Discussions that mention morphine

Pain Management board


Hello, all:
I have just started on Methadone. I have been on all (that I know of) LA opiate's. I just have some question regarding Meth. 1)st. I was taking MS Contin 100mg 3xdaily. and my new PM doc put me on Meth 20mg 4xdaily. I have been on it for seven day's now, and I can't sleep and feel "icky" like when I used to accidently go 12hr or more without taking my MS contin. Is it going to take awhile for the Plasma levels to level out were I am doing okay? because I think I read that dosing from morphine to meth is 5:1. Anyhoo, I have not slept more than 30min at a time since I have started, and I have been on everything and never had this problem. Also, I know Meth is for nerve pain, and It seems to be helping, but know my actual bone pain is starting to hurt. Does anyone hetre use a BT with methadone? My apologize for the bad grammar on this post, I hope I can update this with a couple more quetions when I have time too, Thank you so much in advance.
I Used meth for several years prior to the pump and use the same BT meds I use now. THere is a misconception that meth negates the effect of other opiates. It doesn't negate the anelgesic effect of other opiates but it will deminish the euphoria caused by BT meds or heroin if on meth for addiction maint. Not that some addicts on MM don't still do it, it just takes a much greater amount which makes using a drug to get high while on meth very dangerous because of the need to greatly increase the dose of the med an addict would use to get high on which compounds the respiritory suppresion both drugs cause. As far as finding an apopraite BT med, as with any LA med, the SA med has to be proportional to the dose of LA meds. If your taking several hundred mgs of morphine, then 1 vicodin would just be a drop in the bucket and not cause an increase in opiates significant enough to be effective. The rule of thumb is usally 20-30% of half your daily dose for BT pain. If your taing 100 mgs of MSC twice a day, 20-30 mgs of SA morphine would be the apropriate BT dose.

It takes 5 days to reach steady serum level. As far as 5:1 conversion from morphine, that's what worked for me, but the reason why meth isn't used as a first line drug is because of the unpredictability of patient response. One patient may do great with a 10:1 conversion and another may need 3:1. It produces the widest patient response of all opiates and this is why it didn't gain popularity after it's invention as a synthetic pain reliever. So just report it's effectveness like any other med, docs usually understand that everyone doesn't convert the same and you may need additional adjustments.

As far as sleep, you have to treat the particular problem it's causing, if your constantly being woken by jerking and twitching, the aproach to better to sleep is to treat it like wrestless leg syndrome. The 30 minute cycles make it sound moe like this type of problem where meds like Mirapex, Requip or Klonopin would be more effctive than conventional sleep aids to induce sleep. If you have a partner to ask, it makes it easier to DX and treat the sleep problem. Otherwise you can waste alot of time and money on sleep aids that won't be effective at keeping you asleep. If you don't have a sleeping partner, you might want to video yourself which may prove to be very informative.

In general opiates and CP cause sleep problems anyway, regardlss of the med or sleep aid it's been 6 years since I slept more than 4 hours straight.
Good luck, Dave
Hi Everyone,

This is my first time on the list. I've been on 100 mg. of Methadone a day for chronic back pain for 2 years. It has been very helpful, but has side effects. I'm currently scheduled to have a Morphine Pump surgically implanted and am concerned that the transition from Methadone to Morphine may be hell. Doesn't Methadone block the effects of Morphine? If I try to ween myself down from the Methadone prior to surgery, my pain goes up. Has anyone gone through this? I would appreciate your advice, suggestions, or experiences.
--Steve
Shouldn't be a problem Steve the conversion is 4to1 so your 100mgs of methadone turns into 400mgs of morphine.Why are they switching you to the pump when as you say the methadone works well for your pain.The reason I asked was I was onopiates for 22 years with the last 10 or so on morphine.I found that my tolerance went sky high with morphine and by the time I switched over to methadone I was taking 3 000mgs of morphine a day (30 greys (100mg pills)).......Dave
Dave,

I'm switching to the Morphine Pump because the dossage is 300th due to it's introduction at the site of the pain, rather than having to take the amount orally that would deliver an equivalent amount to the source of the pain. The one person I know who did the same thing hasn't had to raise their dossage of Morphine dossage in six years and to see her is to know she has her life back. --Steve