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"Buprenorphine for Pain Management" - Michael M. Miller, MD, DFASAM, DLFAPA
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When people find out I take bup (suboxone) they automatically assume I have a drug problem. I served 4 years, 2 deployments in the US Army, and my back is destroyed. Pain management tried all sorts of different opiate pain killers that just made me high as as kite and completely non-functional, not to mention they barely worked. I tried suboxone from a friend once, and it took all of my back pain away, without the inebriation. The sad part is, I couldn't get insurance to pay for it as a pain killer. I had to go to recovery clinic to get insurance to pay for it. Just shows how insurance and pharma companies really run the world. I wish more people knew about buprenorphine, and more Doctors would prescribe for pain, and most importantly, that insurance companies stop dictating what they think is best for a patient.
Word up it works better than prescription opioid to me
Thanks for sharing brother… glad it’s working for you… I suffered with the ups and downs of a short acting opioid for chronic back pain for years before finally a nurse practitioner offered me the Buprenorphine. It’s been great, no negative effects except for what I feel is an analgesic ceiling ( just have to add an ibuprofen 800 on bad days)
Similar situation here. Pain management where I live required a contract, 2 appointments a week, and a 4 hour window to make it to the clinic if you're called for a random drug screen and bottle check.
The health clinic on the other hand started with bi weekly appointments, and no restrictions other than hard drugs. Oh you smoke weed? No problem. You like to knock back some drinks on the weekend? Go for it.
Weird how that goes.
Is that similar to buprenorphine, and does it actually give you long time relief?
@@stevesauck7001 yes it IS buprenorphine, and yes it works very well. As I said above, when I started out I was going to a pain management clinic that specializes in opioids. They had to keep giving me stronger and stronger prescriptions of them going through the gambit from vicodin, percacet, to oxycodone and morpine. All the while I was completely non functional being high as a kite just to take the edge off my pain. I tried suboxone from a friend who had it and it's like a miracle. To this day I barely take much at all and 1 dose takes my back pain away ALL day. Which beats having to take 2 to 3 pills 3 to 4 times a day. And I'm 100% sober and functional, no "high" what-so-ever, not even drowsiness. They NEED to make buprenorphine available as an analgesic- this doping everybody up on opiates has to stop. But, we all know big pharma has an agenda and it's NOT to make people well. Just to make profit off of them, in as many ways as possible.
Thank you for making this presentation available for wide consumption. As a prescribing PA in a PMR clinic, this information is invaluable. I see many long-term chronic pain patients that are appropriate for bup, I now feel better armed for those discussions. Thank you Dr. Miller.
I’m on 24 mg SL per day for chronic joint and skeletal pain. I find that the bup. Works better that the very high doses of morphine/ oxycodone that I’ve used for 20 plus years. I just moved 2000 miles from my pain doctor and very concerned about being able to find a doctor that understands all this. I’ve had many doctors thinking I’m drug seeking. I never had opiate use disorder but most doctors assume the worst.
This has been very enlightening. Thanks very very much!
Ken
Yeah Ken, especially with the so called opioid epidemic, they treat anyone thats on pain meds as an addict or potentially one... so they lump us in together with a tweeker on the streets.
I have been on it since 2008 and I am maxed at 32mg but it still works. Even worked for acute pain after elbow replacement.
I moved from Ohio to Florida and they couldn't see ANY prescription history unless I went to corporate. Went to mom n pop pharms and was fine. But it took a sour turn
My Butrans patch 5mcg rx was denied by my Medicare Part D. My PM doc is doing a Prior Authorization. I have multiple autoimmune disorders and pain is 24/7. Praying it gets approved.
I hope it was approved 🙏🏻
@@ronnie-lynn Actually, it was but I’m not using it. My rheumatologist advised not to. My methotrexate dose was increased and weaning off steroids so I can use naproxen again, within reason.
Yea our government regulations are ignorant and alot of them make no sense, idk what we need to do to get them to change.
Thanks for sharing your information. My pain management has put me on this medicine and I feel so much better cause I have chronic pain 24/7 but so far I haven’t been in pain & it’s been a week. I enjoyed y’all conversation so I fully know more about this patch .Again thanks so much.
I have severe back conditions I have been on 60 mg of methadone daily and subutex 8mg 3 times daily in my opinion subutex is better for pain it worked better for me I believe the only reason its a partial opioid is because the euphoric effect is taken out not pain control because subutex works
Do you know that only a tiny percent of people feel this euphoria? How did they take that out? WHAT did they take out? This is the world answer to treating pain patients and treating drug addicts! More information please 🙏 🙂
Buprenorphine works well for pain. At least for me.
Unfortunately the DEA scares the crap out of doctors because they do have the power to arrest them for whatever trumped up charge they want. I don't know how the government can cruelly cut legitimate patients for no reason (My doctor passed away). My dosage was cut immensely and now I suffer on short acting oxycodone which I do not like at all. Thank you for this, I pray my doctor listens when I ask about bbuprenorphine.
They need to get educated as the injustice has to stop! I have stenosis and started from 5mg patch and went to 7.5 mg and will go up a bit more but I have better pain relief than all the other garbage they put me on, the pain management failed me, they had me so drugged up I couldn't barely put out of bed and still was in pain and ended up going into the emergency room 4 times. What was their solution? Increases the garbage drugs EVEN MORE! I Couldn't even function on the nerve pills they gave me plus muscle relaxers plus ibuprofen 800s. Just blasting the hell out of my liver and kidneys taking multiple drugs and then they want me to increase the dose! DONE! One patch took care of everything better than all the others put together. They are not going to kill me! The patch is way to go start small and go up until you are pain free. The first thing I noticed with the patch is depression went away, woke up with energy and not tired, I could think again and act normal and function normal for the first time in a year. I will writing to the doctors about my experience and they need to start helping people with treatments that are better and work instead of drugging them with multiple drugs that don't even kill the pain that are toxic to your organs and kill your ability to function like a normal human being! The entire medical system needs to be redone and educated and more helpful to the people instead of a cash cow and treat you as a number.
Keep helping pain patients.
You know. Everyone is different "Always". Its hard to find identical twins thats have the same body chemistry completely.
Why should any doctor think we are clones? #cattle
Its network medicine and big insurance. Wake up! Time to beat the knee caps off a couple giants i say! Size them down a bit!
Agreed! I've often thought to myself I wish one of these "higher ups" could watch a loved one, or experience chronic moderate to severe pain themselves. Sick thinking I know but maybe then something would get through.
OMG I can't even concentrate on what he's saying bc all I hear is uh um uh um uh um... PET peeve sorry
Same here😢
great talk. can anyone postt the bibliography?
“The DEA doesn’t have that authority.” Tell that to all the terrorized doctors out there. They barge in and take all their hard drives! The Guidelines are enforceable, which is a misuse of the English language.
I am on 100mg of tramadol per day for chronic pain. Can I switch over or do I have to go cold turkey for a few days first?
I'm not a doctor. I'm a patient. I am pain management in Arkansas and on Butrans patches at the highest level 20mcg. I also have to take three Norco 10-325s daily for breakthrough pain. Along with Gabapentin 600 mg three times daily and Flexeril two 20 mg daily. I need to get a hip replacement in the next month, also a total knee replacement and a disc replacement after that. I'm just wondering if I still have the 20 mcg patch on after surgery will the pain medicine be as effective? I'm on the Butrans for pain not addiction.
How did the surgery go KJ?
Try kratom
The first caller was thinking of the combination of bup and naloxone (i.e., suboxone).
Why are there no links to the research? Bummer!!
Doctors prescribe something called belbuca(buprenorphine). Indicated for pain not off label.They run in sizes 75mcg to 900mcg (MICROGRAMS)there's 1000mcg in 1mg,that means it would take 10 of the largest belbuca to equal one 8mg Subutex/Suboxone and it would take over 100 of the 75mcg belbuca to equal one 8mg Subutex/Suboxone.Its said to be absorbed 10% better but why make it 100x smaller and cost 10x more than subutex.So what your getting is the same old drug branded with a new name so they can charge 10x more with a very tiny amount of medicine in it compared to the original formulations Subutex/Suboxone.How is this helping anybody other than the people who make the shit and the doctors they push to prescribe it.
is Buprenorphine the same thing as bulbuca?
Thanks for the breakdown
That's why I'm telling people to go to a Suboxone clinic if they are already going to pain management it's pretty easy to get into a suboxone clinic in most states all you have to do is test positive for opiates in your urine and you qualify. I have Medicaid and was first approved for pain management and after doing that for several years it was super easy to switch to a suboxone clinic when I found out about it. As an opiate patient you already qualify the same as a heroin addict would, you just came about your addiction legally. And suboxone is approved for lifetime use so there's no time limit for being a suboxone patient.
@@jeffreymcgill4075Yes it is.
@@jeffreymcgill4075 yes exactly
My insurance covers mine and l use suboxone for pain management
This guy says UMMM UHHH UMMMM UH UHHH Ummmm WAY TOO MUCH. Very frustrating. But useful info thanks
I didn’t realize till you said
What's better for long term pain morphine or Subutex ????????
Subutex ...
Subutex
Buprenorphine, well both but Buprenorphine will last longer. Just make sure there's no naloxone
@@Bettinasisrgcurious why you say leave out the Naloxone? My film is 8mg .2 mg. I was not an opioid user prior to starting Buprenorphine and Naloxone. I ask my doctor to take it off and and it made me anxious so he added it back to the script.
How can you get off long acting morphine to get on subs with no withdrawal?!
Most of my pain is in my low back and left ankle (chronic wound with neuropathy - non diabetic). Where on my body can i put a Buprenorphine patch for Pain Management? Thank you for your reply and video.
Great information.
I take a generic sublingual 6mg for pain. It works so well! But yeah people think I'm a junky or something.
MAYBE I AM! HAAHAHAHAHHAHAHHA
But it really works
So many ummmmm’s
Great information, but every other word from the speaker is “Uhm”.
I guarantee if one was to have a drinking and everyone took shot every time the speaker said “Uhm”. It would take 90 seconds before everyone would be inebriated.
Cowboys used whiskey
“Ummm”. “Uhhh” “And uhhh” “And umm”.
I stopped counting at 600. Genius. Clicked on this for info. Got anxiety and uhhh. And ummm. Annoyance. Uhhh
It destroys your TEETH
The patch or just the oral film
True!!
Not if you brush them
@@xglitterkissedx79 oral film
@@EaselCat lol
“Ummm”. “Uhhh” “And uhhh” “And umm”.
I stopped counting at 600. Genius. Clicked on this abortion for info. Got anxiety and uhhh. And ummm. Annoyance. Uhhh:
Also might I add that everyone commenting this far is a James😆
my name is james lol
That right
Can u get high from this medication. I hurd it is safe and u cannot
Uhhh..uhhh..I can't..
Kratom 👌
Kratom? Helps well with withdrawals!
@@jerodcullers171 I've heard this- and I figure this is why it was outlawed in the state of Alabama- interfering with that sweet rehabilitation money. They also decided to let the state DEA pretty much run their Suboxone clinics now- now they're throwing ppl out of treatment for smoking pot. That's not a lie or an exaggeration and you did read correctly- the state of Alabama is currently as we speak throwing ppl out of opiate addiction treatment because they smoke marijuana. They do taper you off but, it's a very aggressive taper and you can expect to be treated very badly while they do it. And if you object or have anything they interpret as "smart" to say about it- they'll just throw you out without the taper.
Not here in Pa at crossroads, i got my license. They dont care for some reason. Maybe its diff in diff states but yes ive heard about getting kicked out its not right. Im tapering at 1 in am and half at bedtime
I tried many brands, capsules, powder and never worked for my nerve pain. I hear it does work though.
Buprenorphine is the only medicine that has helped my pain. I wish more people would take this instead of oxycodone & hydrocodone.
i take soma benzo and have take sublocade shit
22:00
Too many umm's!
Suboxone works so much better for me than Tramadol. 4.1mls once every 2-3 days.
A paper bag and a watch will do the same thing. Control your breathing, focus your attention on the watch. Record the time this controlled breathing took to control or reset the anxiety attack. Although a paper bag may be too conspicuous and breathing into a medical looking devise that costs much more may be more helpful to some.
Biting on a willow stick while shouting obscenities enhances the paper bag / wristwatch technique.
Doesn't work. Stop pushing stupidity on people