Morphine brand w/ lowest abuse potential

[Hammilton]

Hello,

I need an answer for this sort of quickly (I'm calling the doctor tommorow). My question is simple (I think).

Which brand of sustained release morphine tablet has the lowest abuse potential. Or, perhaps looking at it from your perspectives, which brand of morphine is the least desirable to you?

I want to switch off of methadone because it makes me sweat so much and because it really messes with my sex life (I thought we got the timing down, but it's been more of a problem than I realized) and I think causes some mental confusion.

I've talked to the doctor in about it in the past but he hasn't been willing to because, me having had addiction and abuse problems in the past- and wanting to keep them there- am a risky patient to have at all, so I've got to take what I can get. I'd just like to have as little of that stuff as possible. He let me try fentanyl for a while, but either the dose was way too low or it didn't work well for my pain.

I see morphine as a good alternative for me. From what I've read, it doesn't work well to insufflate, some people saying that it takes almost as long to come on in the nose as it does in the stomach. So that leaves me with chewing, IV/IM/SC and smoking and eating more than I'm supposed to.

I'm not interested in IV/IM/SC or anything else that might involve a needle. But whatever I find should be difficult to prepare for this method.

Smoking is probably not something that can be avoided for any sort of pill. I don't know if there's any type of pill that can't be smoked. Even those that 'can't' really can if you're to sacrifice your lungs.

I don't know if there's a pill that can't be chewed. Is there? From what I can tell, MS Contin seems to be the best for this, I don't know. I was told that the've got this sort of waxy inside that really needs to be broken down by the stomach acid to get it into your body.

I thought that even smashed up wax needed to be dissolved first because the morphine is still inside of it. Like, a pellet of morphine, with a slow dissolve core broken in half exposes the morphine right away; In a wax core, though, with morphine spread evenly in the wax, you can't just crack it open to expose a bunch. Thats just by my understanding (and is quite easily wrong)

If my understanding is right, this would mean that the design of MS Contin would prevent IV/IM/SC, snorting and chewing. There's no way to prevent eating too much (other than the withdrawals that'll come when I run out early). I think theses might be the best.

The other one I looked at was Kadian. I guess the pellets are hard as shit to crush up. They're un-injectable (without doin a lot of work). I don't know if you can crush them for oral use.

Are there any others I should be considering that are harder to abuse? Does anyone have enough knowledge of these to be able to make an ordered by abuse-potential list? I'd really appreciate it. I can't find anyone I know personally who does.

Any help is incredibly appreciated.

Thanks!

Hammilton

[chemboy7]

I don't know if there's a pill that can't be chewed. Is there?

Yeah, those Methamphetamine pills (I think they are called Desoxyn); you basically need a vice to break those.

[dorje]

Sorry but there is no form of morphine that is not abusable.
Whether you shot it, snort it or shove it up your ass the result is the same addiction.
Junk is a one way street W. Burroughs

[Hammilton]

Well... I'm sure there are pills out there, I really meant just morphine and, broader, narcotics.

I'm really seraching hard for a hard to abuse form of morphine and you guys are the best source I've got.

Maybe not one I can go to my doctor quoting, but certainly the most knowledgeable.

Hammilton

[vanilla_mlkshake2007]

Kadiens have the lil time released balls just like the avinza and are very easy to inject.Avinzas are harder to inject but I still did it everyday till I got on methadone,which for me is a lifesaver.I am sick of trying for two hours every morning to find a vein.If you are looking to get the morphine that I myself find the hardest to abuse it would be the 15 or 30 milligram morphine sulfate the ones that gel up that way you can't shoot em,snorting them is kinda useless andup the ass well haven't tried always just crushed and ate.
Now if you think Morphine is going to keep the sweats at bay believe me I have what I call my morphine mustache that starts under my nose but eventually my whole body sweats terribly until the dose really kicks in.With me this could mean a couple hours or more.So don't switch to Morphine because of sweats alone.

[Hammilton]

Dorje, I realize there's no form that isn't abuseable. There are forms that are more and less abuseable than others are though.

I don't abuse my pain meds one bit and I don't want to. My doc doesn't want to give me morphine because he feels it's more abuseable than methadone. I'm sure it is. He put me on the Fentanyl patch for a while though which is way more than morphine or methadone without doing any work.

I'm not looking for a narcotic that isn't abuseable. I'm looking for specific one that because of it's mechanical properties isn't easily abused.

I need one that's long acting because this would be a change in my base med.

The studies done so far indicate that methadone is a better narcotic painkiller for neuropathic pain, but it has some major downsides. Analgesia lasts 4-6 hours but sedation and mental foginess lasts about 12. We've switched from taking two pills twice daily to taking one pill in the morning, two between 12 and 2 and another one between 5 and 7; the goal was to produce a constant serum-methadone level. I don't think it works very well. I'm still stuck in a sedated fog and not getting the same level of pain relief that the bidaily dosing did.

At the MS Contin site, they have a graph of the serum-morphine levels over twelve hours. It's almost constant. Methadone is relatively level too, but the painkilling ability still goes in these peaks and troughs.

[chemboy7]

What about Lomotil? It's not Morphine, it's Diphenoxylate, but it has a half life of 12 to 14 hours and has small amounts of Atropine mixed with it to prevent abuse. Diphenoxylate is actually pretty potent but being marketed with Atropine it's schedual V. I never tried it myself but I think that Set said something about being scripted Lomotil before.

Either that or you could always just do the tea thing, that's a source of Morphine that your doctor can't control.

[Hammilton]

I sweat tons from methadone if I've taken it for the day or not; doesn't matter at all if I'm coming up, down or it's been anywhere between 18 and 30 hours.

I try not to take them when I'm at work because I have a hard enough time staying awake in the hours from 7 to 11. Usually after that I'm good, but that period can be rough as shit. I take adderall too, but only three, four days a week.

Even though I don't take it in the morning, and the latest I'll take it at night (unless I'm really in pain) is 9pm. In the morning on my way to work I'll sometimes have a good sweat already. For me it starts on my brow, working down my lip and nose a bit and then wrapping around my back- sometimes enough to make my shirt visibly wet. My hands start to sweat, usually a sort of clammy cold sweat that's mild, but my arms- the tops anyway, glisten visibly. Unusually, my under-arms don't sweat a whole hell of a lot; or if they do, they don't smell a whole lot. I do know though that Methadone is reported to be more sweat-inducing than the other narcotics.

The mornings are usually the better time of the day for me. In the afternoon I really start to sweating. The sweats usually last 15 to 35 minutes. I can end them shorter when I can get into a cooler place, like a room with low-temp air conditioning. At work that isn't a possibility; it isn't usually anywhere, 'cept when the outside temp is cold at night (tween 55 and 60) and I have a fan blowing it in hard. My car has decently good airconditioning and when I can I get in that when I get a real bad one. Another method to cut down on them has been taking my cycle out. The wind blowin' through my clothes makes it perfect. I'm getting a touring bike to take out on the interstates and county highways.

Anyway, no, I don't want to go onto morphine because it'll cut down on the sweating. It is a big part of it though, however.

Morphine though, has several advantages over methadone.

Here's a rank-ordered list them, as I see them, here:

1. The 12 hours of mostly constant serum-morphine levels, produce analgesia the entire time, instead of the 4-6 hours of analgesia m-done produces to the 12-16 hours of sedation and fog.

2. Generally less-sweating.

3. Less sexual-problem causing. I find a condom-like loss of sensation at a minimum, near total on the other end. My fiance has been complaining about it... a lot.

4. Morphine- from what I can tell- is a better painkiller in general, though Methadone might be a better for neuropathic pain.


Since I don't and haven't injected by any method (IV/IM) and I don't believe my doctor thinks that I do. The only abuse methods that are really a concern, given my past, are taking extra pills, chewing and snorting. Like I said, taking extra pills isn't something that can be solved for; it does have an inherent safety mechanism- take too many, run out and suffer withdrawals.

I never really snorted any pills, except the rare pure oxycodone I would procure. My doc will still be concerned about the ability to use this route. Is morphine much stronger insufflated? I was under the impression that it was slow to come on and marginally better than oral morphine. If snorting isn't much more enjoyable than oral, it may not be neccessary to find a pill that isn't snortable, but it can't hurt. Its my understanding that most of these long-acting morphine pills aren't very snortable in general.

The biggest obstacle is finding a morphine pill that isn't much more effective because of chewing it. Hard to break small beads are good, but if MS Contins wax cellulose matrix system doesn't cause a massive release of morphine when chewed, that'd be awesome. It has a really stable serum level over twelve hours so It'd ought to provide great pain relief for those twelve hours. I'd love to be pain-free for twelve hours. Methadone is never close to that with it's two-hour dose-to-effect lag-time and all.

I'm doing a lot of research because I really need the constant pain relief and methadone doesn't give that, plus my girl has been bitching about me sweating all the time- the most and my lack of sexual abilities, second. Strange ranking ;)


So, if anyone has much experience with these continuous release morphine pills, I'd really be greatful if you could make recomendations. A. I'm looking for a pill that isn't very 'fun' insufflated (snorted), either because of morphines properties or the pill gumming in the nose or something; B. I'm looking for a pill that- if this is possible- doesn't cause a massive release of the 'goods' by crushing it. I think that either MS Contin or one of those beady capsules is probably the best in this respect. C. I'm looking for a pill that isn't easily injected. Not neccessarily impossible, but difficult and plenty dangerous. Like I said, I'm not interested in doing it, but even so, if they made a 12-hour sustained release morphine solution in ampoules for ingestion, I wouldn't propose it to my doc (It'd be fucking weird and interesting, though). D. The pill should have enough shit in it- that isn't easily removed- to make smoking not worth the pain on the lungs. I don't think this is a big worry. E. Most importantly, I think, is the length of action. They need to last at least 10 hours, twelve+ is preferable though.

So, which brand of sustained/extended/continuous/whatever release morphine the best fitting in these respects? Is Kadian or MS Contin better? MS Contin was said to have a low abuse potential because of the waxy cellulose matrix the morphine is in, in a book I read called "Painkiller" about the rise of the oxycontin abuse plague in eastern kentucky (I think Ky, it was Appalachia, at least). Are there any other brands I haven't mentioned that are even better- or perhaps worse from most of your point of views :smile: ?

I'm so this is so fucking long and probably repetitive. It's just really important that I get this figured out by tommorow between one and two so I can call my doctor while I'm on break. I'd like to talk to a pharmacist; if my doctor says no, I might ask him if I talk to a pharmacist about which one he'd reccomend if he'd consider that.

Hammilton

[Hammilton]

Diphenoxylate is a cogener of Meperidine, aka Demerol. It is supposed to be pretty enjoyable, but half-life isn't the same as length of time it relieves pain. A Half-life of twelve means it'd probably relieve pain for six to 8 hours and 8 hours is on the really low end of what I need.

It's pretty interesting stuff, actually. The atropine is actually present in such low quantities that it can be abused quite easily.

Lomotil isn't even marketed for pain, only diarhea. It might be the easiest opiate to get scripted, though since most docs don't even realize it's chemical relatives.

Anyway, it isn't a real chronic pain type med because of the Meperidine-type long-term use heart problems.

There's really only a handful of meds that would be appropriate and methadone, morphine and some brands of the fentanyl patch are the only ones we've really considered because in general they have low-ish abuse potentials.

Sleep

Hammilton

[SirDonkeyPunch]

if u have the means, u should try buprenorphine. Since its derived from thebaine instead of morphine, some people dont feel some side effects. Its also perscribed for medium to severe pain (i beleive) for arthritis. Im a abuser of pills, theres rarely a good pill i havent seen before (opiate wise, for the exception of a few). Check in the bupe part of the boards, you will see people Raving about it. As for first hand experience, i can say its a lot more energetic opposed to sedative, or at least in the beginning. When first administered you may feel a small burst of energy and it will start to decline. and then, being a CNS depressent, will start to have the good ol' classic opiate effects.

Ive seen it used as a pain med, and ive seen it used more often as a methadone alternative of sorts. If u can get a hold of some i suggest u try it. Or maybe talk to your doctor. There are some stipulations as to what doctors can perscribe it but im sure his advice is a lot more worth while than mine.

take it easy and i hope it works out for ya. peace

-SDP-

[dorje]

I understood your question. I guess I answered from my experience. If it was more or less abusable, I abused it maximum. First, if you don't IV good for you. Second, if you and your doctor are clear you don't ever abuse drugs then once again great.
The first Fentanyl patch I was given was because the Doctor said it wasn't abusable. One pair of scissors later and that wasn't true.
Lomotil is not a good pain pill. It will constipate you however.
I don't find Suboxone to be a great pain pill either.
So if you don't abuse pain medication , I do know why you would need the least abusable form ? Unless the doctor has doubts. The worry is usually IV administration thus the little white balls of Kadian,etc. Good luck on your quest. And i am glad you don't face the too much time left at the end of the script syndrome. I always found three or five to work better than one when in pain, so my prescriprtions would last a third of what they were supposed to...

[Hammilton]

I've been on suboxone once- i stayed on a suboxone maintenance program for about a week and a half. I hated that shit. It may have kept the withdrawals at bay tho' it left me craving real bad. I always feel real sick on it.

It was too expensive, too- $40 per prescription.

It didn't take away my pain very well, though.
-----------------------

I guess I have a few questions about morphine to ask then.

1. Does snorting it produce bonus euphoria in excess of what eating it or letting it absorb sublingually?

1a. If it does, does MS Contin, snorted, produce these effects? Kadian?

2. Do any of the extended-release types of morphine not release the full contents of the pill if broken or crushed?

Anything else that might help me out?

My doctor knows about my history of abuse and doesn't want to put temptation in front of me, you know?

Thanks,

Hammilton

[jab]

I've found the Teva brand MSContin to be the least abusable, least fun, whatever you want to call it.

Good luck!

[candy]

If your doctor knows of your potential for abuse, then I suggest talking to him about this. I didn't read your posts fully, but are you taking these meds for pain control? If you are, then I would suggest sitting down with your doc and having a bit of a heart to heart. If your abusing your meds than trying to find Morphine with low abuse potential is pointless. IMO, anything can be abused to the fullest.

This can be a problem with pt. who are in chronic pain and on high doses of narcotics, such as Morphine or Fentanyl. Once they build a tolerance and need heavier doses, the potential for abuse of other opiates, such as illicit opiates becomes a problem.

If your doc knows of your potential for abuse and your looking for a drug that you won't abuse, then my suggestion would be to open this discussion with your doc.

Maybe a better history would help us to understand what your needs are!

[Hammilton]

No, I'm not abusing my methadone, candy. I don't know if it can be abused for any degree of enjoyment. I am taking it for pain control. I have abused medications in the past, went on a suboxone maintenance program, but after the first group session, I realized I wasn't really like those people. They talked about being unable to control themselves at all- using when they shouldn't, taking more than they wanted to, being entirely unable to ration their doses out. I have done all of those things a little, but not to the extent that they have. The suboxone made me pretty sick, too, at the doses it took to relieve cravings.

Even today I sometimes crave the opiate high (not from methadone at all, though. ugh) and I wonder if I'll ever to stop using for very long. I do worry a bit that I'll never make it more than a month without taking an opiate.

The biggest reason I went to the suboxone clinic was because I had become physically dependent and I worried that A. I wouldn't be able to do without for very long and B. I would get in legal trouble eventually.

I was procuring my painkillers illegally then, and using a lot of poppy tea (1.5-2 cups of grounds twice daily). I used it for it's euphoric properties for 4 months prior, about once or twice a week. After I injured my arm, though, I began using daily. With the way things came together, I had trouble distinguishing recreational use with illicit medical use, the latter being the reason I worried I was becoming an addict (I think the truth was that I was a pseudo-addict according to the current terminology). I displayed a lot of the signs of addiction to keep myself out of pain. This isn't to say I didn't enjoy it at all. I did, but it was a lot different then.

I have been perfectly honest with my doctor about this. I haven't really explained everything to him in detail, but he has a good understanding of what went on; however, he is still understandably concerned with giving my easily abused medications given my history of abuse.

In a fairly recent appt. we discussed the cravings I have still. I was honest. I still have some, especially when I'm really stressed.

In general, though, I've never really abused painkillers as given to me by doctors, or any meds for that matter. I always sorta thought that when a doc gives me abuseable meds, its because he's trusting me with them and I hate to betray that trust. I have adjusted by doses for meds, though, usually slightly, because I have tolerances I don't like to discuss. I've only once had a problem doing that. It was with valium 5mg tabs. I get no effect from valium from less than 20mg, and she'd allotted me 5mg once daily, so I took four of them. At this time in my life, 20mg was enough to make me a little drowsy. I often take tagamet for my stomach and the addition of the tagamet had me really messed up. I kept forgetting if I had taken them and consumed 60mg or so.

Now, I would never do this- ever, and in the circumstances, it is even more obvious. I had a midterm at 5pm. Fiance says I took my four valium right before we left and said I seemed really happy, but not fucked up. Once I got to class, as the tests were being handed out, I started to hiccup. I hiccupped through the entire fucking test. The class was pissed cuz it was loud. At one point I stood up and said, "I'm sorry, my doc has me taking VALIUM and it's messin' me up a bit." I finished the test before anyone else in the class, handed it in and left. Fiance followed in 10 min or so. She had to hold me up for the rest of the 15 minute walk. I couldn't do a fuckin thing without falling over.

NOTE: I did get the highest grade in the class!!!! Or I tied for it. She had a chart with high, low, average and a bell curve.

This is irrelevant, I guess. sorry.

[HeidiW]

Yes, the Teva MS-Contins are virtually impossible to manipulate.