Chronic Pain

Editors: Mercede Erikson, MD and Camille Adajar, MD
Faculty Editor: Brandon Pruett, MD

Suboxone/Buprenorphine management

  • Can restart home regimen if they have taken their suboxone in the last 48 hours
  • Look at CSMD to verify their home regimen
  • If re-initiation is needed, consult addiction psych
  • Important for patients taking suboxone to remain on the medication
  • If pain is an issue, continue their medication and consult either chronic pain or acute pain service and addiction psych
  • The most effective pain medication while on Suboxone is hydromorphone, oxycodone cannot overcome the receptor affinity of Suboxone 

Methadone management

  • Patients need to be evaluated by addiction psychology service for methadone recommendations while inpatient (often requires QTc monitoring)
  • Patients should be continued on home regimen
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