The short answer.
Buprenorphine was originally developed and approved as a pain medication, years before it was used for opioid use disorder. At the doses used in Suboxone treatment, it does have pain-relieving effects — but the degree of relief varies, and it does not work the same way as stronger opioids like oxycodone or morphine.
Many patients on Suboxone report that their chronic pain is manageable. Others find it less effective for pain than what they were taking before.
The answer depends on the type and severity of pain, the dose, and the individual.
How buprenorphine works for pain
A different kind of opioid effect.
Buprenorphine was originally developed as a pain medication. Low-dose buprenorphine products — such as Belbuca and the Butrans patch — are prescribed specifically for chronic pain by pain management specialists. These are separate from Suboxone treatment and are not offered at MyStreetHealth.
At the doses used in Suboxone treatment for opioid use disorder, buprenorphine does have some pain-relieving properties — but pain management is not the purpose of Suboxone, and the degree of relief varies from person to person.
Chronic pain
Many patients on Suboxone find their pain manageable.
A significant number of patients with opioid use disorder also have chronic pain — often the original reason they were prescribed opioids. Many of these patients report that their pain is adequately managed while on Suboxone, particularly in combination with non-opioid approaches.
This is not universal. Some patients find that their pain is less well controlled than it was on their previous medication.
Chronic pain management is best addressed with your primary care physician or a pain specialist, who can work alongside your Suboxone prescriber to find the right combination of approaches.
Acute pain
What happens if you need pain treatment for an injury or surgery.
This is one of the more complex aspects of being on Suboxone. Because buprenorphine attaches tightly to the same parts of the body that other opioid pain medications act on, those other medications may not work as well while you are taking Suboxone. The buprenorphine occupies the space and limits what the other medication can do.
This does not mean pain cannot be managed. It means it requires planning and coordination between your Suboxone prescriber and whoever is managing the acute pain (a surgeon, an emergency physician, etc.).
Options may include adjusting the timing of Suboxone doses, using non-opioid pain management, or in some cases temporarily modifying the buprenorphine regimen. The specifics depend on the situation and should be discussed in advance when possible.
If you are on Suboxone and anticipate surgery or a procedure, let both your Suboxone prescriber and your surgeon or anesthesiologist know in advance. Planning ahead makes a significant difference.
What this means
Pain is worth discussing — with the right physician.
If you have chronic pain alongside opioid use disorder, it is worth raising with both your Suboxone prescriber and your primary care physician. The Suboxone prescriber manages the opioid use disorder. Pain management — particularly chronic pain — is a separate clinical question best handled by the physician or specialist who manages your overall health.
At MyStreetHealth, we treat opioid use disorder. If pain comes up during your visits, your physician can discuss how buprenorphine may or may not be affecting it, and whether a referral or coordination with another provider would be helpful.
Sources
Pergolizzi JV et al. — The Role of Buprenorphine in Pain Management (J Pain Res, 2010)
Review of buprenorphine's properties as a pain medication, including its effects and clinical uses in pain management.
Clinical guidance on managing chronic pain alongside opioid use disorder when the patient is on buprenorphine.
Common questions
Things people ask about Suboxone and pain.
Will Suboxone help my chronic pain?
Many patients find their chronic pain manageable on Suboxone, especially in combination with non-opioid treatments. Individual responses vary — this is something to discuss with your primary care physician or a pain specialist.
What happens if I need surgery while on Suboxone?
Pain management around surgery requires coordination between your Suboxone prescriber and your surgical team. Do not stop Suboxone on your own before surgery — talk to your physician first.
Can the dose be adjusted for pain?
Sometimes. Your physician may adjust the dose or the timing of doses. Because of buprenorphine's built-in limit on how much effect it produces, there is a ceiling to how much additional pain relief comes from increasing the dose — but other strategies can help.