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Old 07-13-2012, 02:34 PM   #1
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Question Morphine detox

I have been a pain management patient for 4 years. I take 100mg morphine ER every 8 hours. I also take 60mg morphine IR every 8 hours.

During my last visit to the doctor he told me that I had reached the max for oral prescriptions (no increase). He gave me 2 options.

1. get a morphine pump
or
2. 60 days of detox for my body to 'recalibrate'.

My concern is the detox portion. I asked about that and was told that was no problem as they would provide 'patches' to get me through detox. He did not tell me what type of patches he was talking about! I was so much in shock that I forgot to ask.

Has anyone had a similar experience?

I realize I will be in great pain (again) for 60 days but my concern is the detox and what to expect.

thank you

 
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Old 07-15-2012, 06:36 PM   #2
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Re: Morphine detox

Quote:
Originally Posted by unclejehu View Post
I have been a pain management patient for 4 years. I take 100mg morphine ER every 8 hours. I also take 60mg morphine IR every 8 hours.

During my last visit to the doctor he told me that I had reached the max for oral prescriptions (no increase). He gave me 2 options.

1. get a morphine pump
or
2. 60 days of detox for my body to 'recalibrate'.

My concern is the detox portion. I asked about that and was told that was no problem as they would provide 'patches' to get me through detox. He did not tell me what type of patches he was talking about! I was so much in shock that I forgot to ask.

Has anyone had a similar experience?

I realize I will be in great pain (again) for 60 days but my concern is the detox and what to expect.

thank you
Wow!!! Detox for 60 days so your body can recalibrate, huh? I am sorry that you have to go through this. I also apologize because I have never went through that with my pmp. But I guess my question is if you don't mind answering....what is your dx that you are receiving pm. I am kind of shocked because I the medications and the doses you are on is not as high as many. Maybe that is what your doctor feel he is comfortable with prescribing you. But regardless the reason I ask what your dx was is because depending on what is wrong with you, you may not be able to go 60 days without some sort of pm. You said the pmp would give you patches. What type of patches? That is something you need to find out. It all depend on how bad your pain is and how much you can handle. Is the Pain that you have is this something you are going to be dealing with permanently? The best thing you could do for your body is to do a opiate vacation. That is something I had to do because I couldn't get the pump due to my disease. My doctor wanted me to get the pump but I ended up getting diagnosed with another illness right before time for the surgery. Lucky me! But all things happen for a reason I guess. Basically this is your decision and what you are comfortable in doing. Let me know what you decide. I would love to keep in touch. Muah!
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Old 07-16-2012, 05:35 AM   #3
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Re: Morphine detox

I had a pain pump that malfunctioned and my pain mgmt doc called in clonidine patches and some klonipin (like valium) - told me I was going through withdrawals and to call them in 10 days if the patch and klonipin did not help.....

They did not seem too upset that my pump had ceased to work and that I was in the throws of severe withdrawal - and they would not see me as an emergency patient - they insisted they would not see me for at least 10 days.

It is up to you what you decided to do - it sounds like the pain pump would be a great option for you if your body needs that much pain medication -

Questions to ask your doctor regarding the pain pump -
What medication or medications will he put into the pump?
What concentrations or amounts to start and how often will he increase in the beginning to find what works for you?
Are there upper limits or caps on the amounts of meds he will put in the pump (like what is happening with you now?)
What happens if you reach the cap or the highest amount of a pain med in the pump?
Will you get oral meds for breakthrough pain while on the pump?
How much oral medication will he give you - will there be limits like the ones you have currently reached?

Also, find out what happens if you need emergency care regarding pump issues - I had several emergencies throughout the years when the wrong meds were put into my pump and I had severe allergic reactions etc and my local hospital would not treat me - until the pain mgmt doctor was contacted and my pain mgmt doc did not call back for 3 days -

So make sure you know who to call and where to go if you decide on the pump.

As far as detoxing for resetting your pain levels - it is a good idea. If you did a slow taper you would be in so much pain for a much longer time....believe me I know. Doing a 60 day detox is a good way to go.

The way narcotics work is that the more you take the more pain you feel - sounds crazy but scientifically it is what happens. That is why your body thinks you need more and more of the narcotic to help the pain....your body's chemistry changes and the way the brain perceives pain is dramatically changed.....

Taking narcotics short term after surgery or an injury is okay - but once you start to take them everyday for narcotic maintenance therapy - your brain develops a dependence and so does your body - and then it takes more and more to narcotics to control the pain.....

Many pain patients take a drug holiday - which means that they either are asked to reduce the amount of meds or change them altogether so the body does not get "used" to one drug or dependent on one drug.....changes them up or reducing the amount can reset your body/brain chemistry also.....

Whatever you choose to do - do your homework and research everything before you decide.

Hope some of this helps.

Powergrub

 
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Old 07-16-2012, 07:11 AM   #4
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Re: Morphine detox

Quote:
Originally Posted by luvinmusiq View Post
Wow!!! Detox for 60 days so your body can recalibrate, huh? I am sorry that you have to go through this. I also apologize because I have never went through that with my pmp. But I guess my question is if you don't mind answering....what is your dx that you are receiving pm. I am kind of shocked because I the medications and the doses you are on is not as high as many. Maybe that is what your doctor feel he is comfortable with prescribing you. But regardless the reason I ask what your dx was is because depending on what is wrong with you, you may not be able to go 60 days without some sort of pm. You said the pmp would give you patches. What type of patches? That is something you need to find out. It all depend on how bad your pain is and how much you can handle. Is the Pain that you have is this something you are going to be dealing with permanently? The best thing you could do for your body is to do a opiate vacation. That is something I had to do because I couldn't get the pump due to my disease. My doctor wanted me to get the pump but I ended up getting diagnosed with another illness right before time for the surgery. Lucky me! But all things happen for a reason I guess. Basically this is your decision and what you are comfortable in doing. Let me know what you decide. I would love to keep in touch. Muah!
**************************************** *****************
Thank you for your answer: I was so much in shock that I didn't get the name of the patches. I will see him again Aug 10 and will have a list of questions for him. I will get back to you when I find out more info.

 
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Old 07-16-2012, 09:19 AM   #5
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Re: Morphine detox

can i just ask you what in the heck prompted him to do this TO you? while you can run into kind of a 'max limit' that any particular pain clinic has set as 'their' policy when it comes to just how far up they will go with THAT particular narcotic, to cut you off ANY prescriptions, esp with severe chronic pain, is in my mind a wee bit insane. at my PM i have been on oxycontin since i started there back in 04. but i am getting closer to what 'their' particular 'max limit' of 300mgs per day actually is at 300 mgs, thats as far as they go with THAT LA narcotic, BUT will have you try others if that should happen. using other methods of pain control also has allowed me to stay at the same dose since 05. i just seriously feel that switching you to another would make MUCH more sense than stopping you completely. it has been shown that when docs do do this to most pateints by giving them that lil sick 'holiday" from narcotics, it does not take very long and everything ends up kind of the way it was PRE holiday. so in the long run, the patient kind of goes thru pain hell for no reallly good reason.

i really do doubt that what he is saying about 'recalibrating' you is even a real 'thing? i have heard of certain PMs doing the 'pain med holiday crap, which i also think, considering you just DO NEED appropraite pain care is kind of stupid, and rather inhumane as well.

what i am wondering is why did he just not temprorarily switch you to another LA form and SA form of narcotics like with oxycontin and roxicodone for BT pain? oxy is also, if you go mg per mg when converted, actually stronger than MS. so your coverted to oxy would indeed be less than you are taking right now,but much stronger at hitting your overall pain. i am also kind of confused about the IR 60 mgs every 8 hours when that is a pretty high dose of the immediate release too? i just am having some trouble trying to figure out this pain docs reasoning in many ways. what does he expect you do actually 'do' about treating your actual overall chronic pain during this little holiday of recalibration? that is what i would be concerned with. he HAS to help you out here with some form of "appropriate pain care".

if you cannot get 'appropriate" pain care thru this PM, i would seriously consider trying to find another,. maybe you CAN try talking to him about trying oxycontin which has worked pretty well for me for many years or another LA form. but of course this is all up to you and what YOU really truely feel IS the best for you overall. just becasue a doc wants to do or try something with any patient, does not always mean that it is a good idea, or even in the patients best interest. if you talk to him and he tells you that you would be tolerant to every other possible LA narcotic or oxy, that is NOT true at all, just so you know. i would tell him that YOU would like to at least give it a try anyway so YOU can judge that one for yourself.

i just really do not want to see anyone have to suffer needlessly because of something stupid that trust me here, not all PMs believe is even IN the patients best interest. my PM does NOT do this to their patients, thank god. just being forced to go without what keeps one going/productive and able to actually even "do' in their lives, or to simply even move actual body parts without suffering screaming pain, that just sounds soo wrong in so many ways to me. but this is of course my own opinion. i just think there are better ways to go about this type of thing. good luck with whatever you decide. marcia
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Old 07-16-2012, 02:36 PM   #6
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Re: Morphine detox

Quote:
Originally Posted by unclejehu View Post
**************************************** *****************
Thank you for your answer: I was so much in shock that I didn't get the name of the patches. I will see him again Aug 10 and will have a list of questions for him. I will get back to you when I find out more info.
Something else I thought about that may help you and your pmp. Do you keep a pain diary? If not, I think you should start like right now. Write down what you are doing when you start having pain, the time, what meds you are taking and how much? Keep a chart of it for like maybe a week or so and see if you have a pattern. Maybe it's something that you do that makes the pain worst. Or a certain time a day. You also didn't say what your dx was that you are on the morphine? If you don't want to answer that, I totally understand. I just wanted to see if it is any future that you may not need to take these type of medications. I do agree with feelbad when it comes to your pmp making this decision all of a sudden. I have been under pm for years and I take Fentanyl (which is 100 times stronger than morphine). I also have meds for BT pain. So it does sound kind of shocking that your doc saying that is the max they will go. Like I said maybe that is as far as he is willing to go. Its just if you are in some real pain and you are having health issues that he would try and do something else. From what I have heard and read on the pump you should def do some research before going through with that. Make sure that you are not left out in the cold if something goes wrong with it. Those are things you would like to know. I look forward to hearing from you after your doc appointment but in the meantime maybe you should try the pain journal for the next week or so. Talk to you soon. Muah!
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Old 07-17-2012, 09:05 AM   #7
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Smile Re: Morphine detox

Quote:
Originally Posted by luvinmusiq View Post
Something else I thought about that may help you and your pmp. Do you keep a pain diary? If not, I think you should start like right now. Write down what you are doing when you start having pain, the time, what meds you are taking and how much? Keep a chart of it for like maybe a week or so and see if you have a pattern. Maybe it's something that you do that makes the pain worst. Or a certain time a day. You also didn't say what your dx was that you are on the morphine? If you don't want to answer that, I totally understand. I just wanted to see if it is any future that you may not need to take these type of medications. I do agree with feelbad when it comes to your pmp making this decision all of a sudden. I have been under pm for years and I take Fentanyl (which is 100 times stronger than morphine). I also have meds for BT pain. So it does sound kind of shocking that your doc saying that is the max they will go. Like I said maybe that is as far as he is willing to go. Its just if you are in some real pain and you are having health issues that he would try and do something else. From what I have heard and read on the pump you should def do some research before going through with that. Make sure that you are not left out in the cold if something goes wrong with it. Those are things you would like to know. I look forward to hearing from you after your doc appointment but in the meantime maybe you should try the pain journal for the next week or so. Talk to you soon. Muah!
**************************************** *****************
Thank you for your input: Yes, I do keep a pain journal as well as a notebook that I annotate for each dose whether morning, afternoon or night. Yes, I'm beginning to think the DR is more interested in selling a pain pump rather than switching me to fentanyl or something else. I will be getting a second opinion next week from another pain dr.

I take 100mg ER and 60mg IR morphine every 8 hours. I have had two fusion surgery's. One on my neck which worked out very well. The last was L4/L5 fusion. There is the problem. All my pain goes from the surgical site to my tail bone. Sitting for extended periods or light lifting aggravates my pain. I can walk (to keep in shape) as long as it's a flat stretch.

Is the fentanyl in patch or pill form?

thank you!

 
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Old 07-17-2012, 02:10 PM   #8
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Re: Morphine detox

Quote:
Originally Posted by unclejehu View Post
**************************************** *****************
Thank you for your input: Yes, I do keep a pain journal as well as a notebook that I annotate for each dose whether morning, afternoon or night. Yes, I'm beginning to think the DR is more interested in selling a pain pump rather than switching me to fentanyl or something else. I will be getting a second opinion next week from another pain dr.

I take 100mg ER and 60mg IR morphine every 8 hours. I have had two fusion surgery's. One on my neck which worked out very well. The last was L4/L5 fusion. There is the problem. All my pain goes from the surgical site to my tail bone. Sitting for extended periods or light lifting aggravates my pain. I can walk (to keep in shape) as long as it's a flat stretch.

Is the fentanyl in patch or pill form?

thank you!
The fentanyl is a patch. It comes in different doses and your skin absorb the medicine in. It suppose to last for 72 hours but alot of people (including me) change the patch every 48 hours instead. Depending on how your pain is and what your pmp want to do. If you don't feel that the doctor has your best interest at heart start looking for another pmp. Just remember don't take any rx or sign any contracts before canceling your previous doc contract. But if you are fine with your doc make sure you talk to him and exhaust all options before going through the pump. Let me know what they say. Muah!
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Old 07-18-2012, 09:52 AM   #9
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Thumbs up Re: Morphine detox

I will certainly reply when I have my next appointment. I'm familiar with fentanyl (sp) patches. I was given for post op pain when my cervical discs were fused. They worked amazingly well.

As for now, I see my primary care doc tomorrow. Next week I have an appointment with another pain doctor (second opinion). I am relatively happy with my pain doctor.

The problem with finding a new provider is that we have so few in this area.
I drive 40 miles to see my current doctor. The other pain doctor (who did a series of procedures on me in the past) is 60 miles away.

Time will tell. Thank you for your encouragement and advice.

 
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Old 07-19-2012, 01:33 AM   #10
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Re: Morphine detox

Yeah that is the same problem I have in my area. I have to go a hour away to see my pmp, and my rhuemy. I dread it. Especially because I have to get someone to take me. Sucks big time. But I love my pmp and I refuse to go somewhere closer and then the new pmp is horrible. It's hard to find a good one. So when you do, you hold on to them. As you already know, you are in my prayers and I will talk to you soon.
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