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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
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Experience:  Over 20 yrs of Family Practice
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Question regarding Suboxone and Hydromorphone: A misguided

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Question regarding Suboxone and Hydromorphone:
A misguided gastroenterologist--who treated me briefly during a short hospital stay--recently decided that I had an addiction problem with pain medication, which is NOT true. (I'm being treated for chronic pain due to an incurable and painful bladder illness.) Anyhow, this misguided doctor convinced my OTHER doctor--my urologist, and a friend of hers--who was prescribing me pain meds for my chronic pain that I was abusing them (with NO proof whatsoever, other than her own incompetant opinion).
NOW the urologist I relied on for my chronic pain won't write me any more prescriptions for any pain medicine, despite KNOWING my illness is EXTREMELY painful and chronic. The doctors' behavior is highly unethical...but that"s not why I am here on this website. After dealing with my gastroenterologist, I was given a prescription of Suboxone 8mg (wafer under tongue) and was heavily pressured into taking it, but after about 4 days I quit using it as it was completely unnessasary, and decided to find a new urologist and receive a second opinion because I had been treated so badly by my doctors.
My question is this: I have a few pain pills, Hydromorphone 2mg, left over before this entire fiasco, and I'm in pain...I haven't taken the Suboxone in about a day and a half to two days. Is my Hydromorphone safe to take right now? Plus, I was also wondering if I could take the pill rectally, as my stomach has been SEVERELY upset before by meds like Percocet in the past, and my stomach is a little sensitive right now. OR Perhaps, I can take half of a 2mg Hydromorphone orally and see how my stomach handles it, then take the other half if everything seems to be ok. Please help! I REALLY need some advise here! The pain is about an 8 out of 10, and it's not getting any better. Help!
Hi--I'd suggest you wait one more day before taking the hydromophone just to assure that you don't have a withdrawal like reaction from the Suboxone still being in your system. You could try the rectal route but the absorption would be problematic.
Customer: replied 5 years ago.
I'm can taking my Hydromorphone instigate a withdrawal from the Suboxone when I only took it for a few days? I never needed the Suboxone to begin with.
Sorry for not explaining that. Suboxone is a combination of two medications--buprenorphine and naltrexone. Naltrexone is an opiate receptor antagonist--it blocks the receptor. If it's still on board, taking an opiate may instigate a withdrawal-like syndrome--nausea, shakes, sweats, etc. Considering that you only took the Suboxone for a brief time, this may not happen if you take the hydromorphone now, but I was obligated to warn you about the possible interactions.
Customer: replied 5 years ago.
I'm nervous about the amount of time Naltrexone stays in the system and blocks the receptors. I was never an addict to begin with, so I'm REALLY puzzled as to how I can experience withdrawal symptoms because of these receptors being blocked. Would it be wise to take about 1/4 of the pill at first and see how I feel? I don"t want to get sick.
I don't think you will, and a small dose shouldn't be a problem. Even if you were to feel a little ill, the side effects would only last a few hours and shouldn't be extreme. It has nothing to do with addiction--just a physiological reaction to the two medications together.
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