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morphine, how long to taper off it?
morphine, how long to taper off it?
My wife has been taking ms contin for almost four years at a dose of 100 ml every 12 hours. She has had extream pain from breast cancer and phybromyalgia.
Recently she smoked a couple of joints and violated the agreement with the pain managment dr, which was found durring a urin test. She did not admit this to the dr and so they said they were going to send the sample out for outside verification.
She did at the time of the appointment let them know she wanted to taper off the drug. They did agree to tapering her off but also said they do not give scripts after a positive test, but they did write for a 2 week supply of 60 ml pills 2 a day so a total of 28. Only untill the test results come back and if it is positive still, it prolly will be, then no more.
What we need to know is can we ween her of with this amount. She tried going cold turkey 2 years back almost and almost died from that, I/we dont want to have that happen again.
Please if someone knows if this can be done or has done something simallar please let us know.
I was thinking just breaking the pills in half or thirds untill she is at the lowest dose of maybe a third of a pill.or so.
Are you saying your wife currently has active breast cancer? If she does, is she
being treated for it...chemo. or radiation, and has she had a mastectomy? I think
when you talk about "ml" you mean to say milligrams or mg. I cannot understand
that a doctor would just desert your wife under these circumstances. She should
have been up-front with him, but if she's in that amount of pain, her doctor needs
to make other arrangements. I can't give you a suggestion for tapering the Contin.
One of the other people here will read your post and respond, but I happened to
see it and thought I'd at least let you know someone's here. I would not suggest
cutting M.S. Contin. That medication should never be cut in half, quarters, whatever.
I guess my suggestion is to maybe try ER and get a referral from there. Good luck
to you and your wife! You'll find great support here...
PM doctors have no problems cutting patients off if anything is violated. Smoking pot is a big no no. If she's still experiencing pain then she should just start looking for another doctor and be up front with him. Office visits=money, I doubt anyone will turn her away
Originally Posted by Swanie
Thank you for the responses. Yes Swanie, I did mean mgs. So, why not cut the pills? Doesn't cutting a 60 mg. pill in half make the half a 30 mg. size?
A friend mentioned that suboxone might be able to help her through the w/drawl which she is already experiencing since we had run out of the med a day before the appt. due to a scheduling glitch. Does anyone have any idea how suboxone works and does anyone feel this might be an option for her?
We/I came to this board for experience and support and feel that it's coming since we saw so many helpful people posting, including some doctors.
Her breast cancer is currently dormant. She found a lump, got the lump removed and it was found to be malignant. She chose to not have any treatment as more and more women are deciding to do since "treatment" may not be the best choice for some women as we've seen in more and more medical journals and we've seen for ourselves how "treatment" can even kill people. It was her decision to make as it is everyone's and she had recurring pain at the site and radiating out along her right side ever since the operation. She did have a few follow-up PET/CT scans which came back clearer and then nothing. The p.m. doc. said that it could have walled itself off but there could be something like "remembered" pain (not his words but he did recognize the pain she was describing as what he called "cancer pain".
We had been referred there by her (then) primary care doc. who felt the she could not treat her pain the way it needed to be treated. She also has a rather crippling form of fibromyalgia and with both those factors we've been seeing the p.m.doc I think about 4 years now. She recently began feeling that she didn't want to be tied to the pain meds and that sort of lead to where we are now.
Further details: Her primary care doc now is a nurse practioner who doesn't really do much examining since she knows that my wife is rather knowledgeable and knows through trial and error with docs. over the years for the fibromyalgia but she has been helpful when things don't work, helping us with decisions, informing us of what she thinks works best here and there. So at the present time she is prescribing:
2 5 mg. valium daily as needed
2 300 mg.neurontin 3 x daily
3 350 mg. soma 3 x daily
1 150 mg. trazadone 1 x daily
1 6.25 mg. ambien cr. 1 x daily
That's it for now. I hope I've been clear here.
We know there may not be any easy answers and finding a doctor these days is just nearly impossible especially in the rural area where we live. Knowing the truth about the "self-medicating" w/pot once or twice lately might very well get us turned away from not one but many docs who may pale at the thought of taking her on. She's not headstrong but she does know what works and helps her and she's had many bad experiences with know-it-all docs, know-nothing docs. and docs that are on power trips. Early on we once got turned away from a doc. for just telling him that she wasn't seeking treatment for the cancer, just for some pain relief and help and support. His answer: See a psychiatrist since you're crazy for not seeking "treatment". Geez.
So here we are today, her sick, me worried to death (both of us really).
I tried posting earlier but something happened as I was typing...so I'll start over.
I'm not the best person to answer your questions. I,myself, am currently detoxing
from opiates, in particular, methadone. I have found the people here to be knowledgeable
and kind. Having said this, I will respond to what I do know. M.S. Contin is a timed-release
medication so you do not want to crush or cut the tablet and have all that medication dumped
into your wifes system all at once. Valium and particularly Soma, are muscle relaxants, Valium
also being an anti-anxiety med. The Neurontin is used for nerve pain in our wifes case..I assume she does not have seizures which is another use for Neurontin. The Ambien is a sleeping pill, Trazadone an anti-depressant. You probably already knew all this...
Has your wife's cancer spread?...oh I believer you said there was no proof that it has.
Your wife needs a physician's guidance, she can't just stop the Contin without help at her doses. Do you have a home health agency near you? They might be able to come out to evaluate your wife and go from there. I realize it's the weekend, but if you could get a referral, or simply call them with your situation, they have to have someone on-call at all times.
I'm sorry I can't help you with more, but I can see you're in a predicament..
Thanks again Swanie! We don't have any home health agencies here and if we did, we probably wouldn't qualify since I have health insurance thankfully. We're still considering the option of the hospital of course since that may be the only recourse. I understand the process of time released pills and they're not being crushed, no powder is being consumed. I don't think breaking the pills would cause the piece to release the medication any faster than the whole pills but I could be wrong of course. The pills aren't coated w/anything so I think a piece would work like a part of a hole.
It seems to be working that way for her; she's not getting a big rush of anything but she's been feeling better for longer periods of time - still sick but not yet throwing up and spewing from everywhere like last time. She's been able to eat small amounts and she's been trying to keep the juices and water input going since she got so dehydrated the last time.
After looking around here and seeing the lack of other responses, I'm wondering if this post is in the wrong place and if it is, I wonder if the administrators could/would move it to a more appropriate place. We really need help, both here and yes, from a doctor but again, like I said, it's hard to find a doctor and especially with the tiny time we have.
I'm sorry no one else has helped you yet. The holidays cut down on traffic here it seems, but hopefully you'll be getting someone to come along side...
I can only repeat that M.S. Contin should not be crushed, cut, or chewed as it is a time-release medication. As far as the home health care...there should be some agency avaiable to you even if it's miles away. HHC and Hospices serve patients in counties other than their own.
But in all of this, it sounds to me like the best option would be a trip to the ER. Your wife
can't just go on like this with this type of anxiety regarding her pain meds., and I'd say get
it taken care of sooner than later.
A suggestion for receiving more support here would be to post your question again...that's what I did , and I've gotten lots of great support.
Hello there, I didn't see your posts before and I'm sorry to hear about your wife. There is woman on here by the name of Melinda 7.5 and she helps people taper off pills. I was never good at doing that so I don't feel comfortable giving advice on the matter, but Melinda has helped many taper off opiates successfully. Your best bet would be to start a new thread with your original question in it and put Melinda's name in the title and I know she will help you. I hope this helps and my heart goes out to your wife. Take care!
Thank you both so much. I did realize it was the holidays and can't blame anyone for not being here. I'm left wondering where best to put this. I looked more carefully around last night here and saw the "Ask the Doctor" threads and kind of wished I had posted there. I hesitate to re-post somewhere else since I've been a moderator of a forum before and one of the things we didn't allow (or like) were people who posted all over. The other place I found here, I can't remember the name of but it seemed there were more people responding - in "Drugs" or something like that; I wish I could remember. I guess I need more help than I thought!
We have the thought of going to the ER in our minds constantly but are still in the process of paying for the last visit. We do realize that her life may be in danger as we are now so if it really comes down to it, we're on the way to the ER immediately. No mistaking when since we know what's down the line here as far as her symptoms go/are going. She's a bit sicker today but not yet throwing up etc.
Any suggestions on where to re-post?
Thanks again and again. You both sound like such caring folk.
I would take Melissa's suggestion and re-post in the "Need to Talk" section saying you have an urgent request and include Melinda 7.5 in your title. Really I don't see with the amount of
pills that would be left that you can do this on your own. Your wife is already ill, and you need the support too Wayne.
Try posting your title again and see if you get any feedback, but remember it's a holiday and a weekend...Good luck!
I've detoxed a few times with tapering and will tell you a method I've helped others with. First of all "there is hope and this can be done" but she has to be determined to quit.
First she needs to go without a pill for at least 24 hrs minimum or longer if possible. It will go a long ways in detoxing her system and preparing her for a much easier taper. Time it so her last dose is at bedtime. She's going to get terribly ill, especially after the first 12 hrs. shakes, cold, restless, depressed, anxiety etc. Hot baths will help a lot with the chills, RLS and bone aches. Once she's gone at least the first 24 hrs or more then give her half a pill. That should stop her severe symptoms in their tracks. Encourage her to eat something, take a few valium and get some sleep. Then she needs to go another 24 hrs before she takes another half pill. It shouldn't be near as hard as the the first 24 hrs but still not easy. Same routine with food, valium and sleep. After another 24 hrs. reduce her to 1/4 of a pill. Continue this pattern for another 4-5 days till she's ready to stop completely. Eventually her sleeping and eating patterns will return to normal but everyone is different on how long with post withdrawal.
This is the least painless taper I've found that gets you off potent pain meds relatively quick. It allows breaks from lack of sleep and appetite, so you're not completely, physically drained.
The other method is to reduce her morphine intake amount 1/3 every three days. It's similar to a Sub taper but you need patience and will power. This method generally works better with people on lesser amounts of meds because tapering from lower doses creates less severe withdrawal symptoms.
Good luck and remind yourselves she's not trapped in anything that can't be overcome.
By the way Wayne I'll try and be here for any questions or support you need. Don't hesitate to seek emergency help should you dertermine her health is in jeopardy. It's not likely she'll die from withdrawal though she'll certainly feel like it.
Are you there? I've been thinking of your situation and am concerned. Chime
in if you can...
Sorry it's taken me so long to get back. Some things came up the past couple of days and I haven't been able to respond but hey Grip, your input was right on the money as far as what we are working at here. You've confirmed it now since that's basically what we've been doing. Excellent advice. Thank you very much!
We still wonder about the use of suboxone as a last resort - Grip, do you have any experience with it? It's not something we want her to use as any long term thing and we wouldn't. Too, she has some oxycodone that didn't really work for her in the past but wonder if that might be used in the in-between times?
I think I'm not going to re-post since as I explained before, it's not a good thing for the moderators to have to deal with and usually not excepted on forums I've known.
Swanie and Melissa, thank you both so much and Swanie, you really seem like such a good and caring person, both my wife and I thank you very much and especially for being so concerned.
Right now I think we're both gonna be napping and (groan) tomorrow I have to be back at work after this 4 day weekend. I'll try and keep y'all updated as to how she's doing and I look forward to your response if you're still here Grip.
Peace, love, understanding and harmony.
Good to hear from you, I was concerned! Sounds like things may be a tad bit better,
at least you found someone who has come alongside with their opinion of how you should
do things. I wish I could help you, but I can't. Dealing with problems with my own situation,
but I'd help if I knew more about it.
I'm sure you will hate going back to work. Your wife is fortunate to have someone who is
so concerned about her.
No prob Wayne I've been running too. Glad to hear the advice helped! Yeah, if she run's out of the MS you could use the oxycodone in between but once you switch it's better to stay with it. There's also something called the "Thomas Recipe" that can help but I think you're already doing half of it.
High dose Morphine extended release is very tough to taper and she might do better with Sub. After induction it's relatively painless when done right and nothing to worry about. It's an opiate replacement and not something you get high on the same way. I know about it but have no real experience. There's a guy I think named Robert_325 who has a link
to his induction and taper schedule for Subutex and Suboxone. Read the whole page thoroughly if you're interested in using this method. If you have questions try to contact him or start a thread asking for his help. I've seen people in much worst shape than your wife have smooth transitions, so he really must be good.
I had a long detox of over 10 days, though I've seen others do well much quicker. If your wife isn't one of those fast rebounders and it's becoming too grueling then get the Subs. It's easier overall and seems to get brain receptors back to normal quicker. She'll find afterward that o/c meds like Aleve and Advil may work as good or better. I've got bad herniated disk, arthritis and old booger disease but pain meds simply didn't work after awhile. All you end up doing is taking more and more just to prevent w/d.
I'm wishing you well and support. Keep us updated.
ps. The people here are wonderful support and experienced. Don't be afraid to ask them questions or for help.
Swanie, Thanks again for being so supportive and I realize now I've neglected to tell you that I hope you go through with your own w/drawl or present circumstances as best as you can with little to no problems. We really do appreciate your being here.
Grip, I've just read (and my wife has been here, reading and yes, even sending messages here via my name) the post about the suboxone and it's a huge amount of excellent information. Thank you so much for pointing us in the right directions here.
She's actually doing pretty good here; mostly weaker, still eating, drinking, keeping it down and sleeping at night and fairly long naps which is pretty normal for her since she's been on the morphine. (not the weaker part) We know she's going to get off this and we're pretty sure now we've got the tools, information and well, no in-person sort of support besides me but there are family we talk with, (our children) and a couple of very close on-line friends we met when we ran an N.A. chatroom and were involved in another longer ago.
We no longer go to nor support N.A. for ourselves. N.A. chatrooms can be places of support for some people but some people just give out information there that just isn't good, practical information on how to properly go through w/drawl and some of it was just plain wrong advice. "Yes, take lots of hot baths, suck on hard candy and drink plenty of fluids, especially fruit juice." If my wife had believed that last time she tried to w/drawl just cold turkey, she nearly died after only a few days and wound up in the hospital. Yes, N.A. was good for us in the beginning but we finally realized that there were so many inconsistancies and hypocritical things that are said and believed in N.A. that we had to close our chatroom since we just didn't feel it was right for us or anyone else going there. I know many wouldn't agree with us but that's just what was right for us. (more backstory)
The only illicit drug she (or I) have used for 12 years now was the pot that came into our lives and we're not about to go back out using the way we did. We know that now, absolutely.
Thank you both again so much for the help, support and advice. It's been extremely constructive input. Consider yourself as having done random acts of kindness and we will pass it on, pay it forward like we believe in doing. Whenever someone does something good for you, pay it back to them by doing something good for others - and to those who lend a hand when and where they can.
Peace, love, understanding and harmony.
Wayne and Jennifer (yes, she has a name!)
Hi Wayne and Jennifer~
I'm so glad things are progressing and that you feel you're on the right track. You might
want to know that I have really debilitating fibromyalgia altho' that is not the reason I was
started on opiates ten years ago. I have neuropathic pain in my face from a bothced job
of having some teeth pulled, and then I deal with facet joint osteoarthritis. I've never felt
tho' that the opiates helped me much but was leary of getting off them 'cause people would
say "well, your pain might be much worse without it," and of course we never want to suffer more. But about a month ago I took it upon myself to withdraw and detox. from methadone...I think I'm having more problems doing it than others I've read about, but I'm haning in there.
That's just a brief story about why I'm here. Since I'm fairly new here I've only commented a
couple of times on others posts, but for some reason your story caught my eye and I wanted to let you know that I'm following your progress.
I hope your day back to work went better than you thought it would Wayne, and Jennifer, I
pray your goals will be accomplished and your health will improve greatly...
Nice to know you guys are feeling more confident about her situation. I felt for you when nobody responded on the holiday weekend. I know that desperate, hopeless feeling when you start a detox journey and there seems to be no light, very scary. Sounds like Jennifer is past the first phase and not too bad. Tell her it gets SOOO MUCH BETTER.... and is worth the effort. Stay determined, resolved and let others help talk you through it. The fatigue can be one of the last things to fade. Let your body rest when needed and don't expect too much at first. Eventually your natural chemistry will find its balance again.
Take only the advice that makes sense to you. You'll get better treatment options when you consider more information. Support groups have helped save me twice and most people (N.A. & A.A.) mean very well but even physicians don't have all the right answers for every circumstance. When you're deathly ill there is no one better than a trained medical professional but their approach at long term care is where they differ and your input is necessary. And we all have such diverse lives that there is no "one size fits all" treatment or advice. Unfortunately online relationships are going to be a little superficial without direct interaction. But they are certainly better than nothing.
I actually watched a lot of Rehab and Intervention Shows on TV and read this site for my last recovery, years ago. I take care of a sick family member (heart failure) and can't leave home much. If for some reason I don't respond for awhile it's because I'm at the hospital.
Swanie, sorry to hear about your pain and w/d from methadone. I know it has a long half life and is a ruff med to come off. Hang in there because it gets easier. I had good days off and on for months, till they all got good
Stay in touch Wayne and let us know how Jennifer progresses. We're here for you in spirit.
Last edited by grip; 01-04-2011 at 11:29 AM.
Thanks Grip...for me each day seems worse...so I don't know.
Glad you could help Jennifer and Wayne. I hope things are going fairly well for
her...Wayne, let us know when you can, ok?
Hi, This is JenniferWOW, (wifeofwayne), haven't registered yet and he's still signed in. Just had to say thanks myself. Just went almost 24 hours I think since last med this morn and sick as a dog. Sicker. But took meds and now able to write here for a sec.
Thank you so much for everyone who has posted here, special thanks to Grip for the constructive and consistant suggestions and links. Thank you Swanie for just being you.
I know the mention of the online relationships etc. about N.A. is only our opinion but I have to stand up for the two, no three friends we have met online and now know to be lifetime friends. It's true and I wouldn't have believed it myself but - it's true for us. Again. only our opinion.
Grip, very sorry to hear of your troubles. We know only too well how it is to take care of someone sick or dying as we've been there more than once. It reallys takes the life out of you somewhat, in a way. In another, it can be the only way and to know you've stepped up and did the right thing is always good for you, even when it hurts to the core if and when it ends. I wish you and I'm sure Wayne does the best possible outcome for both you and the person you are caring for. When you showed up here Grip, it was like an angel or something. (not that I'm religious but more, um, spiritual) You showed up with just the right words, just the right tone and help we needed, right when we needed it. Again, you did the right thing and I believe you showed up here now, for us, for a reason and it worked. Thank you so much.
Swanie, you keep working at it and you're gonna get through. You may be sick now but the caring that you've shown is priceless. Thank you as well, so much.
Peace, love, understanding, and harmony,
Swanie that's not untypical for methadone users to have a long post withdrawal. Different strange symptoms will pop up, off and on but you do improve overall in time. I promise it will get better and your body will heal. Believing we help each other can be empowering in your struggle. You've been pushed up against the wall by this stuff, now it's time to come out fighting like a tiger!
Jennifer wonderful to hear from you. And I'm very touched that my counsel was so appreciated. My angel was a stranger also when the sun went down in my life. I guess I'm also more spiritual but "something" moved me to try and help you and Wayne. Unfortunately it wasn't because I'm such a good person but rather that "something" was. We all need that outside confidence when things seem bleak.
I understand about your N.A. encounter because I've had similar experiences. And I've had strange to bizarre advice from doctors. You have to take the best of what people offer and quietly dispose of the rest with a smile. My family is always offering goofy suggestions but I keep an open mind. Even an old addict (me) is right sometimes
Thank you for the condolences about my sick family member. Yes it's very hard to accept and deal with suffering and the end. It makes ever day seem like such a gift.
You hang tough. You're through the worst and only a short time from the big improvements. Eventually you'll start putting days together without opiates before you're completely free.
Talk at you guys later, grip
Last edited by ddcmod; 01-06-2011 at 01:26 PM.
Reason: link added
Thanks for the support Grip!
I can chime in about being a caregiver...Have done it twice now with both
my husband and mother. They're both "gone" now,..and I'll never regret
caring for them!
Jennifer~ that's always been one of my favorite names...How are things
going now,..any relief at all or are you still so sick? Thank you for the
compliment...very gracious of you when you are fighting a battle yourself.
You're in my thoughts throughout the day...
Swanie I'm hoping you win your struggle. I've done the caregiver thing twice now and it's very hard emotionally. I won't ever regret it either though the worst is the helplessness to stop their pain, then the abandoned feeling when it's over. But I do them no honor by not living my life to the fullest. We only get this one shot, so you got to grab it and growl instead of sitting on the pity pot.
Hi Jennifer and Wayne,
Just checking in on you to see how things are going with the taper. I saw where you were considering suboxone as an alternate route to take. That is what I used to get off the opiates and it was pretty much painless after I followed Robert325's taper plan. Just another option if your still thinking about trying it and I imagine it would be a lot smoother then tapering off the contin. I have been following your story and I hope all is well with the both of you. Keep posting and give us an update on your situation. Hang in there and take care.
Okay now. Jennifer here. Just quckly. We are going to go for the suboxone and it should be in our hands this weekend. I also called my nurse practitioner this morning and told here the truth about what happened at pain management. I asked her if she could please up the valium intake for one month. At first she was starting to say no, did say no but I pleaded with her that at this point, I'm having panic attacks; waking, sleeping and it's the truth too. Moreso now than ever. She finally agreed. Triumphant feeling for me this morning.
I'm sicker today obviously w/lower and lower dosages but know in my heart we're nearing the end and I probably won't wind up in the hospital. Probably. (Yep, there's that question in my head - more panic but pushing it away. At least I have a great book I can lose myself in when the tears are stinging which is much of the time at even just looking out the window, not thinking about anything. Heightened emotions, lovely.
Still hungry though and off to find some oatmeal w/blueberries and raisins..
Thanks again and Grip, don't tell me you're not a good person, that is the old you maybe.
Thanks to all for everything.
Peace, love, understanding and harmony,
Hope for some update from you when you're able. I thought about you as I lay
awake again last night. I wondered too just how many thousands and thousands
of people are attempting opiate withdrawal, and I said a prayer for them all.
Our bodies all react somewhat the same yet somewhat differently to this struggle.
I'm hoping you are through the worst of it, that is my prayer for you Jennifer...
The emotional roller coaster and panic attacks are very common. Movies, music, reading, conversation all help process the moods and thoughts. I even had short spells where my chest would tighten up and breathing get labored. All scary occurrences though fortunately didn't last real long. That MS is a real bear for w/d symptoms. The taper is less intense than CT but can seem torturous in duration.
You'll be amazed at how fast you feel better with the Subs and probably won't need much extra valium. I seriously suggest following Robert's instructions for induction amount (starting dose) and tapering schedule. Getting a 26 on the w/d scale (COWS) and stabilized the first few days on the correct amount (1-8mgs) is key to an easy taper. His method is proven to be extremely successful for the least amount of discomfort and time.
If you have questions I'll try and answer but hopefully more experienced members will help respond.
Hi, Jennifer here. I'm not sure Grip what you meant by CT in your last post, been thinking about it and everything else since yesterday. Wondering too what the Thomas recipe is but feel like I can't research anything today, I can barely sit or lie down. Screw pain managment, I'm so glad to be out of there. (excuse my "language")
Swanie, I think we posted at exactly the same time yesterday, I feel like hell today, hope you are better than I. Very sick today.
I've got some other questions about suboxone but I think I'm gonna post in the drug info.. area so if you want to check there, please do.
Last edited by wifeneedshelp; 01-07-2011 at 11:35 AM.
I think Grip meant "cold turkey." So you're really sick? I'm so sorry,..I really
am, and I think of you so often, wondering how things are going. I wish I
was wise and had answers, but even tho' I don't, I want to let you know I'm
following your journey here. Bet it seems like a trip to hell right now!
I'll hang in there if you do,..ok?