hey SHAW, i have been following your plight since Florida passed that stupid law. if i recall when you were converted off methadone you were underdosed by a big margin. what dose of Morphine Sulfate CR are you on and are you using the 15 or 30 mg Morphine Sulfate IR for breakthrough pain? i think your CR morphine is made by Watson generics and if it is thats a pretty good one, the other generic i like is the Endo MSER. i do not think your doctor's logic of using the same agent for breakthrough pain is right in most people. Morphine has the best affinity for all the various receptors, more than any other narcotic pain medicine. by the way, the most important thing to remember is the cure or treatment is not the cause. it has been found that although tolerance occurs with some opioids, long term use does not make the pain of your paticular problem any different, you would still hurt but have less control if you taper down, you also would have a long term opioid-abstience syndrome unless the taper is very slow. opioid-hyperalgesia may be a myth or very slight if anything. if you want to try it without then the Suboxone taper is probably the most comfortable and not traumatic to your central nervous system. even using the Suboxone it's still good to have 1-7 clonidine patches on and have trazadone or amitrityline to fix sleep patterns and a type of benzodiazepine tranquilizer that strong for the "bad" times: Klonopin, Ativan, Valium are good. some doctors will not use benzo's with suboxone because of respritory depression possibility, instead they are doing trials with Rohypnol (date-rape drug stigma). i think instead of tapering down you should taper up and use a different agent for brkt. also try some adjuvants like soma, dextroamphetamine, bupropion, lyrica, neurontin, tizanidine. drugs like vistaril or phenergan can be potentators to opioids also. for constipation morphine is about the worst for that because it has such high affinty for the type of opioid-receptor in your guts. changing to a a more targeted opioid for brkt. can help this (fentanyl, oxycodone, hydrocodone). also taking a few apple-pectin tablets or capsules with meal can be a big source of good fiber that will also lower LDL's. a good quality pro-biotic complex will help (brand: New Chapter).
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,
current Rx: fentanyl patch 75mcg. , Roxicodone 30mg prn qid,vistaril 50mg prn nausea, Lyrica 150mg 2x,Adderall 20mgs 1x A.M. 10mg PM prn, Soma 350 mg 3X, Elavil 25 HS, diazepam 10mg bid prn, Supplements: CO-Q10 100mg, Vitamin D 2000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, GABA 750mg,