A question about Morphine and Codeine.

[bob78]

Swim takes morphine in quick and slow release tablets, he takes it for pain but also sometimes for recreational use.
Recently swim found his old pain meds he used to take before morphine, Codeine Phosphate 30mg. Swim was in an uncomfortable amount of pain and his quick release morphine was not working as good as it used to, so swim took 90mg of codeine about 2 hours after taking 40mg of morphine.
The Codeine seemed to help his pain a lot better than the morphine, but swim wonders why as morphine is the stronger analgesic. Maybe it was placebo but it didn't seem like it.

Cheers
bob.

[Nagognog2]

Taken orally, morphine is quite inefficient as an analgesic. I don't know why it's even put into pills for oral use. From what I read years back, it was calculated that 60mg of morphine - orally - would provide about as much pain-relief as 8mg would if taken i.m.

90mg of codeine (phosphate or sulfate) orally would certainly work better to relieve pain than 40mg oral morphine. But the usual maximum dose of codeine prescribed is 60mg oral. Perhaps this is why SWIM was given the morphine instead of boosting the dose of the codeine. Now with things like oxycontin - which are time-release - there is even less reason to prescribe codeine for management of chronic pain as oxycodone is quite effective orally.

[Forthesevenlakes]

Like Nagog says, morphine is only about 10% bioavailable orally. Much more so through other routes, but no doctor would advise those. Additionally, most codeine preparations contain acetaminophen, due to scheduling laws. Any morphine is going to be schedule II already, and won't need acetaminophen in it to make it a lower schedule. This lack of acetaminophen could save swiy's liver alot of wear over time, might be another reason why doctors prescribe morphine over codeine.

Mg for mg, morphine is the stronger drug, but only when enough of it makes it into the bloodstream and brain.

[Fantasian]

SWIY could try plugging the oral morphine, however SIGNIFICANTLY drop the dose as Morphine is relatively highly absorbed rectally.

[bob78]

Swim is interested in plugging. Would this involve using water and a syringe (obviously non sharp)? Or could it simply be taken as a suppositary?

Would 30mg of MST crushed be too much for his first time taken rectally?

[Forthesevenlakes]

30 mg may feel like about 60 mg morphine oral. so maybe try half the effective oral dose rectally. it could probably be taken as a suppository or definitely with a water and syringe. here is a good guide for rectal admin with a syringe.

please be careful though and drop the dosage down, rectal admin is both potent and hits fast, and swim doesnt want anything to happen to your lab rat.

[MrJim]

You took the Morphine 2 hours before the codiene. It was the combo of drugs that you found so effective - There was still alot of morphine in your body and the codiene added to that. Now if you were in pain and took the 60mg codiene without taking the morphine at all beforehand, then we would know it's effectiveness on your body.

[bob78]

Well swim decided to plug 10mg of sevredol tonight and could not believe the difference. Swim has been taking slow and quick release morphine everyday for 3 months now, therefore his tolerence has increased quite a bit. Normally 10mg orally does nothing but when plugged it makes swim a lot happier.

Swim thanks the swiy's for their advice, and thinks this procedure will come in handy for when he's running low on his meds, but would obviously not use it all the time.

[Forthesevenlakes]

Glad to hear that the rectal method worked so well for swiBob! This is also a very good lesson on how the dosages must be lowered substantially with rectal administration, even if the person is a seasoned opiate veteran. So swiy is staying on morphine, SWIM takes it? This method could also work for pain control with a 5 mg dose for the opiate tolerant individual. Morphine has notoriously poor oral bioavailability, so swim is thinking swibob could use this method for breakthrough pain sometimes if it seems to be pain that a usual oral dose would not be effective on. But then again it may be best to stick with the methods siwy's doctor suggests.