has the best deal, but you probably want to try a small bottle first. I've heard you can't take too much of it. I take it 1-2 times a day. No cramping or other got to go now issues like stimulant laxatives. It also both moves things along and makes everything smoother. Its best to take it daily instead of as needed as it takes awhile to kick in. I just adjust my dose slightly daily based on how things are moving. If I forget a day or two it takes a long time to catch back up. It dissolves best in a hot beverage like coffee, but it'll eventually dissolve in any liquid. It tastes funky in water but I've had to do that on vacation in a pinch lol.

I have horrible constipation even without the pain meds and still only find myself taking less than the recommended dose. You may want to start with a fraction of a capful for a couple days until you see how you react. Some people need several capfuls though. Actually, a high fiber diet makes my bowels worse. My gastro dr has me on a low fiber diet for small intestinal bacterial overgrowth and I'm definitely doing better...a lot less bloating, gas, cramps, etc. I agree when the constipation gets so bad the fiber often actually makes it worse. Best wishes.

[lor]

I take Miralax in the morning. Yes it's not great in water but I'll take it, if it helps me.

[Diandra]

Hello Barbara,
I was offered a script for Suboxone to get me off my current opiate medications. I ended up not using it. It was not offered to me for pain mgmt. As far as constipation, there has been a recipe for Yakima Fruit Paste passed around on this forum for yrs. I will go look for it and add it to this post. It works VERY well. Just start slowly. It is basically a senna tea/prune/fig jam. I like it best because it is natural and I just make sure I have a TBSP or two per day. I often put it on toast in the morning. Hope it helps...Diandra


Yakima Fruit Paste

DOSE: 1-2 tablespoons per day

1 pound prunes
1 pound raisins-pitted
1 pound figs
4 oz senna tea (look in your health food store, it looks like a bunch of leaves)
1 cup brown sugar -(Barbara, I never use this as it is sweet enough with the raisins and figs)
1 cup lemon juice - (I skip this as well...or just add a minimal amount...a cup of lemon is ALOT)

1. Prepare tea-use about 2 1/2 cups boiled water added to tea and steep 10-15 minutes.
2. Strain tea to remove tea leaves and add only 1 pint tea to a large pot, then add fruit.
3. Boil fruit and tea for 5 minutes.
4. Remove from heat and add sugar & lemon juice. Allow to cool.
5. Use hand mixer or food processor to blend fruit mixture into smooth paste.
6. Place in plastic container and place in freezer. (Paste will not freeze but will keep forever in freezer).
7. Spoon out what you require each day.

Enjoy eating it straight off the spoon.
Spread it on toast or add hot water and make a drink.

[alex44]

Barbj - Be caeful with this medication. #1 You reach a ceiling where more won't help? #2 If I am not mistaken, Suboxone is an Opoid Anti-Agonist, which in short means you cannot take regular opoids - to me this would be scary. Pehaps Phamacist Steve would be so kind as to stop in and comment as I am not 100% sure of my facts but I am pretty sure I am right.
Alex44
Skypilot

[tortoisegirl]

Yes Alex you are right. The dose "ceiling" for Suboxone is 32 mg...you can take more than that but apparently the studies show it doesn't do anything more above that for pain or addiction.

The opinion varies on what type and how much opiates you could take with it, but I was told if I started Suboxone I'd be limited to Vicodin and Percocet and the like at most, which won't do anything for me at this point (other say no opiates at all...I assume its dose dependent).

It was offered for me to be referred to a clinic which prescribes it but I declined. From what I knew about the conversion rate, dose ceiling, and that I wouldn't be able to take bt meds in a quantity which could be helpful, it didn't seem like a good fit at all. Seems ideal for someone starting pain management who has failed other treatments who has a very constant pain level though. Best wishes.

[alex44]

IMHO Suboxone is a sneaky way to get your dose down - and possibly off opoids that doc's try to pawn off on uninfomed people - My VA Doc. tried to pull that crap on me. Tortoisegirl - You are right - I do not believe this is a true P.M. drug, just something that docs can use to pawn off on their patients since a lot of doc's are still GOD to their patients. I personally would have NOTHING to do with this drug.
Alex44
Skypilot

[tortoisegirl]

I so know of some people who get pain relief on Suboxone, but yes I agree that high dose opiate patients shouldn't be pushed onto it as its likely they will reach the dose ceiling, have uncontrolled bt pain, etc. The doctor that offered it to me wasn't so clear on if the goal of it was to actually maintain me on it or use it to get off my pain meds (which to me doesn't make since as if you have to taper off what med you do it on shouldn't matter too much). I can see it as a way to get you off your meds even indirectly as if you get switched to it and it doesn't help, they could then tell you that you can't switch back.

I'm currently having to taper off my pain meds to try a nerve stim procedure and the pain has been horrid, but it has shown me that I can actually do it on my own with minimal withdrawal symptoms (so far). Even the doctor who wants to do the nerve stim trial has a hold over me as I was required to get off half of my meds before they would even start the insurance paperwork, and now they are out of the office and no one will get back to me on who can start the paperwork. Even though I have a doctor with a more caring heart, I do get that feeling that they have a huge hold over me with these prescriptions.

Too often I hear online of folks getting kicked out of PM due to no fault of their own, such as misinterpretation of a UA or the doctor telling them something that goes against their pain contract (like seeking treatment for acute pain in the ER) so they do it and then get kicked out. Best wishes.

[alex44]

You said it all. Hope all goes well.
A.
Skypilot

[Fillmore]

Ya, I see you are getting plenty of laxitive advise... but the Q was about the drug eh.

I think that is one of the SYNTHETIC opiates... the natural morphine might be better for you? I have found that when on a stable dosage that morphine is not so constipating, as I think you had found.

PS - but, if I may, the natural Cascara Sargada and Docusate stool softener, plus a diet with freshly ground flax seed is what I find effective at those rare times I need help. Cascara has been widely and roundly dismissed as "not good", which I assume must be Pharma trying to sell stuff. I have no problems with it, it is gentle, effective, albeit bitter.