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Thread: Taking Subutex for chronic pain

  1. #1

    Taking Subutex for chronic pain

    Does anyone have experience taking Subutex for chronic pain?

    I've been taking methadone for 2 years. I've kept the dose low, 15 to 20 ml per day (with 10 ml Norco at night.) It helped keep my pain at a managable level for a while, but its not working as well any longer and makes me tired and unproductive. When I first started, it actually gave me energy.

    Since I don't want to increase my dose, my doc gave me a scrip for oxycodone. I just don't like the side effects of narcotic pain meds. It would be fine for temperary use but its hard for me to live life and be productive on these powerful opiods. I know everyone responds differently to pain meds and people have differing levels of pain. I know for lots of people, powerful opiods are a life saver.

    I would love to find something that actually works on pain without sucking the life out of me. Since pain also sucks the life out of a me, it seems to be a constant battle trying to find the right balance between drugs and pain.

    I'm wondering if Subutex could be helpful? My doc told me he would be open to trying any of the pain meds

    (not suboxone, which contains naloxone)

    Thanks!

  2. #2
    Interesting you should ask about suboxone. It is sometimes used in a treatment for opioid addiction since it has dual action. I am not surprised it would come up since you have a history with methadone but now want to get off but still have pain relief.

    From what little I have heard, this group of drugs can either help or hurt with pain depending on dosage, which is weird. Ever alert for a new anti depressive, is is also being studied for that, since anything that affects dopamine is thought by some to be a candidate as an antidepressant. Dopamine is supposedly the feel good molecule. If so, those of us with central pain seem to be a little short.

    A related compound JTC 801 is a research drug which is being mentioned as a possible treatment for neuropathic pain.


    A receptor is a site where a neurotransmitter works. Common neurotransmitters include serotonin, dopamine, and norepinephrine. Not so long ago, neuroscientists thought they could solve everything by just figuring out which neurotransmitter was involved. The presumption was that some would be excitatory and some inhibitory. Subsequently, it was realized that in the economy of the body, the same neurotransmitter could be either inhibitory or excitatory, dpending on the RECEPTOR. One suspects that it will ultimately be learned that is not the end of the story, and that receptor interaction with something else, probably gene products, will further define the real function.

    Many receptors require the production of something else, such as a G protein to work anyway, and G protein production is linked to gene activity, so we may go all the way back to what turns on and off the genes. This illustrates that we are still scraping the surface of how pain works. Still, right now, researchers are hoping that attacking one or the other of the opiate receptors will help neuropathic pain. Right now, they are touting the ORL1 receptor as a possible candidate for neuropathic pain.

    The common opioid receptors are mu, delta, kappa, and the ORL1 (aka nociceptin) receptor, which is the latest discovered. This newer class of opioids, is directed at the nociceptin receptor. Not a lot is known about it. They have even developed norbuprenorphin, which catches the ORL1 but also the mu and delta receptors.

    It is thought the way the nervous system works is that the peripheral nervous system gathers this huge amount of information all the time and then the brain limits what it will pay attention to, permitting discrete thought. So in that sense the cord is excitatory and the brain is inhibitory. The brain is mostly fat. The acids which can build up are fatty acids. Some think central pain is due to overacidification in brain synapses so that its normal inhibitory action fails and pretty much every superficial sensation creates a pain message. This causes the brain to function as an organ of pain generation, but not in a coordinated fashion, a disintegrated fashion. Acids burn. Protons, ie the Hydrogen ion part of HCL from acid, can cause the TRPV1 receptor to fire continually, even without a stimulus being applied to the skin surface. This acidification apparently becomes self duplicating at all three major synaptic connections all the way up to the brain. Interestingly, the ORL1 receptor seems to respond to cannabinoids, or TRPV1 active compounds. That is why they hope maybe it will help neuropathic pain, since TRPV1, a calcium ion receptor, is thought to be the focus of neuropathic firing.

    Opiate receptors are generally inhibitory in the cord and excitatory in the brain. Since central pain is thought to be mainly about the thalamus in the brain, where opiates are excitatory (by inhibiting inhibitory tracts) we probably need to break out of the box and find something new for central pain.

    Are ORL1 antagonists the answer. Who knows. Let us know if suboxone works for you. I doubt you will find very many with central pain who can advise you on it.
    Last edited by dejerine; 01-24-2012 at 04:26 PM.

  3. #3
    Have you tried smoking medical marijuana? Your profile does say California.

  4. #4
    People with neuropathic pain think they have to choose; a life with pain or no pain but be a zombie

    Just try medical cannabis. You're in California ou can try the he's stuff and judge from there if you need a contact let me know

  5. #5
    dejerine,

    thank you for your detailed response. I read through it three times to take it all in. Pain is a complex problem, especially given its subjective nature.

    I did find a couple of other websites where people shared their experiences using subutex for chronic pain. One person mentioned that he uses it for neuropathic pain and it works for him.

    You mentioned that subutex (or suboxone) could possibly work as an antidepressant. If so, would methadone work as an antidepressant by activating dopamine in the same way? Are the two drugs similiar? As I mentioned in the post, methadone gave me energy when I first started taking it.

    In addition to neuropathic pain, I also have back and joint pain.
    I'm going to give it a try and I'll let you know how it works.

  6. #6
    I haven't smoked pot in a long time. I tried it 5 or 6 years ago, not having smoked since I was in my twenties, and it was way too strong for me. Nothing like the good ol home grown we grew up with in the 70s and 80s.

    My father died a few years ago from cancer. Chemo and radiation left him with no appetite and bad taste for food. He was getting all of his calories from Ensures... and he hated Ensure.

    When his doctor said there was no treatment available to help him get his appetite back, I asked about medical marijuana. He gave me a disapproving look and said, "marajuana is illegal!" I knew it wasn't at the state level. So, I got some from a friend who lives across the street from us and has a card.

    On my dad's last birthday, my husband took him out to smoke while I cooked his favorite meal. He ate a whole platefull of food. It was the first time he had eaten solid food in weeks and it turned out to be his last real meal. He died a month later.

    That experience gave me a real appreciation for medical marijuana. But, as for myself, I'm trying to avoid gettng high and avoid gaining weight. Is there medical marijuana that works on pain but doesn't get you high (zombie like) and doesn't give you the munchies? (I'm aging myself)

  7. #7
    Senior Member alan's Avatar
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    I read somewhere that the indica strain of cannabis is better for pain. No medical pot here, so I can't try it.
    Alan

    Proofread carefully to see if you any words out.

  8. #8
    My experience with Subutex for treating my pain (FBSS - nerve damage) was absolutely great. I took 8mg x 6 for 2 years. I was taking 240 mg of oxycodone a day and when I switched to subutex it was just as effective in treating my pain. The only side effect I had was increased anxiety. I definitely recommend it, but remember... you need to stop all your meds for 48hrs or more before you can start it.

  9. #9
    Quote Originally Posted by alan View Post
    I read somewhere that the indica strain of cannabis is better for pain. No medical pot here, so I can't try it.
    I hadn't smoked pot since high school (1982), never really liked it. But being in cali and having a lot of neuro pain I tried it. It was a horrible experience, my pain went to 11 and I spent two hours just praying for the whole experience to be over.

    So I know it works for some people, but for me at least it didn't.

  10. #10
    Senior Member wtf's Avatar
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    Quote Originally Posted by t8burst View Post
    I hadn't smoked pot since high school (1982), never really liked it. But being in cali and having a lot of neuro pain I tried it. It was a horrible experience, my pain went to 11 and I spent two hours just praying for the whole experience to be over.

    So I know it works for some people, but for me at least it didn't.
    In HS I was a pothead (probably why I have a hard time grasping stuff now.) Recently I tried pot again for recreational purposes and I had a bad experience too. My ex said this stuff was really good and I guess it was cuz it really messed me up or maybe I'm just a lightweight probably the latter. I felt dizzy almost ill and my chest got super tight almost like someone was squeezing me really tight. I started to get paranoid and asked my ex when does this shit wear off, he just laughed at me and told me to go to sleep. There was only one positive thing and that belongs in the R&S forum. I couldn't wait for the experience to be over too, I don't think I'd try it again, am glad I don't have pain issues where I might need to.

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