Surgery while on Suboxone: Need to Know?
You’re trying to make your life better. You’re overcoming your addiction with the help of Suboxone, and your life is finally starting to become manageable. And then you find out you need to have surgery. No big deal, right? Well, if you’re on Suboxone, there’s some things you need to consider before going under the knife.
Suboxone Is an Agonist
Suboxone is a combination of two different drugs. Buprenorphine is an opiate agonist, meaning it binds to the opiod receptors in the brain, and mimics the body’s natural pain killing chemicals. This means that there is a certain level of pain control associated with Suboxone, but not that which is always appropriate for both during a surgery and for post-operative care, especially for those with a history of opiate addiction.
While other opiates can be used, such as Vicodin or morphine, those on Suboxone typically have a rather high opiate tolerance and the threshold of pain management needed may be difficult to meet.
Suboxone Is an Antagonist
Suboxone also contains naloxone, a drug that is an opiod antagonist. Naloxone blocks the brain’s opiate receptors and does not allow other opiates (other than buprenorphine) to bind. For those who take naloxone, if other opiates, such as heroin or morphine are taken, they’re unable to bind and therefore ineffective.
For the addict, this stops the compulsion to use, but for those in recovery who are in need of surgical procedures, naloxone can cause a difficult situation as its use needs to be halted before surgery can take place. It’s important to have all the naloxone out of your system for other pain medications to work.
Talk to Your Doctor
Before you proceed with surgery, be sure to talk to your doctor about taking Suboxone and get his or her recommendation. Some doctors may switch you to naloxone without the blocker, and drop your dose slightly. Others may want you to taper down, than cease use the day before surgery, allowing your body to be receptive to other opiates administered.
Once surgery is complete, it will then be determined if you should continue with a pain management regimen or return to your regular Suboxone dose. Once Suboxone is taken, it’s important to remember that other opiates cannot be used. That’s why some physicians and surgeons prefer to taper off, giving you more post-operative options for pain control.
Yet this has its own risks. Suboxone should not be administered when any other opiates are in the body. Naloxone is stronger when it comes to opiod binding and if other opiate drugs are still active in the brain, taking Suboxone can throw you into severe withdrawal. In a post-operative situation, this is not only uncomfortable, but can be extremely dangerous as well.
Over the counter medications such as naproxen and ibuprofen can be surprisingly helpful for post-operative pain, and while often overlooked, should be considered to help with pain management.
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