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Duragesic instead of MS Contin?

I've been on MS Contin (otherwise known as Codeine Contin) for more than 2 years now.
I'm taking 100mg twice a day. I once went up to 300mg a day (150mg, twice a day), for at least 6 months, maybe even a year, but since I didn't see any improvement, only more side effects, I came back to 200mg/day.

Now, the MS Contin is only helping get the pain to a lower, more manageable level, not relief it completely. When the pain gets worst (what I call the "crisis") or if I have an injury, I need to take Tylenol or Advil (or both) on top of it... which kinda help, but are no miracle... and over time, have their own side effects.

I've been wanting to change this pain med for over a year now. Not because it's addictive, I'm pretty sure I'm addicted and since my condition is chronic and incurable, I don't really care. I mean, I'll happily deal with that if I ever get healthy... It's just I'd like something that would work better (maybe help with the pain 75-80% instead of 50-60%), have less side effects (or maybe the same, but simply less harsh)... and if it would work better, maybe I would have less side effects from the over-the-counter meds too... And something maybe less bothersome... having to take the pills at a different time than your other pills, and then because of the side effects, having some more meds that you can't take at the same time than any meds... well it becomes pretty frustrating.

I asked my doc more than once for a different pain med. He told me there were none other, or all would be just as bad. No "maybe it'll be just as bad, but would you like to try?". Nope. Just "No." No help at all. It even had to be the pharmacist and my GP who came up with the meds to help with the side effects!

So anyways, I learned about Duragesic. Wow! A patch, every 3 days! Less hassle. And if the info I got is right, maybe slightly less harsh side effects too!

But when I asked my doc about it, he, again, said no.
Told me that Duragesic patches were way too high-dosed for me, and that the side effects were the same.
But I don't trust him anymore.

I'd like to know if anyone here ever made that switch, preferably someone with the same dosage of MS Contin...
Or, if anyone is knowledgeable enough, could you tell me if it's logical that a Duragesic patch with a dosage of 12mcg/hour be way different than 300mg/day of MS Contin? Maybe that calculation isn't right and is comparing apples to oranges, but put differently, it would be 288mcg/day of morphine vs. 300mg/day of codeine... or 12mcg/hour of morphine vs. 12.5mg/hour of codeine.

I'd really like to know, because if that doc was wrong, and just didn't want to try and help me, I could ask my GP about it next time I see her.

Thanks!
2 Responses
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356518 tn?1322263642
The only way you will know what works for you is to give them a chance. It sounds like your Dr asks you if your willing to try so maybe you should try something else.
You should not aim for total pain control as you will most likley be disappointed. The best you can hope is to get your pain level to a tolerable level and go from there.
I wish you the best of luck and hope you do find some relief.
Helpful - 0
501792 tn?1261111106
Hi

In the beginning of my Pain Management I was on the patch. I didnt like it for a few different reasons.  I didnt feel that I had control over my medication. That it was just entering my body on it's own without my action, that made me nervous. I also didnt like the warning they give about body heat. That fact that you shouldnt take hot baths, or long hot showers. Or that I couldnt use my heating pad in a certain area when I needed it.

The important thing about pain medication that we all forget sometimes is that they use it ti reduce the pain enough that where were no longer rocking in the fetal position in a dark corner. It isnt ment to take all of out pain away. If it ends up doing that, it's great. But the DR's will shoot for just a lower number on the pain scale. They never intended to hear you say your pain is zero. To get that kind of pain relief would leave most if us spaced out zombies.

I'm not sure anyone can tell you which one will be better as you run the risk of side effects no matter which medication you take. Someone can tolerate MS Contin while they cannot tolerate the patch. So it's all a chance when it comes to the severity of side effects for each person.

I can defenitly understand the appealing qualities of the patch. You dont have to keep taking pills, pills and more pills and that gives you freedom. That is a great thing when you have chronic pain and take alot of meds.

It really all depends when talking strength of a medication. The medication in a patch is measured differently because of the route it travels.
Maybe someone else will come by and feel comfortable telling you witch one is stronger or better. The thing is,  your DR feels that it's too much medication for you so to tell you it's not wouldnt be right. There are alot of differences between the meds.

But if you dont trust your PM and do trust your PCP then maybe you could talk to them about it. Just be careful and make sure you let them know your only asking for imformative puposes. If your PM already told you he doesnt feel okay with that and you go somewhere else to get advice about it, he may see it as an "addict behavior." Seeking out narcotics somewhere else. I'm not saying they will know, but PM's are usually really strict about consulting abother DR about there pain regimine and see that as a behavior that could indicate a problem.
It is always a risk leaving a PM who is actually treating you with a strong narciotic(or narcotics at all).Not all PM's are created equally and you always run the risk of not being able to find one that will accomidate your needs. Then find your old PM wont take you back because you went searching out a second opinion for narcotics somewhere else. He may not know why your getting the second opinion but he'll go off of the last few appointments he had with you.
Of course all are different. And they react differently. But just make sure your not completely risking the mediaction you need or you and your DR's relationship so you dont end up without any of the treatement your getting now.

One thing did stand out to me more than the rest, that you consider yourself to be an addict but do not care because your condition is chronic.
There is a difference between Dependace and Addiction. All of us CP'ers are dpendant meaning our bodies have built somesort of a tolerance and will go through withdrawls if the medication is abruptly stopped.
Addiction is the psychological compulsion to take the medication without severe pain or despite negative effects of the medication is Addiction.

So if you feel yourself wanting the medication when your not in pain just to feel a high than you do have a reason to be concerened. But of you take your medicaton as prescribed and dont abuse it, if you dont take the mdication to get high, then it is considered only dependace.
People confuse the two all the time because the defenitions are not so publically known and alot of people in society or even others who have abused the medication are led to believe that everyone who taked a narcotic for chronic pain will become addicted. This is where the stigma comes from and it's just not true.

I hope I have helped you out with some things althoug I feel uncomfortable telling you one medication is stronger or better than than the other after your DR had voiced there concerns. But that has nothing to do with you. That is something I feel uncomfortable with for my own reasons. I just feel like I would be helping you go against your DR's advice.
I hope you understand.
I do hope your able to figure things out and get as muchr pain relief that is possible for you.

Take Care TMA
Helpful - 0
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