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Alternative to Morphine for chronic pain from severe Crohn's Disease.
I am currently taking Morphine Sulfide 100MG X 4 daily and Morphine IR 15MG X 6 daily for severe abdominal pain. Unfortunately I am starting to experience a horrible side affect that causes my blood to feel like it is on fire, which causes me to sweat horribly and feel like I am running a fever. I have tried fentynol patches, but experienced severe mental side efffects and could not continue use. I was also on Methadone, which worked great, but when we moved to Seattle, I could not find a doctor willing to prescribe Methadone and had to switch back to Morphine. I have been on the Morhine for 2 years now, fentynoal 1 year prior to that, Methadone 1 year prior to that. The only options I have are pain medication or the freezing and destruction of my abdominal nerve centers. My doctors say that freezing my nerve centers would prvent me from sensing serious injury, so they refuse to go that route. What other pain control options or alternatives to Morphine do I have?
This post is quite old & most of the members who posted/commented are no longer active on this forum. If you post a new question, you may have better responses. Best of luck. I have no experience with Medicare.
I am 42 yrs old on SSDI for 13 yrs. Pain is horrific to say the least. The only thing that helps me because of malabsorption is ACTIQ (Fentanyl Citrate OTC) or Fentora. Recently Medicare will not give me prior authorization since i do not have cancer. I can not afford to pay for it out of pocket. I can't eat, sleep or have any quality of life. IF ANYONE CAN HELP I WOULD BE EXTREMELY GRATEFUL.
I can't take anything and be open about it with my family. I'm taking 50 mgs. of Morphine sulphate (Generic Kadian), and 15 mgs. of Morphine sulphate IR for breakthrough pain.. I'm new to anything other than Norco, so I really appreciate these forums. I was on 50mcgs. of fentynal patch, and could only get about 30 hours out of each WATSON patch, so a dose of Kadian every 12 hours makes it much easier to keep track of my daily dosage. I still am not sure about this combination, but I need to give everything a chance. My family thinks Advil would take care of all my Fibro problems. I'm their Junkie brother that they don't want me around their college age kids, or my Mother. Anyway, I'll save that for another day. Good luck, and hang in there. It takes time to find the right combination..
Methadone doesn't "block" other narcotics and it's actually a fine long-acting and inexpensive pain medication. I think you may be thinking of suboxone. The active ingredient is the synthetic opiate called subutex (buprenophine). The second ingredient in suboxone is an opiate antagonist (naloxone) that will either render additional opiates merely ineffective or actually cause precipitated withdrawal. The reaction depends a great deal on how much suboxone is on board and the specific full agonist opiate taken along with it. The antagonist properties of suboxone are why a patient has to be in a fair amount of withdrawal from a previous opiate before taking the first dose. If not, it can bring on all-out withdrawal that can take quite a while to wear off.
Some PMPs are now using suboxone and subutex for chronic pain patients thinking they can avoid potential abuse problems. The problem is that the FDA only recommends suboxone for 21 days as a detox tool from other narcotics. I have read reports that detoxing from suboxone or subutex is incredibly difficult and quite a bit longer than other opiates. Both of these drugs get abused every day and already have a street market value. Any opiate naive person will be in big trouble taking either one as a party enhancer.
The FDA recently approved subutex in a long-acting patch form for chronic pain patients. Subutex alone will not cause a problem with breakthrough meds. Again, the patch form is considered to have less risk for abuse. I don't care to be any doctor's guinea pig for either one of the meds if prescribed long term because we just don't know the ramifications of long-term treatment.
Some PMPs are now using suboxone and subutex for chronic pain patients thinking they can avoid potential abuse problems. The problem is that the FDA only recommends suboxone for 21 days as a detox tool from other narcotics. I have read reports that detoxing from suboxone or subutex is incredibly difficult and quite a bit longer than other opiates. Both of these drugs get abused every day and already have a street market value. Any opiate naive person will be in big trouble taking either one as a party enhancer.
The FDA recently approved subutex in a long-acting patch form for chronic pain patients. Subutex alone will not cause a problem with breakthrough meds. Again, the patch form is considered to have less risk for abuse. I don't care to be any doctor's guinea pig for either one of the meds if prescribed long term because we just don't know the ramifications of long-term treatment.
I guess I don't understand how people use Methadone for pain management IF they have to use a BT med. Doesn't Methadone block the effects of other narcotics? So how can BT meds work if they are blocked?
I've had the same experience with morphine making the pain much worse. All it did was vacuum my brain out and leave me a trembling crying mess from the pain. My mom was the same way - maybe there's a genetic component to that reaction? Good point on the synthetic versus organic opiates. It's not at all uncommon for people to experience more nausea and side effects from the organic compounds. Maybe "natural" isn't always better or safer. ?
Ok, here's what I found from an old thread about drug testing. I'm thinking based on this you may be allergic to opium, which is why the true synthetics work best for you.
Oxycodone, oxymorphone, hydrocodone are all semi-synthetic derivatives of opium.
True synthetics are fentanyl, sufentanil, alfentanil, and methadone. Methadone is converted to hydromorphone in the liver.
Dilaudid is hydromorphone, so that may be a good one for you.
Hope this helps.
Oxycodone, oxymorphone, hydrocodone are all semi-synthetic derivatives of opium.
True synthetics are fentanyl, sufentanil, alfentanil, and methadone. Methadone is converted to hydromorphone in the liver.
Dilaudid is hydromorphone, so that may be a good one for you.
Hope this helps.
I found this interesting because my grandfather is the only other person I've known who found more pain than relief in morphine. He said any time he needed to have it (which was maybe when he had an appendix out, otherwise I can't even get him to take a daily aspirin) the morphine intesified his pain. I found it barely worked for me in the MSContin form.
There are a lot of options and there are other meds in the methadone family that may be an option for you. I think tramadol is one, although while they claim it is "non-narcotic", some doctors disagree and it can be habit forming, but when you're dealing with prescription pain relievers, everything is habit forming to an extent. I personally would prefer tramadol to suboxone from what I have read about it. I think it's odd that your doctor won't prescribe methadone as it one of the most reliable and inexpensive medications on the market. The only real negative is that it has a sort of stigma, as you probably know, however, I was on the medication for almost a year after the MS Contin didn't work and I found it to be fine as a pain reliever, as long as I had some meds for the breakthrough pain. If anyone asked what I was taking whom I didn't feel comfortable sharing with (nosey and unsupportive family members), I told them I took morphine.
Although doctors don't always do what we consider to be reasonable. Someone here posted a really great post about what meds are in the same family and perhaps you can find one in the methadone family. I'll try to find the post for you.
I'm sorry you're having so much trouble with this and I hope you and your doctor can reach a good decision soon.
There are a lot of options and there are other meds in the methadone family that may be an option for you. I think tramadol is one, although while they claim it is "non-narcotic", some doctors disagree and it can be habit forming, but when you're dealing with prescription pain relievers, everything is habit forming to an extent. I personally would prefer tramadol to suboxone from what I have read about it. I think it's odd that your doctor won't prescribe methadone as it one of the most reliable and inexpensive medications on the market. The only real negative is that it has a sort of stigma, as you probably know, however, I was on the medication for almost a year after the MS Contin didn't work and I found it to be fine as a pain reliever, as long as I had some meds for the breakthrough pain. If anyone asked what I was taking whom I didn't feel comfortable sharing with (nosey and unsupportive family members), I told them I took morphine.
Although doctors don't always do what we consider to be reasonable. Someone here posted a really great post about what meds are in the same family and perhaps you can find one in the methadone family. I'll try to find the post for you.
I'm sorry you're having so much trouble with this and I hope you and your doctor can reach a good decision soon.
Fentynol workes great, unfortunately it causes some mental sideaffects that are rare but are officially acknowledged by the manufacturer. I have tried Fentynol three times and suffered the same sideaffect the first two times but the last time I was given it in the hospital it caused a severe reaction which made it feel like my blood was on fire.
I have been on Morphine for more than 3 years and while it does not work as a complete solution it does make the pain bearable.
Right now my big concern is the proposed switch that my pain specalist is planing. The new drug is called Subuxone and I have found posts that have been both positive and negative inregards to it's use. I am really scared.
I have been on Morphine for more than 3 years and while it does not work as a complete solution it does make the pain bearable.
Right now my big concern is the proposed switch that my pain specalist is planing. The new drug is called Subuxone and I have found posts that have been both positive and negative inregards to it's use. I am really scared.
Oxycodone (oxycontin) , and as someone else stated, dilaudid are both very good pain medications. I have heard that morphine and methadone are best for long term , although I'm not sure why that is.
Hello and Welcome to the Pain Management Forum.
I am sorry to hear about the unpleasant side effects you are experiencing from Morphine and also sorry that you are unable to be treated with Methadone which works for you.
There are other opiates that you should discuss with your prescribing physician. I very much agree with your physician not wanting to "freeze" your nerves so you would feel nothing. Some years ago that procedure was offered to me and I declined it. I am so glad I did. I was young at the time and now know that it was the "wrong" nerve they were going to "kill." I would have still had the pain and would have been left with basically a dead leg.
I too tried the Fentanyl and the side effects initially were not comfortable. However I listened to Mollyrae and tolerated them. Unfortunately I had a severe allergic reaction to the adhesive just as the side effects were diminishing. So you may want to consider Fentanyl again.
Have you been to bio-feedback, acupuncture or tried a TENS Unit? These are just a few possibilities that won't replace opiates but may help reduce the amounts you must take or at least make you more comfortable.
Please keep in touch and let us know how you are doing. Our members may have other suggestions for you as Molly said.
Take Care,
~Tuck~
I am sorry to hear about the unpleasant side effects you are experiencing from Morphine and also sorry that you are unable to be treated with Methadone which works for you.
There are other opiates that you should discuss with your prescribing physician. I very much agree with your physician not wanting to "freeze" your nerves so you would feel nothing. Some years ago that procedure was offered to me and I declined it. I am so glad I did. I was young at the time and now know that it was the "wrong" nerve they were going to "kill." I would have still had the pain and would have been left with basically a dead leg.
I too tried the Fentanyl and the side effects initially were not comfortable. However I listened to Mollyrae and tolerated them. Unfortunately I had a severe allergic reaction to the adhesive just as the side effects were diminishing. So you may want to consider Fentanyl again.
Have you been to bio-feedback, acupuncture or tried a TENS Unit? These are just a few possibilities that won't replace opiates but may help reduce the amounts you must take or at least make you more comfortable.
Please keep in touch and let us know how you are doing. Our members may have other suggestions for you as Molly said.
Take Care,
~Tuck~
Hello:
You have obviously tried most of the "big dog" meds and one in my opinion should have worked. There are a couple more out there that might be effective and they are Dilaudid and Opana. I have not tried either of them but hear of good pain control from both.
Is it possible to try the Fentanyl again. This is what I use and at first, the side effects almost made me stop; but I hung in there and I'm glad I did. It has saved me from a lot of pain where other meds did not.
You might want to chat with a Pain Management Specialist, they are up to date on the most recent meds available.
Others will post at some point, so be patient. Good luck to you and take care...
Mollyrae
You have obviously tried most of the "big dog" meds and one in my opinion should have worked. There are a couple more out there that might be effective and they are Dilaudid and Opana. I have not tried either of them but hear of good pain control from both.
Is it possible to try the Fentanyl again. This is what I use and at first, the side effects almost made me stop; but I hung in there and I'm glad I did. It has saved me from a lot of pain where other meds did not.
You might want to chat with a Pain Management Specialist, they are up to date on the most recent meds available.
Others will post at some point, so be patient. Good luck to you and take care...
Mollyrae
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