<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 advice 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 with conventional narcotics. And, this is a common context for 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>