Gifts

I live in the Chicago land area, and I have been on Suboxone for almost 4 mos. I started at 12 mg every morning. After 1 wk I decreased to 8 mg every morning. Today is Thursday and I am having surgery Wednesday, in six days, and over the last wk I have decreased to 4 mg every morning. Today was the first day on 2 mg, and my last dose (after researching this subject) will be Saturday. The doc here says the half life of Suboxone is 70 hrs. I am hopeful that stopping on Saturday will allow the pain meds they give me to work and not be blocked by the Suboxone. I told my orthopedic surgeon that I was a recovering addict and on Suboxone, but he never heard of it. I called the anesthesiologist office at the hospital where I am having the surgery, and they were familiar with Methadone but not Suboxone, but did understand the partial agonist and antagonist properties of the medicine. I printed out copies of some great info I found on http://www.naabt.org regarding Suboxone/surgery/tolerance, and I will have a copy for the surgeon and recovery nurses. I gave one to my Sub doc because when I called him to tell him about me having surgery he told me to stay on the Suboxone because it is for pain. Well, being the good addict I am, I looked more closely at Suboxone to see if this was true and NAABT was a great source of info, and said to stop Suboxone 3 days prior to surgery. I was very anxious about surgery and pain meds b/c I do not want to return to abusing them, but I don’t want to be in pain. Hopefully I can have the surgery, get post-op pain meds, and maybe a script for a few days worth of pain medication, and then induct back to Suboxone. The key is honesty with self on pain level. I was clean and sober for 8 yrs and attended NA meetings that saved my ass..crack head that I was. After several surgeries, and my dishonesty about being an addict with my previous doctors, I abused pain meds and gave up my clean time. Life sucked for years, and I felt pretty hopeless until Suboxone…it saved my ass. I attend mostly AA meetings, a few NA, and my sponsor, home group members, and several other people know I take Suboxone. I am not judged and I AM clean and sober. The only requirement for membership in AA/NA, is a desire to stop! I do not abuse mind/mood altering drugs…Suboxone does not get me high, but it does effectively reduce craving and I feel “normal” I am grateful for all you people, and the Doc for this site. NAABT web site has a document (http://www.naabt.org/documents/PCSSAcutePainGuidance.pdf) that states the following: “For patients receiving bup/nx who develop or are anticipated to have acute and limited (e.g. 2 hours to 2 weeks) pain that will not be adequately treated with non-opioid analgesia, the following steps are recommended:
1. Anticipated pain (e.g. elective surgery, tooth extraction)
· Temporarily discontinue bup/nx 2436 hours prior to anticipated need for analgesia
· Provide adequate opioid analgesia, titrate to effect. It is good practice to know the usual doses needed for patients undergoing the planned procedure. Discuss with your colleagues and remember that patients who are opioid dependent and who have recently received bup/nx will likely need higher than usual doses of opioid analgesics due to their physical tolerance and/or narcotic blockade from recent doses of bup/nx.
· Do not provide bup/nx while patient is receiving opioid analgesia
· Discontinue opioid analgesia once pain has remitted or can be managed with nonopioid
analgesia.
· Allow patient to experience mild to moderate opioid withdrawal.
· Re-induce patient onto bup/nx as per usual.
· Note: single doses of opioid analgesics (e.g. post dental extraction) may be effective even if bup/nx has not been discontinued. However, patients should be cautioned to avoid bup/nx dosing during period that opioid analgesic is likely to be occupying receptors”. This is another good link for information: http://www.annals.org/cgi/reprint/144/2/127.pdf