I had a severe back and neck injury 35 years ago which is hurting terribly now. My pain relief from pain meds has been less and less as I go along. I am alergic to NSAIDs so relief is hard to find. My doctor feels that the narcotics that I'm taking is too high and is reluctant to prescribe higher doses.
It's a high dose for someone not tolerant to opioids, not really in the big picture. What high for some is minimal for someone else. This sounds like a General Practitioner and not a Pain Management Doctor. As you go along your tolerance will go up, this is normal. As it goes with Doctors today we're lucky they write pain meds at all, many of them are afraid. So again, while there are other things to consider (your history with this Doctor and the exact nature of the injury) in the chronic pain community this is not a "high" dose, that's not to say it's not a high dose for you, or in your Doctor's judgment. I hope this helps answer your question.
Anything over 100mg of morphine or its equivelent is considered a high dosage but that is not to say that higher doses are not necessary for some conditions and there is no "ceiling" effect for morphine. Are you seeing a pain specialist or a primary care Dr? Many primary care, family Drs and general practitioners will not prescribe the higher doses of opioids. They are not trained properly for it and many are afraid of scrutiny by the government agencies that regulate, like the DEA. You must really see a pain specialist to determine the safety and necessity of higher doses of opioids. If you can find a multidisciplinary pain practice, that is your best bet but also be open to adding non-opioid drugs to your pain regimen. Sometimes adjunct medicines can help to make the opioids work better without having to raise the dose of the opioids. Drugs like Neurontin (gabapentin) Lyrica (pregabalin) and Cymbalta (duloxetine)among others are very good at helping chronic pain and they are not NSAIDS or related to NSAIDS. You might also want to consider a drug "rotation" which is based on the premise that even though you may be coming tolerant to the morphine, you may be able to take a lower amount of another opioid without the cross tolerance so, in other words, just because you are tolerant to morphine doesnt mean you would be tolerant to fentanyl or methadone or one of the others in the opioid family and might be able to get good relief from a lower equivelent dose of those meds. Do some research and find out if there is a good pain specialist in your area and ask your Dr for a referral. If you dont need a referral, you can just set it up yourself and allow the pain Dr to take over the responsibilty for managing your pain.
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