Morphine Tolerance

Is it possible to become tolerant to Morphine so it ceases to be
effective in pain control? I was under the impression one could just
increase the dose, am I wrong?

Is Morphine as effective as the synthetic opiod drugs like
fentinal ...

If morphine is just as good why do medics prescribe the other
substances for pain control?

Isi

islavision2004@yahoo.com wrote:

> Is it possible to become tolerant to Morphine so it ceases to be
> effective in pain control? I was under the impression one could just
> increase the dose, am I wrong?
>
> Is Morphine as effective as the synthetic opiod drugs like
> fentinal ...
>
> If morphine is just as good why do medics prescribe the other
> substances for pain control?
>
> Isi

You and your doctor might want to read this
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01711.html

I will try to see if Mike R will come here and help you out.
I have to email him.
J

On Oct 3, 9:30 pm, J <nswex@nalid;anon> wrote:
> islavision2...@yahoo.com wrote:
> > Is it possible to become tolerant to Morphine so it ceases to be
> > effective in pain control? I was under the impression one could just
> > increase the dose, am I wrong?
>
> > Is Morphine as effective as the synthetic opiod drugs like
> > fentinal ...
>
> > If morphine is just as good why do medics prescribe the other
> > substances for pain control?
>
> > Isi
>
> You and your doctor might want to read thishttp://www.fda.gov/bbs/topics/NEWS/2007/NEW01711.html
>
> I will try to see if Mike R will come here and help you out.
> I have to email him.
> J

Thanks J,

Dangerous stuff, I doubt they have it here. I know they have
morphine, if it's only available in injection form, i am not sure.

I feel very uncomfortable asking and trying to talk about these things
with my doctor, as it makes me feel a bit like a druggie, and thats
the last thing I am.

I think I am going to have to move up in my pain control soon at the
moment I take DHC continus prolonged release tablets 120mg at 6am and
120mg at 6pm, 240mg a day. My doctor suggests that I take more if my
pain is severe between my regular doses as it sometimes is. However
and this is my concern on a web page

http://www.medsafe.govt.nz/profs/Dat...ontinustab.htm

It says "Dosage and Administration
DHC CONTINUS® tablets must be swallowed whole and not chewed. The
tablets should be taken at twelve hourly intervals at a dose of
60-120mg twice daily depending on the severity of the patient's pain.
The maximum recommended dose is 240mg daily since higher doses do not
provide any further analgesic effect."

I don't know who is right my doctor or the web data sheet. Any ideas?

One day, I forgot to log that I had taken my dose and took it again
and that made me feel really out of it! Not a welcome feeling, I like
to have my wits about me. Now I make very sure I log every pill that
i put in my mouth LOL

Isi

On Wed, 03 Oct 2007 12:08:30 -0700, islavision2004 wrote:

> Dangerous stuff, I doubt they have it here. I know they have morphine,
> if it's only available in injection form, i am not sure.

Hi, islavision2004

In general, morphine is available by IV drip, by injection, by an oral
liquid and by tablet, buth regular and sublingual, though, for some
unfathomable reason, medicare dropped the sublingual morphine from their
formulary, forcing cancer patients who use it to foot 100% of the cost.
Go figure!

I have had morphine in all of the above ways.

--
Andy -- The Cheerful Pickle still in a pickle

Isi wrote :

"Is it possible to become tolerant to Morphine so it ceases to be effective
in pain control? I was under the impression one could just increase the
dose, am I wrong?"

http://en.wikipedia.org/wiki/Morphine

"Is Morphine as effective as the synthetic opiod drugs like fentinal ..."

Fentanyl is an opium analogue 80 times more powerful than morphine. From
what I have read about it is, when prescribed and used properly under
medical superivision, less potentially addictive than morphine. But I've
only had morphine (self-administering pump) twice in my life. I know for
myself morphine leads to a general state of inflammation, nervous system
stimulation as if I were on excess caffeine, and itching reactions. I hated
it. Fentanyl did not have these side effects for me, but I think the side
effects of morphine I experienced were not common ... or, more accurately, I
should say that I just don't know enough about morphine and fentanyl to give
accurate comparisons.

http://en.wikipedia.org/wiki/Fentanyl

http://en.wikipedia.org/wiki/Duragesic

I personally had a good experience with use of a lower dose fentanyl patch
made by Duragesic that give continuous release over time during the period
of one month when my mucositis and oral/esophageal inflammation was so
extreme due to RT. But remember that I had no lung problems whatsoever, no
respiratory problems, no systemic infections at the time.

"If morphine is just as good why do medics prescribe the other substances
for pain control?"

I know my Oncologist felt strongly a low-dose fentanyl patch was much better
for me in my weakened state than morphine; I'd guess that's based on
clinical experience and, possibly, taking into account my previous negative
experiences with morphine.

If Fentanyl patches are easily available in Thailand (in hospitals), I would
think they would be available in Romania, but I think you have the issues of
respiratory problems to evaluate here and deal with that really require
expert advice and, perhaps, monitoring.

best, Uncle Sally

islavision2004@yahoo.com wrote:

>
> I don't know who is right my doctor or the web data sheet. Any ideas?

I think you should contract with a physician at the hospice in Sofia, for telephone support, following
an examination by them at their location. Your questions would go through your doctor to the hospice
physician, who would relay the answers back to your doctor who would prescribe the appropriate
treatments for you.
J

"Uncle Sally" <uncleSally@auldUncleSally.com> wrote in
news:zQWMi.15775$TR1.1578@fe06.news.easynews.com:

> Isi wrote :
>
> "Is it possible to become tolerant to Morphine so it ceases to be
> effective in pain control? I was under the impression one could just
> increase the dose, am I wrong?"
>
> http://en.wikipedia.org/wiki/Morphine
>
> "Is Morphine as effective as the synthetic opiod drugs like fentinal
> ..."
>
> Fentanyl is an opium analogue 80 times more powerful than morphine.
> From what I have read about it is, when prescribed and used properly
> under medical superivision, less potentially addictive than morphine.
> But I've only had morphine (self-administering pump) twice in my life.
> I know for myself morphine leads to a general state of inflammation,
> nervous system stimulation as if I were on excess caffeine, and
> itching reactions. I hated it. Fentanyl did not have these side
> effects for me, but I think the side effects of morphine I experienced
> were not common ... or, more accurately, I should say that I just
> don't know enough about morphine and fentanyl to give accurate
> comparisons.
>
> http://en.wikipedia.org/wiki/Fentanyl
>
> http://en.wikipedia.org/wiki/Duragesic
>
> I personally had a good experience with use of a lower dose fentanyl
> patch made by Duragesic that give continuous release over time during
> the period of one month when my mucositis and oral/esophageal
> inflammation was so extreme due to RT. But remember that I had no lung
> problems whatsoever, no respiratory problems, no systemic infections
> at the time.
>
> "If morphine is just as good why do medics prescribe the other
> substances for pain control?"
>
> I know my Oncologist felt strongly a low-dose fentanyl patch was much
> better for me in my weakened state than morphine; I'd guess that's
> based on clinical experience and, possibly, taking into account my
> previous negative experiences with morphine.
>
> If Fentanyl patches are easily available in Thailand (in hospitals), I
> would think they would be available in Romania, but I think you have
> the issues of respiratory problems to evaluate here and deal with that
> really require expert advice and, perhaps, monitoring.
>
> best, Uncle Sally
>
>
Here the Fentanyl patches were very, very expensive & not covered under
the formulary we were under at the time. Another consideration.

Isi, there are so many possible pain relievers & they are often used in
combination. One is often used to acheive a steady baseline dose &
another (or could be the same) for 'breakthrough' pain or spikes.
Sometimes Socks had 3 different things going under doctor supervision &
advice. Sometimes they medicated heavier at night for sleep, while
other docs thought a steady 24/7 dose was most effective. There are
lots of different preferences/opinions among medical professionals, but
the most important thing is what they do for YOU as an individual with
unique metabolism, pain cycles & threashholds, tolerance & other
considerations.

If you are uncomfortable asking this doctor for pain control, maybe
think about whether it's something with you or with him. Ask him about
his philosophy re pain control. If it's his reluctance, maybe you need
to consult a different doctor about this. It makes such a difference
when your pain is under control.

Hoping you find a solution very soon,

Fig

On Oct 4, 9:36 pm, Figgertoes <agent01...@my-deja.com> wrote:
> "Uncle Sally" <uncleSa...@auldUncleSally.com> wrote innews:zQWMi.15775$TR1.1578@fe06.news.easynews.com :
>
>
>
> > Isi wrote :
>
> > "Is it possible to become tolerant to Morphine so it ceases to be
> > effective in pain control? I was under the impression one could just
> > increase the dose, am I wrong?"
>
> >http://en.wikipedia.org/wiki/Morphine
>
> > "Is Morphine as effective as the synthetic opiod drugs like fentinal
> > ..."
>
> > Fentanyl is an opium analogue 80 times more powerful than morphine.
> > From what I have read about it is, when prescribed and used properly
> > under medical superivision, less potentially addictive than morphine.
> > But I've only had morphine (self-administering pump) twice in my life.
> > I know for myself morphine leads to a general state of inflammation,
> > nervous system stimulation as if I were on excess caffeine, and
> > itching reactions. I hated it. Fentanyl did not have these side
> > effects for me, but I think the side effects of morphine I experienced
> > were not common ... or, more accurately, I should say that I just
> > don't know enough about morphine and fentanyl to give accurate
> > comparisons.
>
> >http://en.wikipedia.org/wiki/Fentanyl
>
> >http://en.wikipedia.org/wiki/Duragesic
>
> > I personally had a good experience with use of a lower dose fentanyl
> > patch made by Duragesic that give continuous release over time during
> > the period of one month when my mucositis and oral/esophageal
> > inflammation was so extreme due to RT. But remember that I had no lung
> > problems whatsoever, no respiratory problems, no systemic infections
> > at the time.
>
> > "If morphine is just as good why do medics prescribe the other
> > substances for pain control?"
>
> > I know my Oncologist felt strongly a low-dose fentanyl patch was much
> > better for me in my weakened state than morphine; I'd guess that's
> > based on clinical experience and, possibly, taking into account my
> > previous negative experiences with morphine.
>
> > If Fentanyl patches are easily available in Thailand (in hospitals), I
> > would think they would be available in Romania, but I think you have
> > the issues of respiratory problems to evaluate here and deal with that
> > really require expert advice and, perhaps, monitoring.
>
> > best, Uncle Sally
>
> Here the Fentanyl patches were very, very expensive & not covered under
> the formulary we were under at the time. Another consideration.
>
> Isi, there are so many possible pain relievers & they are often used in
> combination. One is often used to acheive a steady baseline dose &
> another (or could be the same) for 'breakthrough' pain or spikes.
> Sometimes Socks had 3 different things going under doctor supervision &
> advice. Sometimes they medicated heavier at night for sleep, while
> other docs thought a steady 24/7 dose was most effective. There are
> lots of different preferences/opinions among medical professionals, but
> the most important thing is what they do for YOU as an individual with
> unique metabolism, pain cycles & threashholds, tolerance & other
> considerations.
>
> If you are uncomfortable asking this doctor for pain control, maybe
> think about whether it's something with you or with him. Ask him about
> his philosophy re pain control. If it's his reluctance, maybe you need
> to consult a different doctor about this. It makes such a difference
> when your pain is under control.
>
> Hoping you find a solution very soon,
>
> Fig

Morphine is an excellent cheap and safe strong pain killer well
tolerated by most people. The only reason for not using morphine is
when it is not effective for your pain or you are one of the
relatively few people who don't tolerate it because of side effects,
then it will become necessary to change to one of the alternatives. I
have had patients on doses up to 1000mg twice daily without side
effects and with good pain control. If it stops working it is because
the pain has got worse or changed in nature and not because you have
developed a tolerance. Sometimes, quite frequently I suspect, cancer
patients don't absorb drugs orally and then it is necessary to look at
alternative delivery systems eg transdermal patches, syringe drivers
etc.
MIKE

addit sorry I've been away so long...moved house lost broadband access
now on mobile broadband but have to use google rather than outlook. I
actually think I might prefer google!

MIKE wrote:

> Morphine is an excellent cheap and safe strong pain killer well
> tolerated by most people. The only reason for not using morphine is
> when it is not effective for your pain or you are one of the
> relatively few people who don't tolerate it because of side effects,
> then it will become necessary to change to one of the alternatives. I
> have had patients on doses up to 1000mg twice daily without side
> effects and with good pain control. If it stops working it is because
> the pain has got worse or changed in nature and not because you have
> developed a tolerance. Sometimes, quite frequently I suspect, cancer
> patients don't absorb drugs orally and then it is necessary to look at
> alternative delivery systems eg transdermal patches, syringe drivers
> etc.
> MIKE
>

Prostate cancer (to bones) hands shook so badly he was having trouble playing the pipes
(organ) and other functions. And he was nowhere near that dose.
Once he had RT to his pelvis and/or hips, he was able to go off all morphine.

> addit sorry I've been away so long...moved house lost broadband access
> now on mobile broadband but have to use google rather than outlook. I
> actually think I might prefer google!

Thanks for explaining Hope you like your new digs.
Isi, may be on less frequently now for quite a while.
Your presence and input is appreciated.
Welcome back, Mike.
J