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Opioids Calculation of meds into morphine.

T

ty50

Greenlighter
Joined
Jul 4, 2009
Messages
8
My Dr. told me that my oxycoden and fentanyl breakdown as Morphine and only allowed 500 mgs of Morphine.
Has anyone heard of this? If so how many 30mg of oxycoden and how many patches of 75mcg fentanyl = 500 mgs of Morphine. She is telling me the DEA is only allowing 500mgs of Morphine per month allowed. Does anyone know if this is true? How do they calculate the break down? Is she just full of shit? Confused she is lowering me down fast after being on this for 6 yrs. all I feel is Pain. Should I go see a different doctor?
Thank you
 
This sounds like bullshit... That's one dose of the lowest dose of morphine orally of ir meds. It would only allow 15 doses of the lowest ER med.

That being said I can't say either way, but you could ask your doctor to show you documentation of the dea stating such a guideline.
 
Neither oxy or fent is metabolized to morphine. I think your doc was trying to convey the idea of analagesic equivalency but in a rather poor way. Basically its how much of drug ______ is equivalent to 10mg of morphine then you do a bit of arithmetic to get your dose.

And the DEA has not changed its laws or regulations. However, there is now a push, led by a publication by the CDC, to get doctors to write far fewer scripts for narcotics in response to the so-called opioid epidemic. What they state is that since there has been a huge increase in the number of scripts for opioids as well as massive increases in overdoses, hospitalizations and deaths from them, it is prudent that prescribers exhaust all other options before turning to narcotics. They should write only the smallest dosages for the shortest periods of time, be very cautious when increasing the strength or frequency, monitor for signs of dependence, pseudo-addiction, and true addiction, and refer to pain management if the pain is chronic.

This publication by the CDC is in no way binding and a doctor can still write whatever they feel is necessary. Unfortunately, the DEA has taken notice and is informing doctors this should be the standard of care and insurance companies and government sponsored healthcare may refuse payment if it is not followed. This scares the shit out of many prescribers so they follow it and/or create their own protocols to adhere to it and cover their ass.
 
^ Precisely.

ty50 said:
My Dr. told me that my oxycoden and fentanyl breakdown as Morphine and only allowed 500 mgs of Morphine.
Has anyone heard of this? If so how many 30mg of oxycoden and how many patches of 75mcg fentanyl = 500 mgs of Morphine. She is telling me the DEA is only allowing 500mgs of Morphine per month allowed. Does anyone know if this is true? How do they calculate the break down? Is she just full of shit? Confused she is lowering me down fast after being on this for 6 yrs. all I feel is Pain. Should I go see a different doctor?
Thank you
Click to expand...

What I do know is that Fentanyl is obviously much stronger than Morphine. It's approximately 50-100 stronger than Heroin. Maybe, just maybe 25 mcg of Fentanyl would be the same as 500 mg of Morphine, but it doesn't look right IMO.

Besides, both meds produce different reactions. While Fentanyl is often used for analgesia and it's does not cause euphoria, Morphine does. So being strong doesn't necessarily means it's good. Just a thought some people may argue it's not strong enough because there's no rush.

I agree with Speed King, ask for another opinion.
 
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Oxycodone I believe would possibly convert to morphine or at least for sure oxymorphone....

norfentanyl is the metabolite is from fentanyl obviously.

Again ask your doctor to quote you official documentation that you can see so you know they aren't lying... As far as I know there's only the CDC guidelines to prescribing Opiates that are over exaggerated by a lot of doctors and used as an excuse not to prescribe where nowhere is their anything that strict in the explanation.

Edit: CDC guidelines for provider

https://www.cdc.gov/drugoverdose/prescribing/providers.html

Found nothing on dea regulations.
 
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OP, you can use your search engine to locate a opiate conversion chart. That will explain a lot.
Just type in something similar to what I typed.

Usually oxycodone is listed as roughly 1.5x as strong as morphine. You have to remember, each drug has its own effects. What is printed may not equate in real life. Any chart is simply a guide line.

Opiate laws are at least tightening up across the country. That is not including a doctors reluctance to prescribe them to begin with.

You may have been given a 15 day supply of one of the lower doses of morphine available.

I suggest, if the dosage is too low for you, or any important questions regarding obtaining a refill or longer supply, you contact your prescribing doctors office.

If you are terribly under medicated, have your records ready and take them to your doctor to prove your point.

After that, besides using opiate threads already on Bluelight, I would start seeking other forms of treatment.
 
As others have said, neither fentanyl nor oxycodone are metabolized into morphine.
Oxycodone is around 1.5-2 times more potent than morphine, while fentanyl is around 120 times as potent as morphine so 500 mg morphine is around 250 mg oxycodone or 4 mg fentanyl, but there's no complete cross-tolerance due to different binding affinities etc. so you have to start way lower than that
 
did you doctor mean equating your meds in the form of morphine? like an opiate/oid conversion chart? this has got me confused
 
I believe that's the case keeping... Sounds like bull to me, but not like I get dea updates...
 
Iirc the NIH refuted or at least refused to adopt the CDC's opioid guidelines. So there's some contention. There are absolutely no laws in place that allows the DEA to restrict prescribers to certain dosages. However, prescribers will sometimes try to convey that idea as a cop out.
 
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