withdrawal

[repsolblade777]

I have just decided to stop taking the DHC 240Mg daily & ORAMORPH 80Mg daily and opted for Slow release MST 30Mg every 12hrs for my back and arthritis condition after a bad accident. my DR has made a mistake and think its causing more pain which is unnecessary ... "can anyone relate to this " ?

[nomoreheels]

I can relate to the reason behind safe tapering having done it on occasion but if you think your doctor has made a mistake then the best thing is to discuss your concerns with either the initial prescriber of the meds or the doctor you think has made the mistake. It is always advisable to seek the advice of a medical professional if you choose to stop meds anyway in order to do so safely as some meds need different lengths of time & doses whilst being tapered, just as they need safe titrating when introduced.

[repsolblade777 in reply to nomoreheels]

hey thanks, although i have been on those meds for over 3yrs, my tollerance is pretty out there, 30Mg of slow release MST isnt even enough to counter the withdrawals let alone stem the amount of pain i am in today. Its nice to be able to share this stuff knowing that there is someone out there who can relate ...

[PFKAAde in reply to repsolblade777]

Hi repsolblade777

I switched from dihydrocodeine to morphine some time ago now.

I found that I ended up on a much higher dose of morphine than the GP originally suggested.

They understandably have to play it safe so they start you on a low dose and slowly increase it if needed until you are as controlled as can be expected.

I was told the 'advantage' with morphine over dihydrocodeine is that there is no limit to the amount of morphine they can prescribe whereas dihydrocodeine is limited to 240mg a day.

It's not clear from your post what your daily dose of morphine from the Oramorph was, I'm guessing you mean 80ml (not mg)? But if I recall it comes in different strengths so to know the dose you need to know the strength and the quantity.

Apparently 240mg dihydrocodeine is approximately 24mg oral morphine, but people metabolise drugs differently and different opiates differently also, so dose equivalence is a bit of a tricky thing to get right first time, hence the caution.

One word of caution, it is a lot harder to reduce the dose of morphine than going the other way, so it is in your interest to keep the dose as low as possible, as long as your pain is controlled to some extent. It's all a balance obviously.

Ade

[Leonwp in reply to PFKAAde]

Wise words Ade

[repsolblade777 in reply to PFKAAde]

Hi ade, 240Mg DHC & 30Ml of 10Mg in 5Ml of oramorph daily!!! Now on 30Mg of MST continus every 12hrs,

[PFKAAde in reply to repsolblade777]

So by my reckoning about 60mg morphine plus 240mg dihydrocodeine so about 85mg oral morphine equivalence.

Which is probably why you feel like 60mg of ms slow release is not enough.

All you can do is explain to your GP and see if they'll increase it slightly.

Maybe they didn't realise what daily dose of morphine you were on already....😉

[repsolblade777 in reply to PFKAAde]

Nice 1 ade, I know he's made a gen mistake so I've Doubled up for now & will explain when I see the Dr again. He listens to me ade as I had 25+yrs of street opiates and had almost 9yrs clean, we've spoken in great detail, Many thanks for your support here

[PFKAAde in reply to repsolblade777]

You have an understanding GP if you have an, erm, history 😀 and he's still giving you dihydrocodeine and morphine. Some GPs would just assume the worst and send you for some mindfulness classes (not that they are necessarily a bad thing).

Might also further explain the caution, as you're taking it for pain he probably won't want to overdo it and lead you back down the street route. If you see what I'm saying.

Probably best not to ask for lots more, just explain the situation in terms of how you feel - both pain and otherwise.

All the best.

Ade

[Leonwp]

To be on oramorph and dihydrocodine you must have been in serious pain my friend. Ive been on slow release ( targinact) for some time and it certainly helps with long term constant base level pain for me but is not as helpful with short term "flares" etc for me. I hope you find a combination that works soon.

[PFKAAde in reply to Leonwp]

I personally was put on opiates for the pain I had when my left knee (vagus deformity- i.e. knock kneed) was slowly deteriorating and I was told I was too young (ha!) for a replacement and 'to put up with it for as long as possible'. 🙄 Fine, but I was also the main carer to my 2 (at the time) pre-school children so needed to be constantly active and able to keep up with them.

Ultimately the dihydrocodeine wasn't enough and so I was put on morphine. Plus others (Pregabalin, Amitriptyline).

After I had a TKR and the pain was reduced I started the process of reducing all of the above, I got off Amitriptyline- which in itself wasn't pleasant, and then I had my first (of 6 or 7 +, nobody knows) slipped discs which caused a whole world of pain and prevented me from reducing the remainder.

I got fed up of being on so many painkillers about 4 months ago and have been steadily reducing them since whenever the pain levels allow me to.

My experience of painkillers is that for arthritic inflammatory types of pain (and I hate to say it) Diclofenac is the most effective.

For eroded joint pain (thinking knee / hip) - opiates.

For sciatica / neuropathic pain - Pregabalin, opiates, paracetamol.

But IME if you don't address the cause of the pain - either by surgery, DMARDS, nerve block injections, exercise and stretching / loosening as appropriate - you will end up taking painkillers for ever and they will become less effective over time.

I ended up on way too much morphine, and started to notice some of the inevitable side-effects.

This motivated me to do something about it and now I am on a much lower dose of morphine and Pregabalin, no NSAIDs, occasionally paracetamol as needed (although if I need it I take it regularly as it is way more effective like that) and following a program of exercise to build up core muscle strength that I can't recommend highly enough to anyone capable and motivated enough.

Oh, and I take curcumin / pipperine instead of Diclofenac. It has taken a couple of weeks but now the pain (wrists mainly) I got when I stopped NSAIDs has reduced to the same level as before.

Sorry for the long post - just takes a while to explain all of my reasoning (and unfortunate experience) with painkillers.

They have a place but are not the permanent solution IMHO.

And THEY ALL HAVE SIDE EFFECTS. Sorry for shouting 😀

Ade

[repsolblade777 in reply to Leonwp]

Many thanks, I am still in a lot of pain but sick to death of medicating all the time which is why I asked to be put on the slow release MST but 30Mg per 12hrs isn't sorting the pain, it's just enough to stop my body going into withdrawal. I did almost 2yrs in bed etc although staying strong and trying to be positive has pulled me through, I'm on Dissability as I'm unable to walk any distance without pain. The flares are the worst thing about it as they give No warning. Fingers crossed the Dr will up my dosage. Feel like I made a difference coming off the DHC & Morphine !!! Chin up and happy days

[repsolblade777 in reply to Leonwp]

Hey thanks for that, yeah I'm kinda getting it all sorted although it's a very thin line trying to get it right especially when the pain flares up for no reason lol, I've learnt to live with it now for so long & been allowed to self medicate by my Gp, it's been a roller coaster ride for a long time !!!

[Leonwp]

Another round of applause, as Yoda would say "the truth you speak".