For those suffering from chronic pain this sets up an extremely dangerous situation. When a patients pursuit of increased pain control drives overuse and abuse of prescription opiates then addictive behavior patterns, overdose, and organ damage become increasingly likely. Due to the current scrutiny these “pain clinics” currently receive, they are more and more frequently turning their longterm patients away through outright discharge from their clinics or reducing patient dosages to even more ineffective levels for fear of reprisal due to wrongful death litigation and DEA investigation. These long term patients are already refractory to the opiate medication due to tolerance (as tolerance increases effective pain control decreases). The effect of this is forcing these patients into the street to fend for themselves causing a myriad of personal problems from safety and legal issues to of course death by overdose and other related illnesses.

Wellness Addiction Recovery Services began using Buprenorphine five years ago in response to this problem based on data published in the American Journal of Therapeutics 2005 titled “Sublingual Buprenorphine Is Effective in the Treatment of Chronic Pain Syndrome” (2005) 12 (5). Malinoff HL, Barkin RL et el. Among other studies with similar findings it was found that buprenorphine sublingual both in singular form (Subutex), and in combination form, (Suboxone) (buprenorphine plus naltrexone), resulted in significantly lower pain scores. In fact, 86% of patients reported improved functional status and capacity, improved mood, diminished sleep disturbance, high patient family satisfaction, and an improved overall sense of well being.

In many instances patients reported significant relief of depression, anxiety, and the “misery” associated with their chronic pain. For the subset of these patients exhibiting comorbid addictive disorders they showed stabilization and the same level of improvement as non chemically dependent patients when both pain and addiction were addressed in a systematic fashion. Furthermore, in these studies, tolerance to buprenorphine was not observed and patients remained on a stable maintenance dose for the life of the study and beyond (one year). Wellness Addiction Recovery Services addresses in a systematic fashion every pain patient on both pain level and an addiction level.

These studies demonstrate the safety, effectiveness, and simplicity of using sublingual buprenorphine to treat chronic pain refractory to long term opiate analgesic therapy. Despite these irrefutable facts, sublingual buprenorphine is not approved by the FDA for the treatment of pain, although the intravenous formulation (Buprenex) has been approved since 1980 and there recently became available a trans-dermal patch similar to the Fentanyl patch. We believe that due to the inherently high numbers of opiate addicted chronic pain sufferers and the well known abuseability of transdermal patch contents and of intravenous drug formulations, a move to FDA approval of sublingual buprenorphine is long overdue. Wellness Addiction Recovery Services has petitioned the department of health to pressure the FDA to immediately approve the use of sublingual buprenorphine for pain. At this time however this form of this medication is still not approved in this country even though sublingual buprenorphine is approved for pain in every country on earth except the United States of America.

All patients are made aware of this "off-label" use of sublingual buprenorphine and give informed consent prior to treatment. Additionally all prospective pain patients are encouraged to bring as many of their medical records as they can for our review. Over the last four plus years we at Wellness Addiction Recovery Services have seen overwhelmingly positive life changing effects of this treatment for chronic pain syndrome.

For further information on how you can break the cycle of increasing tolerance and decreasing pain control inherent to long term opiate use, please contact our office today!