Morphine

[days70]

Hello,

I was wondering if anyone has any advice on morphine and if Gps prescribe it for osteoarthritis.

[tselph]

Morphine is used for cancer patients and terminally ill patients. It would not be used for osteoarthritis to my knowledge. Anti-inflammatories are normally used for this maybe along with prednisone on occasional flair ups.

[days70 in reply to tselph]

Thank you for responding!

[moods in reply to tselph]

Hi tselph, We all learn something every day especially when discussing Morphine in the same sentence as Osteoarthritis. I know many people who go from day to day in excruciating pain from the above ailment in all its many forms; only wishing to be able to live their life as when they were younger, with no arthritic pain. I am an old gentleman on Morphine and know others on stronger Opioids to quell the misery caused by arthritis. These patients do not wish to be, but have to be, just to attempt to feel normal................and I am also one, who has to be. Good Luck.

[Bcol]

It's not something that I have ever come across with OA and would be surprised if it was.

[days70 in reply to Bcol]

Thank you for responding!

[Exedous]

Hi to all I’m very familiar with hydromorphone (dilaudid) I actually have a pain pump filled with dilaudid which is in the same category. I get a prescription every 3 months when I get my pump refilled. It’s not something I imagined I’d be on but with fibromyalgia, a neurological problem and the ability to function daily is a blessing.

[days70 in reply to Exedous]

Thank you for responding!

[Marnie22]

Hi. I have codeine for my osteoarthritis from my GP. Codeine is more likely to be prescribed for osteoarthritis than morphine. I have problems taking anti inflammatory medication and other painkillers aren't strong enough. I don't take it all the time, just when I really need it.

[HeronNS in reply to Marnie22]

I learned recently that codeine metabolises into morphine in the body.

[Marnie22 in reply to HeronNS]

Yes, that's right.

[days70 in reply to Marnie22]

Thank you for responding!

[HeronNS]

I haven't read about any medications which actually end up leaving you better off than if you just managed without medication or the occasional anti-inflammatory (not every day). Nsaids interfere with cartilage renewal. Codeine and its relatives are addictive and may require increasing dosage as your body becomes accustomed to it. Yes I am familiar with chronic pain as I have not only extensive osteoarthritis but also polymyalgia rheumatica.

For many years I've taken glucosamine for OA (a capsule not a tablet, with food, 1000 mg twice a day). I recently got Flexiseq (a non-medicated lubricant) for my knees (if in North America have to order from the evil A). I try very hard to manage the OA without additional meds, but do enjoy the overall relief if I have to take aspirin or tylenol for a headache!

[Marnie22 in reply to HeronNS]

I don't get any relief from aspirin or paracetamol which is why I use codeine when I really need to. My GP understands that I won't become addicted or need higher doses as I only use it when I have to. If I didn't use codeine I wouldn't be able to sleep or function due to the pain. I have periodic cortisone injections as well and they are incredibly effective and can last up to eight months. I also use Dynamint.

[HeronNS in reply to Marnie22]

I understand. We all need to do what we have to. But I do think that if alternatives were offered at younger ages, at onset of illness, we might be able to at least put off the need for heavy duty meds for a long time. I was first diagnosed with OA when I was 40, probably had it earlier in my neck and feet, and I have just turned 74. I've done everything I can over those decades to avoid having to turn to other medications, Unfortunately I've had to take prednisone for the PMR and I think that in the long run has been bad for the OA. In order to get relief for OA from prednisone I'd have to take too large a dose. My starting dose for PMR in 2015 was 15 mg which wiped out ALL my aches and pains. I don't think the OA pain started to return until I'd got down into single digits, but don't remember exactly when. Probably around 7 or 8. It was lovely to have six months of pain free living!

I'm not criticizing others for taking the stronger medications, but if they don't yet need them it's wise to defer taking them and try and find other ways to manage as long as possible.

[Marnie22 in reply to HeronNS]

Yes, it seems to be a common experience that people don't get a lot of help to negotiate the alternatives early on after diagnosis.

[HeronNS in reply to Marnie22]

It's even worse for osteoporosis, when we aren't given guidance early in life - you know, like we learn the ways to prevent stroke or avoid type 2 diabetes, or heart problems, but no one says this is what you need to do to maintain your bone density!

[Marnie22 in reply to HeronNS]

Yes, we don't have that sort of guidance. You would think it would be logical to provide it for patients.

[HeronNS in reply to Marnie22]

We have sickness care, not health care. Oh well, at least we are better off than people were a hundred years ago!

[Marnie22 in reply to HeronNS]

That's true!

[Bcol in reply to HeronNS]

Morning Heron. I think your first sentence can be a bit misleading. If the only way to lead your life is with medication then you are better off with it. I have managed my OA for over 40 years now and without the appropriate pain medication (for me), I would probably not have got through those first horrendous 10 years or so before I had a surgical input, and in the end medical retirement. I tried different medication, none of the gels did or does have any effect at all, ibuprofen had little or no effect. Things which worked for me and still do were Naproxen and Co-Codamol (30/500)and of course our best friend Omeprazole!! I spent many, many years on the full daily dose, or more, of all of these and without them I would probably have lost the will to continue with life. As far as I can tell, none of these medications has had any noticeable long term detrimental effect on my health and I'm not addicted to any of them. I haven't taken Naproxen, in real terms, for many years and wouldn't now anyway because of Pred but I still usually/often take 2 Co-Codamols a day, early morning which generally keeps my OA under control. So yes, without any shadow of doubt, for me my medication leaves me better off with it than it would without it. I have a life.

[Shurra]

In 2012 iIneeded a full right hip replacement for bone-on-bone OA, but couldn't have the surgery for two months. Went from holding onto walls to walk, to cane, to walker, to wheel chair quickly. GP tried various meds, the final of which was norco. Prior to going to operating room, I informed anesthesiologist I was "not a cheap date" and would probably require extra monitoring (didn't want to wake up during surgery.) But in recovery room I yelled my head off because pain was like a hot knife in my hip. Nurses said I'd already reached the threshold of what pain meds could be given. So, beware of what seems good now, might have an unexpected & unwanted tolerance factor if surgery is planned.

[kohai OA Ambassador]

I'd like to chime in here... Morphine - prescription name Oramorph, in liquid form CAN be prescribed for OA. I know this for a fact, as I myself was prescribed it at 300ml per month, 5ml-10ml four hourly by a GP who is not under the nhs umbrella.. I was on this from 2014-2018, then moved to a different town. The new GP, who does come under the nhs umbrella still prescribes me Oramorph (Morphine) but on a lower does of 200ml per month even now.

The Oramorph is purely for my OA, which I have in every joint. Prior to be given the liquid Morphine, I was on MST Contin (an extremely milder tablet form), then later Morphine based patches which are worn for 7 days..

When the MST and Patches both failed to control my OA pain, I was prescribed Oramorph (Morphine), which to this day I am still on!

The only reason my Morphine dosage per month was lowered from 300ml to 200ml is due to the fact I live in one of the drug dealing/abuse capitals of Wales, and being a new patient, the GP's at my surgery aren't as aware of my conditions as my previous GP was. That said, I am still being prescribed it.

I don't take the Oramorph as prescribed, I take it as and when my joints let me know it's needed. The fact Oramorph is fast acting does help, and over the years of being on it ; 1. because I take it when needed, not when prescribed (which I do not recommend to anyone else) I have not built up any tolerance, 2. I haven't become dependent on it, 3. Oramorph does control the pain allowing me to do things I wouldn't otherwise be able too.

I've been on a long, long list of previous medications before Oramorph was prescribed though. So YES! It IS possible for an OA sufferer to be prescribed Morphine. It is down to your GP though.

* Added note - After reading the previous replies, please bear in mind that just because a person replying has not, or has never heard of a certain/specific medication being prescribed before, it does not, by any means, mean it is not possible.

[sdds]

Let me start by saying that this is not for everyone. But if it works for you as well as it does for me, without major side effects or unwanted symptoms- you may want to consider fentanyl patches. I have DDD, OA, fibromyalgia and neuropathy. I've had 6 back surgeries and 2 neck surgeries. I have a spinal neurostimulator. I have dealt with all of this for 18 years. I've taken prednisone, had injections, nerve blocks, anti inflammatories, oxycodone, hydrocodone, oxycontin, morphine, and methadone. Add to that gabapentin and lyrica and too many muscle relaxers to name. Any combination that you can imagine. Also numerous topical medications as supplements. Nothing ever worked. I was always in pain. Not discomfort or tolerable pain. I mean debilitating, can't function, please put me out of my misery pain. My life was nothing. I couldn't do anything that didn't cause more pain. I became so depressed and angry that I was more than ready to end my life. My family constantly worried that I would become addicted to the meds that I was on and this only angered me more. I secretly hoped that something would work so well, make me feel so good (or just not care) that maybe I would become addicted. At least I would feel better.

That never happened. Some meds did help make the pain less but not enough to actually have a life of any sort. Depression, anxiety and insomnia took control of my life and antidepressants, anti anxiety and sleeping meds were introduced to my situation.

Most pain specialists wouldn't touch me at that point, citing that I should be unconscious, maybe comatose and definitely feeling no pain given the medication that I had tried or was currently taking.

Three years went by with no change and I assure you that God and my faith in Him are the only reason that I lived to tell this story.

My doctor asked me if I wanted to try fentanyl patches. He warned me that they may have undesirable side effects, they are costly even with insurance, they have high addiction rates and because of government policies may be difficult to get in combination with some of my other medications(muscle relaxer,anti anxiety meds etc.) We both doubted addiction issues because of my tolerance to all other medications so I searched until I found a pharmacist who was willing to trust that my doctor knew what was best for me. (I've been with this doctor for over 20 years)

Starting at the lowest dosage and working up, we found the strength that works for me. I can function, pain free most days! I currently use the fentanyl patches, a medium dose muscle relaxer for spasms at night, an anti inflammatory in the morning, and an antidepressant daily. I have as needed anti anxiety medication and a rapid release morphine for any break through pain as needed (for particularly active or strenuous days). I rarely need either one of those and no longer need a sleeping pill. I've lost weight because I'm more active now and no longer need blood pressure meds.

I'm aware of the pain killer addiction epidemic but I am a walking poster child for someone who is an exception to that situation. There are no one size fits all resolutions.

I apologize for the extreme length of my response but this is my story and if it can help anyone else, then I'm glad that I shared it.

God bless you and best of wishes on your journey to relief.

[days70 in reply to sdds]

Oh thank you so much for replying to my post.

I found your story so interesting and you have certainly given me hope that there is a medication out there that will work for me and reduce the pain, making each day easier to deal with. x

[sdds in reply to days70]

Yes there is! Don't give up.