Opana is pretty much at the top of the list. You can increase the strength or dosage which is not unusual to have to do as we get use to an opiate. Without knowing more about your source of pain and what you have tried it is difficult to make suggestions.
The only pain medication I can think of that would be stronger than Opana is fentanyl. Fentanyl patches are the only fentanyl product FDA approved for chronic non-cancer pain, all the other products are only approved for cancer related chronic pain.
Just because you build tolerance to one opioid medication doesnt mean you have tolerance to other opioid medications. You may be able to rotate to another opioid just fine as long as the dose is equivalent. There is no ceiling on pure mu opioid agonists.
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