Discussions that mention morphine

Pain Management board


[QUOTE=feelbad;3528060]another actual "loss' of the active med actually takes place during the metabolization process where part of the "active' ingredient gets destroyed in just trying to metab and release it.you would think this part would be taken into acct since it just occurs naturally in the way the metab process goes. but of course they dont. even with brand name meds,you never are going to get what it actually staes on the Rx it actually gives you...

However, the metabolization process is critical to the whole pain relief mechanism.

If it weren't for the active ingredient(s) getting metabolized many of us would be in sad shape. Quite often, it's the metabolites that deliver the actual pain killing power. There are loads of examples. Morphine is metabolized into M3 and M6 metabolites, and one of them is both active and much more potent than the morphine itself. Tramadol is metabolized into M1 and another metabolite, delivering the real analgesia. If it weren't for the metabolism we wouldn't even get the pain killing effect at all.

Each of us individually possess different anatomical qualities in how our organs, specifically the liver, behaves. You may be a super-metabolizer, which would be very unfortunate, since you would be losing much of the analgesic quality of your meds. I, on the other hand, may not be able to metabolize well at all, making me a prime candidate for an overdose. Then there's the other drugs we take. Some of them, like the SSRIs, can have a detrimental effect on metabolism, causing our meds to be either more or less potent depending on the particular medication.

This is so complex. But the bottom line, as Marcia, Ex and others have pointed out, is that if the generic or the brand drug have such wide variability in what they're allowed to actually put into a pill, then who knows what we're getting? We do, eventually, when we either get the pain killing effect, or go into withdrawal, but by then it's too late.

This is really sad.

steve