I have received a query about Suboxone. I will try to answer it according to the rules and regulations I know from the College of Physicians and Surgeons of British Columbia. Other rules and regulations may apply to other Canadian provinces.

I have found Suboxone to be highly effective for many patients who have chronic pain. I tend to offer it if my patients have a history of prior tolerance to opioids, which may make them more likely to use more opioids than prescribed. If patients have a history of alcohol abuse or a strong risk of opioid abuse, then Suboxone is safer. 

The person has to be off opioids for a few days to avoid opioid withdrawal before starting Suboxone. The taste is horrendous to some people, but there are tricks that can make it easier, like eating sour candy before, and then holding a sour candy in your mouth while the tab dissolved. Goodness knows why the company can’t make a better tasting drug. Ew. 

In BC, physicians do not need special licensing to use Suboxone for pain. A short, easy course on the College site will enable any family doctor to prescribe it. It is a shame more doctors don’t use it, but I understand how stressed and overworked most doctors are. It may feel to them like just another burden. Perhaps you could ask your doctor to think about it. I think I spent an hour or two on the course – far quicker than the Methadone4Pain course – but the Methadone course is also very valuable.

The College is encouraging virtual visits and most certainly this drug can be prescribed by means of a virtual visit. Again, your health care provider will have to be contacted. 

I have found that patients using Suboxone and Methadone have often ended up using the tools to cope with chronic pain. Once a patient has found the tools that work for them, they may decrease or even quit the medication. Many of my patients have. Not all of them. I feel strongly that docs need to support patients to achieve the best quality of life they can, and if that means using opioids, then YES!

A shout out to rural docs who practice emergency medicine, obstetrics, anesthetics. I realize how hard they work. Less busy family doctors are in a better position to help their patients with chronic pain. Develop a good relationship with your doctor and then try to convince them to learn about these tools. Spending heaps of time with a patient in the beginning almost always pays in the end with a patient who is a perfect partner in care. Someone who makes my work easier and a pleasure.

Good luck. My heart goes out to you. I have a terrible tolerance for pain which is also one of many reasons I started the website. I thank the universe and spirits out there that so far I am lucky enough not to walk in your shoes. 



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