Discussions that mention morphine

Pain Management board


Welcome!

You've come to the right place for compassionate support and info.

What you're experiencing is totally normal, and it is as you guessed - tolerance.

I happen to agree w/the doc that methadone may be just the right thing. And it has a special quality that kinda halts tolerance. Getting off of it is like with other opioids, go slow and taper. I was switched from meth to morphine and was real worried about withdrawal, but had none. So now, if I go off narcotics it won't be from meth. I recommend this process for others when it's time to stop opioids and one is on meth - switch to morphine first for awhile, then taper down.

FWIW, I found meth to be the best pain med I've ever used. You seem like a perfect candidate.

steve
Hello pain2004:
I know that there are several LA(long acting) medications that could be used besides the fentanyl patch. There are several different forms of morphine including Avinza, Kadian, and MS Contin. There is also Opana(oxymorphone) which is a pretty powerful long LA med. There is Oxycontin(oxycodone) as well although doctors sometimes are hesitant to prescribe it. And then there is Methadone which you seem to be a little hesitant about trying. I try to think of it as just another drug that is used for pain management, which it is. I think of it as merely a prescription pain medication and yes it has a dual purpose for treating heroin addicts. You might want to print this thread out for reference so you can ask your doctor about them. I believe the Avinza is a once daily form of morphine which makes it nice to not have to take too many pills although the other medications are taken 2-3 times per day. Hopefully the PM doc can get your pain under control. There are always options so don't be scared that it can not be treated. I am 34 years old and currently on the fentanyl patch with Percocet for my Bt med. I was also very scared that once I started on a strong LA med that my tolerance would sky rocket and what would I use say 20 years from now. However, the many people on this board who are knowledgable have calmed my fears, or at least some of them:) Please keep us posted on how things go with the appt and what meds you are switched too.

brian

p.s. You really do not need to be sharing what medication you take. You never know who is interested in taking your meds or who may be a drug addict. Trust me, sometimes you have no idea who is an addict.
Pain2004,

You have got a lot of good responses. The first thing I would like to say is that there is no ceiling to opiate meds like oxycodone, morphine, fentanyl. Unless they contain something else like tylenol. The only ceiling would be side effects. So in other words for some, a certain mg will work and for others it takes much more. That doesn't mean your a junkie or addict. It just means your body requires a different amount. There are people on this board that take 20 mg of Oxycontin twice a day and other that take 240 mg daily.

Like Brian said, fentanyl can cause your tolerance to meds to go up. Like Brian and Executor mentioned, methadone is a very effective pain med. Yes it is used for heroin addiction where the stigma comes from. However, if you are bringing a script to pharmacy for methadone, they know it is for pain and not heroin addiction. Heroin addicts go to a methadone clinic.

Another plus with methadone is that it works on something called NMDA. This helps keep your tolerance low to opiate meds. Methadone binds to more receptors more strongly than other opiate meds. It has a very long half life. It works on all the receptors but has a strong affinity for the mu receptor. The same receptor as morphine. Many people on meth notice that they don't have to change their dosages every office visit. So in my opinion it is worth looking into.

As far as looking on the internet.... I believe you can learn a ton from the internet (this board, medical research, etc.) Once you learn how drugs work in the body from the neurotransmitters, to the primary opiate receptors, it makes a lot more sense and gives you an understanding when your doc is talking about meds.

You are right that alot of meds have a stigma. Oxycontin, methadone, morphine. To give you once example, many people believe morphine is the strongest med around. This is far from the truth, it has just been the gold standard that other drugs are compared to and one of the first line drugs in an ER. In fact if you look at most equiananlgesic chart (gives medication conversions and comparisons), you will see that oral morphine has about a 1:1 ratio with hydrocodone. Meaning, 1 mg of oral morphine is generally equal to 1 mg of hydrocodone. Where oxycodone (percocet, oxycontin) is 1.5x stronger than morphine. And fentanyl is around 80 times stonger than morphine. Ok that was more than one example.

Not trying to confuse you, but knowing about these meds and how they work is knowledge in my opinion. Coming to a board like this, where people take these meds and have a wide range of different experiences is only going to be helpful to you.

So, I will get off my box now. But welcome to the boards. Read, ask questions, and you will learn alot.

Good luck with your pain management. Hope everything works out well for you.

Take Care
[QUOTE=ARANGER;3499661]...Another plus with methadone is that it works on something called NMDA. This helps keep your tolerance low to opiate meds. Methadone binds to more receptors more strongly than other opiate meds. It has a very long half life. It works on all the receptors but has a strong affinity for the mu receptor. The same receptor as morphine. Many people on meth notice that they don't have to change their dosages every office visit. So in my opinion it is worth looking into...

Pain2004,

This is what I was getting at in my earlier post regarding tolerance. Aranger is great at explaining these things and has done a good job for you. I went from a very high dose of the fentanyl patches to 80mg of methadone daily and held to that dose for a couple of years before being switched to morphine. And I didn't even require BT meds.

But I am in no way trying to push methadone on you, I just want you to be aware of the benefits of this medication. Many folks and docs look at methadone as the last line of defense, while many others consider it right out of the gate. As always, it's a decision for you and your physician.

Take Care,

steve
[QUOTE=ARANGER;3499661]In fact if you look at most equiananlgesic chart (gives medication conversions and comparisons), you will see that oral morphine has about a 1:1 ratio with hydrocodone. Meaning, 1 mg of oral morphine is generally equal to 1 mg of hydrocodone. Where oxycodone (percocet, oxycontin) is 1.5x stronger than morphine. And fentanyl is around 80 times stonger than morphine.

Aranger provides some great info and is absolutely correct. However, it's important to note that because of the differences in potency, the doses are adjusted accordingly. For example, fentanyl is scripted in Mcgs instead of Mgs. Thus, it's all proportional. One isn't going to go from 10Mg of A to 10Mg of B and B is 5x more potent than A....Or at least they shouldn't.

Ex