Treating Acute or Chronic Pain While on Suboxone

For people in recovery from opiate addiction, the treatment of severe pain presents some challenges.

Pain management should, ideally, first be attempted with non opiate based analgesics, such as anti inflammatory drugs, and/or with other therapies, such as physical therapy. If such treatments do not control pain, then stronger medications are needed – no one should have to live through pain being denied medication that can control it.

Managing Strong Pain While on Suboxone

Although the buprenorphine in Suboxone is an analgesic, it may not be strong enough to provide relief from severe pain – additionally, because the onset of analgesia can be slow, Suboxone may not work quickly enough to manage acute pain satisfactorily.

Buprenorphine has a very strong affinity for the opiate receptors in the brain. If, after taking buprenorphine, you try to take another opiate analgesic for pain relief, the buprenorphine will block access to these opiate receptors and you will experience no real benefit from the additional analgesic taken.

Because of this:

• Patients needing temporary opiate treatment for severe pain should stop taking Suboxone for the duration of their temporary need for pain management. Once pain becomes manageable with non-opiate based medications, the patient can resume Suboxone treatment. Until the buprenorphine in Suboxone clears the body, patients may need temporarily higher than normal doses of short acting opiates to achieve sufficient pain relief

• Patients needing chronic opiate treatment for lasting pain are not good candidates for Suboxone treatment, and should consider treatment with methadone instead. ¹