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MS Contin to Kadian?
I have been on MS Contin 60 mg's 3x day. I feel it is not working as well as it used to, as i have been on opiates for chronic failed back syndrome for the past 20 years. Been through the hell of oxycontin, the laughable results of ultram, and methadone madness. I would like to switch to kadian, my mother-in-law being an R.N. and a chronic pain sufferer, suggested asking for a switch from the ms contin to kadian, to see if there is any difference. Is this a just request? My pain can be very severe at times, i just want to stop hurting. peace
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It is probably too early for me to give any help, but I too have failed back syndrome, and have had 2  back surgeries, and it has been about 18 or 19 years since the pain started, the surgeries were in 1995 and 1996, but I was unable to walk before either surgery. After the second one, for a really bad herniated disk, my second, the pain waas ALWAYS there. Just very recently, and I mean REALLY recently, an insurance Doctor had to take over because they didn't want to pay for the costs. Well, I went through the gamut, and I mean EVERYTHING except Methadone, which I adamantly refused, and they couldn't MAKE me, oh boy they tried though! What I wanted to ask is what KIND of pain are you suffering from, muscle pain, nerve pain? I finally tried something for the nerve pain, Neurontin, and it has actually been helping my sciatic pain, for the first time EVER...since 1995! But I have just started, but the very first day, it was noticable! Nevr have I had a minutes relief before! And I was so desperate, I finally took what the doctor wanted me to try. I have only had some relief with oxycontin in the past, but it was noticably less effective when they obviously changed the formulation. I just wanted to also say I feel for you, and it is SO hard to get through the day....that is why I wanted to mention ssomething that actually seems to work on nerve pain! I hope you feel better, and find the right combo, it is ALL such a drag! Just to feel somewhat normal!I tried the MS contin but it didn't work on me and gave me stomach problems, and I was taking ibuprofen, which helped, at the maximum, OTC levels, but I developed ischemic Colitis and 3 feet of my colon was almost gangrene, and I can't take NSAIDS anymore. They did help, but the pain of the colitis, (not to mention the docs saying NO ever again.) Well, I took the gabapentin an hour ago, and I am praying again for some relief!
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Hi there...

Sorry to hear of your pain issues..

Just so you know...Kadian is the exact same medication/opiate as MSContin...They are both time released Morphine.

The MSContin last from 8-12 hours and the Kadian is dosed at every 24 hours.

How long have you been on the dosage of MSContin of 180mg per day?

I don't see you mention any type of "breakthrough" medication. Most people in chronic pain management are also given a short acting medication to take on those really bad days for what is called "breakthrough" pain.

My PM happens to believe that it is more effective to be on a different opiate for your long acting than your short acting.

I am on MSContin as well...but have OxyIR for my BT medication to take as needed.

Also...I don't see you mention any type of nerve pain medication like Lyrica, Neurontin, or Cymbalta.

Or a muscle relaxer like Flexeril, Robaxin, Skelaxin, Baclofen, or Zanaflex.

These two types of pain...nerve pain and muscle spasms...are best helped by the actual medication I above listed. An opiate does not do much for that type of pain so most of us with FBS are on these as well.

This way you do not keep having to tirate up your opiate medication and keep the tolerance at a low level. I haven't had to change my opiate dosing in over 3 years.

Also, there is so much more to chronic pain management than just medications...

There is daily exercise, yoga/stretching, physical therapy (easy to learn and do at home), massage, acupuncture, TENS unit (found used online), ice, heat, biofeedback, counseling, injections, steroids, nerve ablation, etc.

Many people with CP actually suffer with depression and need to be treated by a Dr. This is nothing to be ashamed of...Learning healthy coping techniques along with how to live with a "new" normal. Some people even need medication for awhile to help them through.

But our emotional health is just as important to take care of during all of this.

As well as making sure you don't smoke (I would hope not with FBS)...eat well and maintain a healthy weight and drink plenty of water each day.

Chronic pain mgmt. is about using every possible modality we can to help get our pain level to a 5 or so with everything. If someone expects their opiate to do all the work...it will just end up not working.

So...I would speak to your Dr. and if you aren't seeing a good PM that provides you with a comprehensive plan to help manage your pain...I would be seeking treatment elsewhere..

Good luck..
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I total agree with Weathergirl21-You should have a doctor writing you some type of breakthrough meds.  I am taking oxycodone for the breakthrough pain but I also take methadone for my long term- I guess that did not work for you?

If anyone knows of a pain doctor in MO. plz. help me.  I moved from the state of GA and had great doctors but in MIssouri I can not find a pain doctor that does not just want to put long needles in my back.  I have had everything done to me in the last 15 years after I was hit by a car walking into work.  I have also had 4 major stomach surgeries from my celiac and have pain in both my back and stomach but my back is the worst. Plz. let me know if you can help?? thank you.  Good luck to everyone who suffers.  MOmom02
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Weathergirl21 hit it right on the head. I have way to much nerve damage and damage to my spinal cord and Chiari and a tethered spinal cord to bore you with all the history. I've had 4 c-spine surgeries with each leaving me with more nerve damage. I've been using a tens unit since 1991, prescription pain patches, biofeedback, you name it I've thrown it at it and always willing to try something new. Meds I'm on:
Lyrica 200mg 3x a day
Zanaflex
Morphine Sulfate ER 20mg 3x a day
Percocet 10/325 for breakthrough pain

The Morphine only works on some of the pain. I wake up every day in such pain that I have to hold my head with both hands and can barely walk. My pain Doctor wants to have me off of the Percocet in an month. He cut me from 3x a day to 2x and it's NOT working. I'm spending my entire morning just trying to handle the pain until I can take a Percocet to simmer it down. I live in Montana and the doctors here are not concerned with helping you get the pain under control. They're more interested in getting you off the pain meds and expect you to be able to deal with it in other ways. I've been doing this since 1989 and try everything I hear about just to deal with it. But what type of life is it when over half of it is spent in such pain you can't move or think. We're only on this earth for a short time, I want to spend that time enjoying life and my children & grand children as best I can.
I'm going to be asking my doctor to switch me to MS Contin 30mg SA and MS Contin for breakthrough. Does anyone have any thoughts on that?
My Neurosurgeon is in Colorado and after talking with doctors and others in Colorado with chronic pain I'm thinking of moving to Colorado.
1. To be closer to my Neurosurgeon
2. Better pain management doctors
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It definitely depends on the type of intractable pain you are having. I was hit by a drunk driver many years ago after suffering from scoliosis as a child. Being young I of course thought I was invincible but the damage has led to cervical fusion and other necessary surgeries that I am putting off until no pain meds work anymore. I started out on Kadian which as everyone has stated DOES provide more steady management of pain if you are able to take it AND you can find insurance that will pay for it. I later had to switch to the Fentanyl transdermal patches. They provided the most overall pain relief of anything I ever tried but working at a surgical clinic at the time, I was scared away from them VERY quickly. There IS a risk of increased dosage if bath/shower water is to hot,there can be serious reactions also if you have sensitive skin. But when I did use them I rarely had to take my breakthrough meds. I am now on Oxycontin with Roxy for breakthrough which ONLY keeps the pain manageable but is allowing me to care for my grandson. My husband on the other hand broke his back in 2010 and has been on MS-Contin since. He raves about it and doesn't have any of the stomach issues that I developed during the one month I tried using it. Summary: you will never know which works best for you until you try them. If you have a good PM doc they will know this and work with you. Some people just don't  metabolize meds the same way. In my 15 years of treatment I went through much withdrawal before finding a doctor who could recognize that I hyper-metabolize certain meds when combined. Therefore,even though I take what is considered a 12-hour med, I am prescribed to take it every 8 hours so it doesn't wear off before the next dose and get sick with pain twice a day. Just putting this out there in hopes it will help someone down the road.
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