Buprenorphine for Chronic Pain Management
There is now an effective medication for both opiate addiction treatment and/or maintenance pain management that is FDA (Food and Drug Administration) approved. The medication is buprenorphine, which is an opiate agonist/antagonist and a very effective pain medication for appropriate patients. It has been used in pain management for many years—mostly in its injectable form. Buprenorphine is now available in the United States as sublingual (dissolved under the tongue) medication and is many times more potent than injected morphine. Buprenorphine is different from other opiates in that the patient usually feels more “clear headed” when taking it.
Being the first oral medication that has been approved in the U.S., physicians can now prescribe buprenorphine in their offices for people who are dependent or addicted to opiates such as opiate pain medication, heroin, or methadone. Buprenorphine is an effective medication for opiate addiction which does not require daily or weekly visits to a clinic. Buprenorphine blocks the effects of other opiates; it eliminates cravings and prevents withdrawal symptoms such as pain and nausea. Patients can be maintained on buprenorphine or go through detoxification.
Subutex and Suboxone are the brand names under which buprenorphine is being marketed for the treatment of opiate dependence. Both medications contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence. Subutex contains only buprenorphine hydrochloride which was developed as the initial product. The second medication, Suboxone contains an additional ingredient called Naloxone to guard against misuse or abuse. Subutex is usually given during the first few days of treatment, while Suboxone is used during the maintenance phase of treatment. Both medications come in 2 mg and 8 mg strengths as sublingual (placed under the tongue to dissolve) tablets.
However, this medication is also being used very effectively by some pain management physicians for people living with chronic pain. It is important to remember that medication is only one modality for effective chronic pain management. It is also crucial to develop non-medication based treatment interventions as well as learning to treat the psychological/emotional components of chronic pain. A multidisciplinary team approach always gives the best treatment outcomes. For someone with chronic pain who has developed an addictive disorder this medication may be the best intervention possible along with concurrent addiction treatment modalities. In addition, it is important to help people differentiate between the physiological and psychological/emotional components of their pain. Once that is done then cognitive behavioral approaches can help people manage the psychological components more effectively.
To learn more about chronic pain management please check out our website at www.addiction-free.com and go to our Publications page and check out my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. If you want to learn more about non-medication intervnetions for chronic pain management you can find my article Managing Pain Without Pills that you can download for free on our Ariticles page.
To check out our July Chronic Pain Solutions Newsletter please click here.
May 12th, 2009 at 3:32 pm
I just started suboxone today and it is great !!!
October 26th, 2009 at 9:50 pm
I started suboxone treatment in April 09. The dr. I went to at that time wasn’t very knowledgable about the use of this medicine for chronic pain. That is the MAIN reason i started back using lortab’s because he told me it wouldn’t help patients with chronic pain. This was the worst mistake in my life. I went today after i’ve been clean for 36 days. Hardest thing in my life was dealing with the withdraw symptoms with NO help. I went to my pain management dr. told him my sister O.D. on morphin a year ago and i feel like the pain was just getting worst the more i told of the narcotic. He suggest me going to a suboxone dr. I’m soooo looking forward to taking it and getting my life BACK!!! I am sooooo tired of the constant struggle and worry about not having anything for my pain. I’m soooo happy i found this article to again reassure me i’m taking the right step. I have alot of medical problems which causes me pain. Neuropathy, fibro. arthritis, herniated disk, degenerate bone disk disease and depression!!!! I sure hope that i’m finally on the right path. I’m soooo happy i found this article to ease my mine!! Good luck everyone…….. this is the right path!!!
January 14th, 2010 at 8:15 pm
Suboxone is a great pain reliever for someone like me who survived herpes encephalitis/meningitis and is left in horrible head pain from front to back of my brain. Thank God for my doctor, he saved my life!
January 24th, 2010 at 9:45 am
While this and many other medications can be used in order to limit chronic pain I think that it is important that it has the potential to become addictive. This medication can be wonderful but like many other pain medications it can be abused. Suboxone abuse is on the rise. So while it has many great features it is important to self monitor for addiction. Thank you so much for this article. I am sure that it is helping many people.
February 27th, 2010 at 3:48 pm
After a terrible car accident, I was diagnosed with Chronic pain.. no end in sight. I was on both Oxycontin and Vicodin ES. The Oxycontin was 20mg x 3 daily. The Vicodin ES 7.5mg was 4 x daily for breakthrough pain. I was literally a walking zombie. Sick if I didn’t take my meds on time. Half out of my mind when I took them enough to control the pain. After walking out of a local supermarket with my basket full of groceries and being arrested for theft, I knew I could not live on these heavy narcotics. I’d taken a Xanax (also prescribed since the accident for PTSD and anxiety) before leaving the house. I felt fine. But later when I tried to remember the incident, i was unable to. Several times I began treatment programs, only to have so much pain it was unbearable long after withdrawal. Then I went to a treatment center where they used Subutex. I couldn’t believe that not only did I not suffer withdrawal, I also minimized my pain considerably. It wasn’t a walk in the park to switch to Subutex. I had tried many methods that I continue to use in combination with the Subutex. Physical therapy, acupuncture, and even meditation. But Subutex has given me back my life. My children are forever grateful to have their mother back. I’d never been a drug user and didn’t even drink alcohol. For them to see me so strung out with seemingly no hope for the future, they were getting depressed and many times embarrased by my behavior. I’m so, so, thankful for Subutex. It is hard for me to believe stories that I hear about it being abused. I don’t see how it could be as I have now been on it since 2004 and never been tempted to take a higher dose or double dose. I don’t feel “high” off of it. No one at work even knows that I take a medication. I am able to take it when I wake up and then I take another one on the way home and one before bed. It’s so great. The cost was a huge burden. I was so thankful when they came out with a generic that actually worked! I think we all know that generics work differently and some are not very effective. But I actually find the generic Subutex better than the brand name. Now in California, we are having trouble getting it at the pharmacy. At first it was available every time, and now that people have switched from Suboxone to the Generic Subutex for cost reasons, they are suffering shortages. I know that the makers of Subutex held back the generic patent for an extra 2 years so they could make more money. I’ve heard they are fighting to hold other companies back from releasing generics. It’s sad that our medical community is so focused on greed rather than what is best for their patients. Hopefully, things will change if a universal healthcare program is adopted by our government. Bless all of you and I’m so glad you found Subutex. It’s the greatest! FYI.. I did find after a few years that it was hard on my teeth. I suggest that you brush your teeth well after the pill has disolved and then use a rinse that has flouride. If not, you may find yourself getting cavities near the gumline especially. All the best to you!
April 1st, 2010 at 10:27 am
as for me Subutex is the best medicine for chronic pain u can have all that other crap and burn it,i have taken methadone,morphine,oxycontin,etc.subutex it is a real smooth medicine,nice to wake and feel normal,I’m 56 had 2 back surgerys 1knee surgery,been through w/d many times but no more Subutex is the best and it don’t take a truck load of it to help u,and the D.E.A. is concerned about deversion and they should be hell, most pain centers load u slap up with multiple drugs insane,u will never stop deversion unless u get people to get serious about their health and well being,they r pathetic all u hear is bs in a pain center i hated them still do no different than a methadone clinic,anyway who can write subutex other than dr,s that have taken a corse can anyone now,since it is a dual medicine,let me know ty steve
May 25th, 2010 at 8:51 am
Great info. Thanks for the publish.
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