Hey Fine art, Obviously you see the wide variations in response to different meds, Blue went from 60 mgs of meth to 60 mgs of mscontin and got better relief, would have been chivering like a wet chawawa. She didn't mention how long and if it was long enough to become acomadated to meth. For me I made the switch from 120mgs of meth for a year to 600mgs of Kadian for a year and back to 120 mgs of meth for 2 more years. I increased the last 6 months of meth to 150 mgs a day and that's what they are trying to convert to intratchecal morphine which I'm on about adjustment # 14.
The thing is you can't print out a equianelgesic chart that ays X amount of morphine = X amount of meth and force your doc to follow the guide you found. He may use one of the other many guides that have completely different conversion rates.
The most reccent artricles do suggest that the conversions I have found and used for other meds grossly underestimate the potency of meth. They also explain that those charts are for single dose conversions. I can see where on a single dose the conversion rate would be be smaller because you have no build-up from the previous 5 days doses. With a 24 hour half life, that means every 24 yuor serum level drops by 1/2.
Monday you take 60mgs
Tuesday your still have 30mgs from monday in your sytem plus the 60 on tuesday.=90mgs
Weds, you have 15mg left from monday 30 mgs from tuesday,plus the 60 mgs on weds=105 mgs
Thursaday you have 7.5mgs from monday, 15mgs from tuesdays dose, 30 mgs from wed, dose and 60 from thursday=112.5mgs.
On friday uou take 60 mgs, have 30 left from thursday, 15 left from wed, 7.5 from tuesday and 3.25 mgs from monday, and you have the same serum level as if you were to take 115.75mgs in a single dose.
This is why meth is underestmiated. You can't really compare a drug that has a 3-4 hour half life to a drug that satys with you 5 days.
By the end of the 5th day you have the serum level of twice what a single daily dose would create.
The longer you take it, the more buid up you have and the more acomadated to meth you become.If you only tok meth for a a month, converting would smoother than if you had taken it a year and become completely acommadated to all the aspects of meth.
Docs tend to start on the low side and I would hate for you to come home upset because I think he should start at at least 3:1
5:1 ration works for me from mrphine to meth and back, meaning meth is 5 times stronger too me. 3 doses a day would leave huge gaps in my relief too.
Have you tried taking 15X4 more frequent doseing will give yo smoother coverage and by the end of the day you do have the entire days dose in you and may find sleepning through the night easier.
I hated changing meds too. I never got relief from OxyContin , meth worked well but I sweat so much and it effected labido tremendously, duragesic didn't touch my pain even up 150ugh per day and I gae it a good 3 weeeks to see how it worked. But was use to the relief from meth and just had them switch me back.
If the doc prescribes 60 mgs a 3 times a day and you devide it into 4 doses, who cares? Why even mention it, your daily mg count is the same.
Knowing in advance what ratio worked for one person or another gives you an idea but when yous ee 1:1 and 1:5 depending on the person in this one thread.
The important thing is to be clear with your doc about how long you should give each dose, Just say your concerned about withdrawal and you don't want to half to wait a month sick to see him again.Ask o se him in 10 days to 2 weeks, That's plenty of time to know if morphine is working at that dose, and enough time for most of the meth to leave your system. Meth is stored in fat so it can take a little longer if you have a higher body fat ratio.
PM docs should know they can't look at someone and guess what dose of any med wil work . It's trial and error and docs will be safe rather than sorry, After 14 trys this pump[ adjustment gets oldd, BUt I would rather keep at it tuntill it's right thanb settle now and then ask for an increase in 4-6 months. You can always go up, but if it's too high from the get go, he would be extremly liable. Tell him your concerns and hopefully he will let you know it's OK to call anfor an adjustment.
Good luck. Dave