Morphine vs. Fentanyl for pain control

[bob78]

Hi this is my first post. SWIM is unlucky enough to suffer from Chronic Pancreatitis (extremely painfull) , which means he's on 30mg MST twice a day and Sevredol (morphine tabs) 20 mg every 4 hours or so.
Now swim is being taken off the morphine and put onto fentanyl (http://en.wikipedia.org/wiki/Fentanyl)and it's supposedly a lot stronger.
Does anyone know anythoing about Fentanyl (http://en.wikipedia.org/wiki/Fentanyl)??

Cheers,
Bob.

[Forthesevenlakes]

you can learn alot more about it by using the search engine. up and to the
right. type in fentanyl and you should see an abundance of posts!!

swim says that fentanyl is supposedly 100 times the strength of morphine. fent patches provide round-the-clock pain relief. but the other threads here should tell swiy what swiy would like to know =]

[bob78]

Cheers, I did not see the search function.

[Forthesevenlakes]

swim hopes that swiy gets the pain relief he needs from the fentanyl script. if theres any questions that the search function doesnt answer, feel free to ask them here and the lab rats in the forum will respond. its just that your first question was pretty general, so swim couldnt figure out a satisfactory answer that didnt involve wikipedia.

[bob78]

Hi, swim seemed to get the info swim was after using search.
But swim also would like to hear from anyone who takes (took) Fenantyl and would like to know there experiences compared to morphine.

Unfortunately swim does get a lot of pain that the MST does not really touch, so had to resort to biting the mst and chewing the sevredol.
Swim has got a good pile of meds most of the time, and would like it if people could post their prefered ingestion of morphine apart from IV, swim's not too keen on IV unless he's in A&E.

;)
bob.

[Forthesevenlakes]

well, swim has used fentanyl plenty of times for...well recreation and pain relief. he found fentanyl was a more efficient painkiller than morphine. other lab rats with large opiate tolerances that swim talked to said that fentanyl worked very well for them when they switched from morphine, too. morphine seems to be more varied in its effects on people. many people say that it feels "dark" somehow or that they dont like it, but cannot explain why. swim enjoys the feeling of morphine, but he says that fentanyl can provide an even more intense euphoria and sense of well-being. would swiy be receiving patches or lollipops?

[bob78]

Swim spoke to his surgeon today and he's arranged for him to see the Pain Clinic next friday.
Swim's surgeon is suggesting he takes the patches for slow release and also the lozenges for breakthrough pain.
He could just have his morphine upped but the surgeon suggests Fenantyl.
I don't think he knows if the experience is like morphine or synthetic like tramadol (swim hates tramadol and it didn't help him).

[Forthesevenlakes]

the patch/lollipop combination for chronic and breakthrough pain is pretty common. the lollipop absorbs through the mouth, so it gets into the bloodstream faster than a pill, which is one reason it may work better than upping the morphine dose. the experience feels a bit like morphine, but really it feels more like oxycodone. it does not feel anything like tramadol, thank god.

[bob78]

Is oxycodone dihyrdacodeine?
Swim used to take Codeine Phosphate 60mg before the Morphine, but Dihydra is a lot stonger isn't it??

[Forthesevenlakes]

dihydrocodeine is approximately twice the strength of regular codeine. so 30 mg DHC would be equivalent to 60 mg codeine phosphate. morphine of course is stronger than either of those.

oxycodone is a synthetic opioid about as strong as morphine. its a drug of its own and not a synonym for dihydrocodeine. its a bit more of a cerebral high for swim than morphine is. less of a body buzz, but his thoughts and mood are pleasantly altered.

[bob78]

Thanks for the info you've been a great help forthesevenlakes.
I think swim is going to give the Fenantyl as go he can always go back to morphine although i suspect he wont have to.
The only other option was an injection into the nerve endings of the pancreas which requires surgery and is quite risky. I don't think swim wants the regular meds to stop though lol.

[Forthesevenlakes]

yeah, the fentanyl should work much better. and swiy can always step back down to morphine if it doesnt work out, he's known lab rats who have in order to keep their tolerance from getting too high. please post a fentanyl experience for swiy on the forum when swiy gets a chance!

and glad swim could help, opiates have been his forte as of late =]

[acexnx316]

Fentanyl is a great drug if used as presribed. Why not stick with the Fentanyl? It is great at pain relief. If you are absolutely totally against it though, then maybe ask for him to put you on a low dose of Methadone (Also work wonders if taken as directed). I would start with 10mg-20mg a day and see how that works.

Everyone's body chemistry is different though. If it were me, I would go with the Fentanyl for pain relief, but like I said, Methadone is also great for pain and also has a much longer half life and will last you anywhere from 24-36 hours per dose as long as you keep taking it as directed.

Just my 2 cents.

Pz.

[acexnx316]

Thanks for the replies, I think swim is going to give the Fenantyl a go. After asking a few people the majority suggested sticking to Fenantyl.

Cheers.

Yeah, good choice. I think Fentanyl will treat you right. Basically you put a patch on your skin and keep it on there for 72 hours (3 days). This will control your pain throughout the day for 3 days. And then you just take off the old patch and put on a new one; repeating the process every 72 hours.

You also said you were getting the Fentanyl pops (Actiq). This will help you out immensely because while the patches will help you throughout the day, if you happen to experience any breakthrough pain, you just use a pop and that will be fast acting to help satisfy the breakthrough pain.

I think you will be all set and this will help with the pain greatly.

If it does not at first, give it at least a week or two since the patches need to build up the medicine transdermally so that you will have a steady amount of the narcotic in your system at all times.

Also if you do not seem to be getting pain relief after a few weeks, let your doctor know. He may need to up the dosage amount of both the patch and the pops. Keep in mind, the highest dose that the patch comes in is 100mcg/hr (Micrograms per hour). Where as the pops come in a highest dose of 1600mcg (Micrograms). The patches release the amount of micrograms per hour for 72 hours and the pops release the amount of micrograms instantly until the entire pop is completely dissolved. And if you happen to get to get up to a 100mcg/hr patch and a 1600mcg pop and it still isn't completely helping your pain, multiple patches may be used at once (I.e. applying 2 or more 100mcg/hr patches or any combination of patches; i.e. one 100mcg/hr patch and one 50mcg or one 75mcg patch on your body in different spots at once). The same applies to breakthrough pain with the pops. If 1600mcg pops were not helping, you could use more than one 1600mcg pop or any combination of dose sizes, i.e. 800mcg pop or 1200mcg pop.

They may start you on a lower size patch and pop to start and see how you respond, but I just wanted to let you know what the highest dose of each was, just in case your doctor tries to give you a 25mcg/hr patch and a 200mcg or 400mcg pop and tells you that that is the highest amount out, trying to screw you out of adequate pain relief.

However, I don't know your background, and depending on it, the doctor may start you on the lowest doses possible and work from there to see how you respond. Some people are content and pain-free with the lowest amount, where some people need multiple doses of the highest. Everyone and every situation is different.

Good luck and I wish you many pain-free days ahead. Feel free to ask if you have any more questions and I will be happy to answer them for you. Also let us know what happens when you see the doctor, what he says, and what he prescribes you to keep us updated and let us know if it ends up working for you. If you have AOL Instant Messenger, feel free to IM me any time, my screen name is NEADmike.

Take care and have a wonderful day!

Pz.