Time to get off of morphine

[larryh]

I have been taking different pain medications for about 5 years until I was taking 60mg of morphine 3 times a day.  It has gotten to the point where the pain is as bad as ever again and the answer of the pain doctor was to add another 30 mg 3 times a day.  I have been thinking about the fact that I am going to be taking more and more morphine the longer I go and I am sick of hoping the doctor will get the prescription sent on time.  That the insurance company will OK the prescription the doctor wrote.  The last time they didn't.

I have not been able to get my doctor to get back to me yet but I have dropped one of the three 60 mg does each day.  I am going to get the 30 mg script filled to help me back down slowly.  At least as far as I can.  I also have hydrocodone to help some.

I am not an addict and have never been addicted to anything.  I have never gotten a buzz from any of the pain killers I have taken, but I do realize my body has developed a need for the morphine.  I am only on the second day but I have not felt any worse than I usually do and I have only take 2 hydrocodone all day which also is not unusual.

I also have Chronic Fatigue Syndrome and Fibromyalgia ( which is what got me taking pain meds).  That is where I stand right now.  I am hoping my doctor will help me but I am quitting either way.  

Larry

[sorryone]

Hi Larry
  Good for you for wanting to reduce the meds.  I also have fibromyalgia & Arthritis & have been prescribed norco's (hydrocodone) & lyricia for pain management.  But I have abused them (hydros) & came to this site for support to stop.
   Sounds like you have a good plan.  Sometimes there is the same amount of pain when you get "used" to the medicine.  I assume you have tried other meds over time?
  As long as you go slow it should be fine.  I did not really see a question...how can we help you?
Keep posting, we are a friendly group here
R
 
 
 

[larryh]

I didn't really have any questions.  I am on day 4 of taking 2 60 mg tablets a day instead of 3 a day.  On day 8 I plan to go to one 60  and one 30.  I guess I do have a questions.  Should  I take the larger dose in the morning or evening? 

Larry

[jagannatha]

Hi Larry,

Are you on regular morphine or MSContin? Probably the regular kind, I'm guessing. I've read that doing your taper in 3 day cycles is the best way to go because of how the brain processes things. And the slower the taper, the easier it will be. I tapered too quickly, and though it wasn't as bad as cold turkey, it was rough.

What is usually recommended is that you reduce by 5% for the days, then go down another 5% for 3 days, etc. You can do that to zero, or you can jump off when you feel you are ready. Some people just slice a little bit off the pill with a knife, so you are shaving off a little from each dose.

If you are going to do the 60 / 30 mg thing with your tapering, I would probably take the larger dose at night, so you'll get a decent night's sleep.

jag

[larryh]

I am sorry I haven't been back.  I haven't been having any trouble until the last cut back.  I started on 180mg of morphine a day and I am down to 30 mg now which is the smallest I have until I see my pain doctor.  Through all of this I have had one on line friend who has been my main support and source of knowledge.  Besides chronic pain I also have Chronic Fatigue Syndrome and in the last 3 weeks I have been fighting a sinus infection that is worse than anything else.  Right now I can't tell if I am having any withdrawal symptoms or not because the sinus infection is so bad.  I am not used to getting sick like this.  My immune system is over active and I haven't even had a real cold for 5 years so I am sort of being a baby about the sinus thing.  I don't see my pain doctor until April 5th.  I have not had any help from him with this.  After calling 3 times and no call back I quit trying.  I don't know what kind of relationship we will have after my next visit.  I also don't know if I am going to drop the other 30 mg dose before then.  It would be nice to know what symptoms are from what.  That is where I stand right now.
Larry

[jagannatha]

Larry,

It's not unusual for opiate withdrawal to cause immune problems. Here's a link to some info on it:

http://www.vicodinwithdrawal.org/opiate-withdrawal/opiates-immune-system/

It makes it rough because your body is already in a compromised state, as you take the opiates away and it's scrambling to balance its chemistry again, but don't let it discourage you. You are on the right path.

I was in pain management too and when I told them that I wanted to get off opiates, they tried to dissuade me, first saying that I "wasn't ready". When I came back the next month for my prescription renewal, and asked how to go off the pills, they still didn't take me seriously and were very vague on how to do it. (I was on both Oxycodone and Fentanyl.)

So I just started tapering down off the Oxycodone till I went off completely -- and did it too fast and it was not easy, but did lessen my eventual withdrawal. Going off the Fentanyl was worse, but it's been 2 months now, and only rarely do I have some disruptive sleep.

You are doing great and have already gone way down in your dosage. Remember the slower the taper, the easier it is. Reducing by 5% every 3 days is one formula. There is a lot of info on here about tapering.

Keep it up! And let us know if you have any specific questions or if you just need to talk something out.

Jag

[larryh]

Thanks for the reply.  The more I read about opiates the more I realize they can make my other health problems worse.  My problem right now is that my pain doctor didn't even return 3 calls I made so I just started tapering off myself.  The last cut was 50% because I didn't have anything smaller than 30mg tablets left.  I am just getting over the sinus infection so now I can tell what symptoms are what.  Maybe. I am hurting all the time but I have realized that it isn't any worse than when I was doing 180mg a day and a storm came through.  I am going to stay at 30 mg a day until I see the pain doctor next week.  There has to be other options than opiates.  I want to get off the hydrocodone too but I have been hold them down to only 3 or 4 a day.  That and lots of Lidocaine cream for my hands.

[jagannatha]

I came to the same conclusion about opiates. They are so harmful on so many levels. If I could have stayed on a low dose for my chronic pain, that would have been one thing, but as you know, the nature of opiates is that you immediately develop a tolerance and need more and more to help with the pain, and eventually you end up taking them just to ward off withdrawal and feel half-way decent.

There are other options, depending on what your pain is caused by. After being on opiates for 3+ years and not really getting significant relief for my burning pain, I found out that my pain is actually neurological and opiates don't touch that at all. My neurologist has me on an anti-convulsant, which I never would have thought of, and it is bringing some relief. If you are in a medical marijuana state, that is something to look into as well, as there are strains that address specific ailments. But your pain management doctor should be able to give you options. Hopefully he/she won't push you toward opiates, as mine did. They did try trigger point injections and epidural injections as well, though they didn't work for me. There is also physical therapy, acupuncture and other pharmaceuticals that could be tried. I know Sorryone has recently tried Voltaren cream, which is a topical anti-inflammatory. It's fairly new and kind of expensive, but your doctor may have samples for you to try. And diet often influences pain and inflammation in the body.

I'm so happy for you that you've cut back to 30 mg. a day. That's great. I'm sorry you are in pain, and I hope you get some relief soon. Are you able to get outside and walk? I've found that to be very therapeutic this spring.

Let us know how you are doing, and if you have any questions or just need to vent!

Jag

[larryh]

jag
I think this is day 9 or 10 on 30 mg and I seem to have reached the point that I need a replacement for the morphine if I am going to get off of it.  I hope I am just taking a really long time because I cut my dose in half last time but nearly all I read is that the worst should have been over by now.  I am still taking 1800mg of gabapentin a day just so I can stand to touch things but I haven't seen any side effect from that.  I also have hydrocodone 10/325s that I am allowed up to six a day of. I am finding myself not wanting to go to bed after taking the morphine in the evening because that is the only time I really feel close to good.  I see my pain doctor on April 5th but the 1st time I saw him he put me on morphine without even trying anything else.  Worse I called and emailed him telling him I was going to start tapering off with or without help and never got a reply.  I may end up with out a pain doctor that day because I can't see an excuse for not returning my calls or emails and I haven't been following doctor's orders either.  I have been doing this mainly with a friend on the Internet for support since Feb 27th.  I don't even know if there are lower doses than 30 mg but I am sure there are.  The last few days depression and mood swings have been hitting me too so I know my brain has finally realized I cut way back.  Until the last time I was fine with no withdrawal symptoms.   At least I now know that even if I have to take morphine when it gets bad I can taper myself back off with little trouble when the weather gets better.  I was feeling pretty good on 30 mg twice a day. I have a question.  How does 60mg of hydrocodone compare to 30 mg of morphine?

I am not in a medical marijuana state.  I have access to it but I can't afford it and taking it would mean quitting the pain doctor completely because of urine tests.  I could even lose my disability.

I have Chronic Fatigue so bad that walking from one end of the house to the other is hard on bad days and it take about 2 hours after I get up to actually eat, shower and get dressed on nearly any day.  I was exercising on the WII before I started this but now I am lucky to hold up a book to read.

I know this is a ramble but so is my brain.  Thanks for sticking with me.
larry

[jagannatha]

Hi Larry,

The "worst" won't be over until you are completely off all opiates for at least a week. What you are doing now by tapering is easing yourself down from a higher dose, getting the brain used to it gradually. So what you are feeling now IS withdrawal, but it's just not total withdrawal. The slower you taper, the less harsh it will be, but then it takes longer.

Are you taking Gabapentin for nerve pain? Opiates don't help nerve pain at all. They may take the edge off or relax you so the nerve pain feels more tolerable, but they just can't touch nerve pain. The Gabapentin shouldn't affect your withdrawal at all. Did the pain management doctor prescribe the Gabapentin? What is the nature of your pain?

Your pain management doctor sounds like he would just like you to shut up and take the pain meds that line his pockets. There are a lot of pain management doctors out there like that. I would talk to him about it on April 5, expressing calmly and firmly that you need to get past your physical dependency on opioids and see what your pain level is like without them. If he advises against it you have the right to ask him why AND to politely insist that you need to do this for yourself, and that you need his help in tapering. I doubt he will refuse, though my pain management clinic was not all that helpful in assisting my taper. See if he can give you instructions on how to taper off. If not, we can help you on here, but it will be interesting to see if he will offer to help you.

Ask him if he can prescribe something for the anxiety during withdrawal (for when you completely go off all meds). I was given hydroxyzinepam for anxiety, which I took at night to help with the creepy-crawlies and insomnia. I'd stay away from any of the Benzos because they are very addicting themselves.

Here is a comparison table for opiates/opiods: http://www.medcalc.com/narcotics.html

Fatigue is part of withdrawal and can exacerbate Chronic Fatigue Syndrome, if that's what you have.

Sorryone is someone who knows a lot about tapering, if you want to PM her.

You are on the right track. Make sure you are drinking LOTS of water and taking good care of yourself. You need your rest, so try to resist the urge to stay up and enjoy the high, which I'll bet isn't much of a high at this point, just a short time of feeling "normal".

Keep posting and keep up the good work!

Jag

[larryh]

I really think all of the misery I was suffering was the sinus infection I had and not cutting back on morphine.  I have spoke to several other people who actually felt worse with the sinus infection than I did.  I have been over it the last 2 days and have been virtually pain free.  At least as close as I think I will ever get.  I actually feel much better than I did when I was taking six times more morphine.  I am seeing my family doctor before I see my pain doctor and if she is willing to help me taper I may be done with the pain doctor.  I will probably still need hydrocodone for really bad break through pain but aspirin works good for me most of the time.  I don't need a pain doctor for hydrocodone.  I already take Welbutrin and clonazapam.  I have bad RLS to start with.  I know all about the creepy crawlies and if I take Prozac it gets so bad I jerk hard enough to pull leg muscles.  I just found out that Musinex does almost as bad when I had the sinus infection.  I know hydrocodone is an opiate too but unless I find a replacement there are going to be times I will have to use it

If I can avoid a lot of stress and the weather holds for a bit I don't think I am going to have a lot of trouble.  As for late nights, I have never been one who could sleep before 11 or 12 at night.  Even as a kid.  Now I just don't get up in the mornings.  When the CFS is bad I get up at 8 and take my meds and go right back to bed. 

I take the Gabapentin so I can stand to touch things with my skin nearly all over.  It cut the pain I had by more than half.  That is part of the reason I think I can kick the morphine.  If neither doctor will help me I have 2 months worth of hydrocodone although I have never taken more than the 6 a day prescribed. 

I did get some good vitamins and I have cut back my drinking Coke to one a day with lots of water.  It seems that the less morphine I take the less pain I have and the better I feel.  It had rained twice while I have been doing this and I didn't have the pain I used to from storm fronts either time.  I know this is rambling and disjointed but I have been that way since I got CFS.  Actually I am much better than I was at one time and that was before any pain meds.  Go ahead and poke holes in what I said if there are any.  I am flying blind here and just going on what has happened so far.
larry

[larryh]

I left out a question.  If I don't get any help from doctors how should I taper off of the 30mg of morphine using 10/325 hyrdocodones.  I have about 150 of them.
Thanks

[sorryone]

Hi Larryh
  I have Fibromyalgia so I know the pain of touching things or worse having someone touch me!  My poor granddaughter asks how tight she can hug me..it sucks
 With all my health issues my doctors feel 6 norcos (hydrocondone 10/325) a day  is reasonable.  I don't..but thats a different story..
  I have no experience with morphine so I can only guess at what you could do..maybe break the pills in half (there are also pill cutters that are inexpensive) & reduce until you are done, for breakthrough pain or everyday pain use the hydrocodone.  Once you are completely off the morphine see what your pain level is. I can now take advil (800mg) & get pain relief from my RA, not everyday but it really does work..I was surprised at that.  I also take a high dose of lyricia which really has helped. After I am done with the opiate thing I want to see if I can reduce the lyrica also. Just to see what dose is really working for me.
  I have a good friend with CFS so I know how debilitating it can be.  There are times I visit her & she can't get out of her bed.  I just hang out in the bedroom & we chat, when I see she is fading I kiss her gently on the cheek & leave.  My heart goes out to her.
  I would not burn bridges with your doctors as your illness is progressive & you may need their help later.  I get the impression you are in Canada..is that right?
  You are doing an amazing job at tapering on your own!  Congratulations

[larryh]

No, I am in the US. Why did you think I was in Canada?  I can't cut the morphine in half because it is slow release and cutting them would be dangerous.  The link Jag gave me the other day helped because I can calculate how many hydrocodone it takes to replace the 30 mg or morphine.  I have hydrocodone with Tylenol though and I don't want to take any more than the 6 I am.  They make it with aspirin and ibuprofen also.  Another reason for waiting a bit and seeing my doctor.  The Gabapentin probably took 60% to 70% of my daily pain and I am only taking about 1/3 of the max on that.  Lyrica didn't do a thing for me.  I guess I am just on hold right now.  I do know that the morphine was effecting my thinking way more than I thought and I am anxious to finish getting off of it.  Even though the hydrocodone is an opiate it does not mess with my thinking the same. I have been on some pain killer or the other for about 7 years though so I don't really remember what it is like without taking any.
Larry

[sorryone]

Hi
 I guess the way you were explaining the medicine & doctors appointment sounded more like Canada then the US. Like you saying the pain doctor never answered your calls or email & that you may not have a doctor when you get to your appointment. Sorry about that.

 It is good that you are realizing your thinking was off.  That is because you reduced so much, some people refer to as it as coming out of the fog.
  You are very determined & that is a very good thing!  What are you going to say to your doctor on April 5th?  Talk to him about other treatments?  I have been seeing my specialist for a year now & I am just getting comfortable with her.  She is very blunt..
  Good Luck with your taper.