Buprenorphine issues during and around surgery.
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from Read more…
I often receive emails from patients on buprenorphine (or Suboxone) who are preparing for surgery or other painful medical procedures. Ideally in such cases, the surgeon would have a discussion with the person prescribing buprenorphine, in order to coordinate the plan for treating postoperative pain. In practice such discussions don’t Read more…
I presented this topic at the Atlanta meeting of ASAM a couple weeks ago. There are too many slides, but the historical stuff was just too fascinating to leave out. I wanted to demonstrate, by lining it up on the side, how time has compressed the most critical discoveries to Read more…
A recent message from a reader: What would be the ideal care-plan for the pt taking 24mg/dayof Subutex who is going in for c section? I would like to show the response tomy OB, so if there is any way, please be specific as to any tapering or substituting of Read more…
I recently resumed writing for the expert forum on addiction at MedHelp.Org. One result of writing for MedHelp is that I receive a number of e-mails from people with questions about specific issues related to buprenorphine. The most common questions are from people on buprenorphine undergoing surgery, asking about the Read more…
I haven’t gone anywhere in case you’re wondering… but I recently started writing a blog on Psych Central, called ‘an epidemic of addiction.’ Please add it to your reading list! This is my favorite time of year and the time I am most likely going to be outdoors, so watch Read more…
A question about Suboxone and Surgery: Hi-this is in reply to your message back to me. I am the girl who is soon to have surgery. You said that 3 days would be good to be off the suboxone, but you said the worst withdrawal takes about 3 days to Read more…
The questions:I am having surgery and my doc was unaware of some things and I thought that you could confirm them for him? Could you advise him to take me off the Suboxone 10-14 days prior to surgery? I have been researching this religously and I have come to the Read more…
The topic of post-op pain control on buprenorphine is important enough to get top billing Many thanks to Dr. J Walsh in Seattle for the following post: I am a physician in Seattle. In two c-section cases we have found that high affinity opiates (fentanyl or hydromorphone) delivered by PCA Read more…
Important enough to move to the front page: HELP!!!!! I’m so confused. I am having surgery on Friday and have been told to stop suboxone(8mg twice a day) 24hrs prior. I’ve taken it for a little over 2 years and it has really changed my life-for the good. Now I’m Read more…
From a patient looking at having surgery: I’ve been on Suboxone sucessfully for three full years, after ten years on everything up to 100mg fentanyl patches every 48 hours for chronic pain. However, it doesn’t work for acute pain, like having teeth pulled. I’ve been on Lortab 10/650 tabs briefly Read more…
A comment from an anesthesiologist: As a practicing anesthesiologist I can only reiterate that communicating with your doctors is key. I have yet to have a patient on Suboxone or their primary doctor contact me prior to surgery. I have had to cancel cases because nothing was done with the Read more…