You should tell your doctor prior to any planned surgery that you are on Suboxone use before your surgery. The medication can interfere with common techniques used in operating rooms, and you may need special considerations to help manage your pain after surgery.
Suboxone is both a medication to help treat OUD as well as manage pain. It has analgesic properties and helps relieve pain to a certain degree. However, during and after surgery you may have increased pain control needs, and therefore it is very smart to talk to your surgeon and post operative team ahead of any planned surgery so that you can discuss a plan for your pain management. Depending on your specific case, your doctor may decide to stop Suboxone temporarily, or to continue it but give you additional pain medications after your procedure.
During anesthesia, doctors typically provide high doses of opioids to produce unconsciousness. Suboxone could keep those therapies from working as they might in a sober patient. Therefore it is important to tell your doctor ahead of time that you are on Suboxone so that together, you can come up with a plan for your care both intra-operatively and post-operatively.
Your doctor may recommend the following:
As you determine what to do with your Suboxone dose, your medical team can consider how to keep you comfortable on the operating table. They might do the following:[3]
Every surgery is different, and medical teams often have complex flow charts and rules that help them decide what is best for their patients.[4] Be as open and honest as you can during your surgery planning process so the team can work with you.
If you require an urgent surgery and ou don’t have time to alter your Suboxone, it can be a tricky situation.
Your team has three basic approaches, depending on the level of your anticipated postoperative pain:[5]
Make sure you advocate for yourself! Because Suboxone is a relatively new medication, a lot of surgeons may not be familiar with how best to manage pain in patients on Suboxone. They may incorrectly believe that because you are already on Suboxone, your pain should be controlled without additional medications. This is not usually true. In addition, they may not feel comfortable prescribing you additional pain medications for fear that they will interact with your Suboxone. This is also a mistake – many pain medications can be given along with Suboxone without stopping the Suboxone, safely.
Ask your Suboxone prescriber – either a primary care doctor, a pain management specialist, a psychiatrist, etc – to contact your surgeon directly so they can advise the surgeon about how best to manage your pain needs for any upcoming surgery.
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