• BASIC DRUG
    DISCUSSION
    Welcome to Bluelight!
    Posting Rules Bluelight Rules
    Benzo Chart Opioids Chart
    Drug Terms Need Help??
    Drugs 101 Brain & Addiction
    Tired of your habit? Struggling to cope?
    Want to regain control or get sober?
    Visit our Recovery Support Forums
  • BDD Moderators: Keif’ Richards

Best CURRENT painkiller for oral usage?

F

frankdidit

Greenlighter
Joined
Mar 21, 2012
Messages
3
Hello all,

CPP here with numerous herniations from a slip and fall accident and only two possibilities for surgery (which did help those discs); neuropathy, fibromyalgia, etc. Was on norco before the fall. Doc upped norco dosage after fall. Given combo of increased tolerance and pain levels getting higher and higher, doc put me on opana a couple yrs ago w/ oxycodone for breathru pain. Tolerance has gone thru the roof, no surprise, and doc has upped opana dosage several times. Opana's been nearly impossible to find at the pharmacies the last 6 weeks (I read there was a legit shortage, something to do with the manufacturer), so I've temporarily asked to switch to the Oxycontin OPs despite reading many folks are not happy with them compared to the old formula. (Was fine with this, really, fearing further tolerance increases on opana and also in anticipation of opana TRF coming out--another new crappy formula?). Started with a 40 OP orally 3 times a day, wasn't cutting it obviously, went up to the 80s. Mg per mg the 80s oddly seem a bit weaker than the 40s... and extended release aside, an 80 OP feels like about 5 percs at best (50mg)-- certainly not 8 (80mg). Plus they take 2-3 hrs to kick in, altho they last maybe 8-9 hours. (Oxycodone usually takes 45 min to kick in and lasts 5-6 hrs for me). Still on the oxycodone for breakthru.

The oxy OP just isn't cutting it. Does anyone have some advice on what MIGHT be a good option re: the best painkiller out there for oral usage? I am thinking of asking to try the 30mg roxicodone (hopefully two, three times a day) and staying on the oxycodone for breakthru. (I would not be surprised if 2 30mg roxicodones worked better than the damn 80mg OP). Not sure what any other options would be unless I wanna mess with methadone (no thanks) or mscontin (have read varying things about that med).

Thanks for any suggestions, appreciate it very much.
 
thanks for the replies. Kayla, it was mentioned to me i could go to a dilaudid "pump" (IV) but that scared me a bit. may need to look into it more.
 
I had the pump and it helped more than morphine for me. Believe me once you feel the meds you will not give a shit about the pump lol

:'(Feel better. You dont deserve to be in pain.
 
ORALLY, any preparation with oxycodone (Roxi, Oxy), morphine (MS Contin, MSIR, Kadian) and methadone.

Hydromorphone and oxymorphone have way too poor oral BA's to be any good orally.

IV, would be morphine, oxymorphone, hydromorphone, fentanyl, and meperidine/pethidine (Demerol).

Overall, orally I'd say a good solid morphine formulation like MS Contin at the right dose is the best pain pill there is. Nothing has been shown to be superior to morphine as far as pain relief goes.
 
^^^^^^


I agree about Morphine being excellent for pain relief. Although it has a low BA orally compared to Oxycodone, its great for relief. I can only imagine if the BA for Morphine orally was as high as Oxycodone........
 
^

Exactly! Morphine, both orally and parenterally, has always been shown to be the most effective drug for pain, hands down. Nothing has been shown to be superior, either they can match it or they are inferior - but never ever superior to morphine.

At the right doses, it is a superior pain reliever than any other opioid - orally or otherwise.

Other drugs like oxycodone, hydromorphone, or fentanyl are administered for pain when one is having too much side effects from morphine. Morphine tends to be more sedating, constipating, causes more respiratory depression, itchiness and is even more euphoric at equianalgesic doses than a lot of the other opioids available (yes, studies have shown this to be true - morphine causes more side effects across the board than do most other opioids). So there are effective alternatives to morphine for those that are morphine-sensitive.
 
Last edited:
As stated Morphine is pretty much the best pain reliever there is going, but the low oral BA causes issues obviously.

Before reading thread and just answering title, I would say: Oxycodone Instant Release. But you're obviously taking that anyway.

You said something along the lines of: You're taking Oxy IR for breakthrough, but may ask for Roxicodone 30's x 2 - 3 times a day. Roxicodone is Oxy IR, so all you would be doing is taking more instant release Oxy than you currently are, but with no time release meds. Have you ever tried the Fentanyl Patch? It is a great pain reliever for someone like you and I with extremely high tolerances. If you haven't as yet tried Fentanyl, then I would suggest having a convo with your Dr and if you are both agreed - then try the Fentanyl Patch ( at the equinalgesic dose to your current time release meds ) along with Oxycodone IR for breakthrough pain, I think you'd find that they work extremely well together.

Good luck, and if want any further info regarding Fentanyl, feel free to ask, am happy to help.
 
Thank you all for the information! My doc is pretty open to trying new things to manage my pain and get it down to a reasonable level... we'll see what he agrees/wants to try next.

As for patches, we had discussed that a couple times (though he never mentioned fentanyl specifically) in the past... definitely worth trying out.
 
Morphine. It isn't as intense but is still very strong and will last easily over 12 hours to around 24 hours. Oxycodones are good for breakthrough pain but for an all day relief I think Morphine takes the gold.
I think Opana should only be used for very serious pain if at all. It's a very dangerous drugs and I have known multiple people who have died from ODing.
 
the painkillers with the best oral bioavailability are methadone, oxycodone, hydrocodone, then morphine, then opana, then hydromorphone


but honestly I think the best painkiller of all time for chronic pain is the fentanyl patch. it really works better than anything else I've ever tried. I had to drop out of school because I was crying all day every day because my back hurt so bad. anyway, long story short my doctor put me on fentanyl patches and I actually have a decent quality of life now! I'm gonna go back to school next semester so that'll be nice. But honestly my doctor saved my life by prescribing these patches. I was contemplating killing myself until I got meds...thank god I did. To anyone who is hurting so bad they think death is the only escape..its not. Trust me Ive been there before.
 
PoppyLlama said:
the painkillers with the best oral bioavailability are methadone, oxycodone, hydrocodone, then morphine, then opana, then hydromorphone


but honestly I think the best painkiller of all time for chronic pain is the fentanyl patch. it really works better than anything else I've ever tried. I had to drop out of school because I was crying all day every day because my back hurt so bad. anyway, long story short my doctor put me on fentanyl patches and I actually have a decent quality of life now! I'm gonna go back to school next semester so that'll be nice. But honestly my doctor saved my life by prescribing these patches. I was contemplating killing myself until I got meds...thank god I did. To anyone who is hurting so bad they think death is the only escape..its not. Trust me Ive been there before.
Click to expand...

Hydromorphone has a better oral BA than oxymorphone does. All charts, including the Bluelight Opioid Equivalence chart, which I made say it is.

30 mg morphine PO =

7.5 mg hydromorphone PO
10 mg oxymorphone PO

Oxymorphone is basically worthless when taken orally. Of course at the right doses it will work, but otherwise it is not a very efficient opioid. Codeine, hydrocodone, and oxycodone have a higher oral BA compared to methadone. Methadone's oral BA is very unpredictable. It can be as low as 35%, but for others it can be as high as 85%. Codeine (oral BA over 90% ), hydrocodone (BA 80% +; some sources claim over 90% ), and oxycodone (BA 87% ) are much more stable in comparison to methadone.

Levorphanol is another drug which has a very high oral BA (70% +). According to this book I have here called "American Medical Association Guide to over-the-counter and prescription Drugs" published by random house (1988 ) and written by a bunch of doctors, levorphanol is listed with an oral BA of 81%. It is a very potent mu opioid receptor agonist and is a great pain killer, aswell as a great recreational drug. I've been fortunate enough to try it before.

Morphine. It isn't as intense but is still very strong and will last easily over 12 hours to around 24 hours. Oxycodones are good for breakthrough pain but for an all day relief I think Morphine takes the gold.
I think Opana should only be used for very serious pain if at all. It's a very dangerous drugs and I have known multiple people who have died from ODing
Click to expand...

Don't single out Opana as being "used for very serious pain because its dangerous and blah blah". It is no more dangerous than morphine, hydromorphone, or hydrocodone for that matter. Potency stands for very little else. Its just a number. Studies have shown that morphine to have a considerably higher incidence of side effects, including respiratory depression, hypotension, and histamine-related effects than most other opioids, including oxymorphone.

Palliative care and hospice care use morphine to comfort the patient before death and for the most severe, agonizing pain imaginable. Morphine is the gold standard, it's the benchmark of all opioids and if an opioid can't prove itself against morphine in any clinical trial then it is considered a "weaker opioid". This has been the case since morphine was first isolated from the poppy - since its birth in 1804 in Germany. The closest drugs to morphine, believe it or not, are not hydromorphone or oxymorphone or any of those.

The closest drugs to morphine (freebase) are its salts and ester salts like morphine sulfate, morphine hydrochloride, morphine diacetate (diacetylmorphine; heroin), morphine dinicotinate (nicomorphine), morphine dipropionate (dipropanoylmorphine), desomorphine, dibenzoylmorphine, and other salts of morphine.
 
Last edited:
I agree that you might benefit from morphine. Even oral morphine at the right dose should do the trick. The key is the right dose. Morphine is a truly wonderful opiate. It is rather sedating, not too sedating however, provides good pain relief, and lasts longer than oxycodone. I would look into MS-Contin with oxycodone (IR) for breakthrough pain. I would not go with methadone or fentanyl, they can work well, but will jack up your tolerance. Morphine, on the other hand, is more forgiving in that regard. Morphine is more forgiving than most opiates in most regards, it is the prototypical opiate, and completely natural. Natural does not always mean better, but morphine truly is a good opiate.

I might also suggest adding Neurontin (gabapentin) or Lyrica (pregabalin) for the pain on top of the opiates. They can work wonders, esp. combined with such strong analgesics as opiates.
 
Never read everything here but orally, nothing beats oxycodone. Not even oral morphine. My suggestion would be to combine your OP 80s with 20mg Oxy IR. Oxycodone orally is the only oral drug that comes close to IV morphine.

This is based on several peer reviewed double blind studies of pain patients.
 
SPC123 said:
Never read everything here but orally, nothing beats oxycodone. Not even oral morphine. My suggestion would be to combine your OP 80s with 20mg Oxy IR. Oxycodone orally is the only oral drug that comes close to IV morphine.

This is based on several peer reviewed double blind studies of pain patients.
Click to expand...


What else comes close to IV Morphine orally because I would like to know since I hate Oxycodone..............
 
To answer the OP, as stated many times above...morphine is a great opiate, but it does tend to have higher incidence of side effects...however...it can be Rx'ed to up to 1600mg/day according to my sister's nursing guide to drugs (which is pretty up to date considering she just started the nursing program this past fall...

@LostBoys...

There's really not a lot out there for us in the US...All the good shit that is less addictive, yet more effective, and has less incidence of adverse effects is Schedule I for some reason and is only allowed for research/making other drugs...

I wish there was Nicomorphine in the US...that would be a great drug to have available from what I've read...so would dihydromorphine and a few others...It's funny how many pages you can end up reading on wiki just from checking the page of something else lol...learned a lot tonight...
 
I Take Oxycodone IR (intranasally, for instant relief especially when I wake up) combined with liquid Morphine ER for BT pain. ask your doctor for Oramorph as it is IMHO the best form of Morphine. I am currently writing this using my PS3 controller so I will post more detailed information later. :)

Also pain medication alone is only 40% of the entire pain management, however that is something I will post later as well.


--» Peace o/
 
I agree with the majority of posters that have said that morphine is the best pain medication for oral use. I find its analgesic duration and efficiency to be superior to all other opiates, so re-dosing and effectiveness is not an issue.

I don't understand why a lot of people feel the need to mention morphines low oral BA in a thread about relief for a chronic pain patient. Bioavailability doesn't mean anything other than that you will have to adjust your dose accordingly if you use a different ROA. A drug can have an oral BA of close to 100%but that doesn't mean a thing if the drug does not provide adequate pain relief, so the drug with the higher oral BA isn't automatically the best oral pain killer. In the case of morphine, yes it has a relatively low oral BA, but it's great for pain and they make them in 100mg pills to account for that so it's not an issue.

Just because a drug has a low oral BA doesn't mean that you have to take it other ways, especially if you are a pain patient. Everybody used the low oral BA excuse for why they had to sniff their Opana, and look at all the threads/posts being started by them flipping out now that they reformulated it so you can't crush it. You never know what prescription pain killers they may reformulate next, so I highly suggest that chronic pain patients take their prescription drugs as prescribed.

Now if we're talking about recreational use then that's a different story and I would say go for the drugs ROA with the higher BA. However, we have countless threads about abusing this, that, and the other thing, and what's the best way to get the most out of whatever pills, so I didn't want to see this thread go down like that.
 
The idea behind oxycodone was to develop a substitute for oral morphine. Something with a lower side effect profile. Additionally I would caution that morphine and oxycodone are not entirely cross tolerant. If you build a tolerance to morphine and then end up in the hospital your options for a good IV pain killer are more limited. I'd suggest (again) oxycodone for at home oral use. If you don't mind a patch fentanyl is another great option. Then if you DO end up in hospital, you'll still get reasonable analgesia from drip morphine without taking insane doses.
 
You must log in or register to reply here.
Top