<s>[INST] I am on suboxone and have to have a major back surgery my sub. dr will not help me with this cricical situation he tells me I don t need any type of subutex or pain meds im sure I will have to in a ton of pain after do u know know what steps I take next [/INST] well, it isn't our place to give advise counter to what you are apparently getting, nor to interfere with you and the two doctors.And, yes, generally people need a narcotic after surgery. It is tricky in the context of suboxone and the two ways to go are to go with the suboxone or to stop everything at least a day before surgery and to go with conventional narcotics around the surgery then go back to the suboxone afterwards. There is a limit to the pain effect of the suboxone that is LESS than the amount that can be obtained iwth conventional narcotics.And, this is a common context fro tapering suboxone. Someone winds up on 30 or less total mg of oxycodone or morphine equivalents, this is less than 10 mg per day of suboxone. </s>