Having trouble detoxing from morphine, for chronic back pain?

Hi I have been struggling with chronic pain for 19 years now.  I have grade c spondylolisthesis, L4 and L5 have slipped 75% forward. (possibly a birth defect, which was agravated by my 3 pregnancies.)
I was on nsaids for many years, but they ruined my stomach, and tollerance for most drugs.
I eventually had a spinal fusion for S1,L5 and L4 with bone from my hip  and rods put in for stability.  After a lengthy recovery I did quite well for 5 years. But slowly the pain returned, it was so bad I became seriously depressed, I had no patience and felt suicidal.
After I found a good pain clinic, I started the rounds of opiods. Most made me nauseas, or caused stomach pain.  
Mophine was the only drug I could tolerate and I have been on it for 5 years now.  But this last year I have had so many side effects from the morphine, that I actually have no energy, sleep all the time and feel like I'm not living at all. Morphine seems like the devil to me? Either I'm not in pain, and don't feel like i'm alive.  Or I stuggle to detox with unbearable pain and feel physically ill.
I've cut down to 30mg of morphine a day, and I'm ready to come off all together. My pain Dr. gave me tylenol 3, and ativan to help with the detox. I also have medical marijuana, but find I can only smoke it at night, since I don't like to feel stoned during the day.  What should I expect detoxing?  And will the pain when I first come off be worse at first,
since I've been on the drug so long.
I would appreciate any input from you, thank you, Sue

[J T Junig, MD PhD]

People have variable degrees of withdrawal, but basically.... it stinks.  The slower you go, the less severe (but longer) the misery.  I would suggest tossing some clonidine in along with the other meds-- along with imodium (immodium) for diarrhea and cramps, and ibuprofen for aches.  

The main problem is that most people simply cannot DO a taper.  They plan it, but when the cravings, depression, and misery are severe, it is very hard to stick to schedule.  Many people, myself included, required inpatient detox for that reason.

You will have a period of 'hyperalgesia' or increased pain during withdrawal, that will resolve over a couple months.  The GOOD news is that I have had many patients-- and many other docs have as well-- who did better OFF narcotics than ON narcotics, for reasons that are hard to understand.  Every patient insists that he/she needs the pain pills... but most simply do better without them.  So I strongly believe you are on the right path.

If you cannot taper off opioids, consider using buprenorphine as a CHRONIC treatment.  It is a 'partial agonist' that virtually eliminates the obsession for opioids, and it has the opioid effect of about 60 mg of oxycodone.  You would become tolerant to it, so it would not be a great source of pain relief-- but it is very helpful at keeping people off the opioid roller coaster.  There are people who argue against using it long term, but I see it just as I see insulin or blood pressure meds;  opioids cause great misery, and buprenorphine can often-- even usually-- relieve that misery, especially if people give up the dream of being 'med free' and realize that when the back has been fused, and things are out of place, a person might need a medication for life.

Good luck!