Opioids Is it possible to take Oxycodone and/or Morphine ER (both meant for oral administration) via sublingual ROA instead for a faster onset?

[ivorymoon]

My mother is in horrendous pain. She used to be prescribed Methadone for her pain but due to the opioid epidemic, her doctor took her off of it and switched her to Morphine ER (15mg) and Oxycodone (10mg).

Even when she's just in a normal amount of pain, her meds hardly touch her pain and now she's really sick and is in so much pain, she literally can't stand up or walk without assistance.

I was wondering if it would be possible for her to take her meds under her tongue so that it'll kick in faster and therefore be provided with more pain relief than taking them via oral ROA.

I know the Morphine is ER but simply breaking it in half breaks the time release.


Thank you so much for your help in advance. I can't stand seeing her in this much pain and I can't think of what else to do to help her.

 

[Deru]

Depending upon the formulation, yes - I'd be wary attempting this with any type of extended release formulations.

What may be much more helpful (and safe) would be to explain this to her doctor, that her pain is not controlled well, and if that doctor is nervous about prescribing opioids, getting a referall to a pain management doctor who specializes in this.

They can really make your mother much more comfortable - and she could take her medications exactly as prescribed in the process. The last thing I would imagine you want is for an overdose situation to occur by breaking the time release.

 

[ivorymoon]

Depending upon the formulation, yes - I'd be wary attempting this with any type of extended release formulations.

What may be much more helpful (and safe) would be to explain this to her doctor, that her pain is not controlled well, and if that doctor is nervous about prescribing opioids, getting a referall to a pain management doctor who specializes in this.

They can really make your mother much more comfortable - and she could take her medications exactly as prescribed in the process. The last thing I would imagine you want is for an overdose situation to occur by breaking the time release.

That's what's fucked up: This is from her pain management doctor. She was on 60mg of Methadone/day for yeaaaaaaaars back when we lived in Michigan (and years before that, she was on an even higher dose than that. I think at one point she was getting like 260 10mg tabs of methadone per month) but when we moved out here, her new pain management doctor took her from 60mg of Methadone a day to a couple 15mg morphine er and a few 10mg oxycodone a day which is ridiculous. What's even worse is how quickly they forced her to taper down. She was in withdrawal for such a long time.

She told me that if she can't get either a higher dose of what she's on so that she can actually function and not wake up in withdrawal or get back on her methadone, she's just gonna quit going to pain management and just go to a methadone clinic and tell them she's an addict so that she can actually get a high enough dose of methadone to control her pain.

It's SO fucked how she can barely get anything for her severe chronic pain at her PAIN MANAGEMENT clinic but if she were to go to a MAAT clinic and lie and be like "hi, I'm an addict", she'd be able to get a high enough dose to manage her pain without a problem.


Like, how the FUCK does that make sense?!
Sorry, that shit enrages me.

 

[Coffeeshroom]

Is the Oxy instant release

Wont taking the 2 together help with instant pain relieve and then the morphine ER for pain throughout the day. Or can they maybe swap to Hydromorphone ER? or increase dosages

 

[Deru]

@ivorymoon There could be a couple reasons for this. With the opioid epidemic they changed the way they treat pain and really forced doctors to change some of their prescribing habits, at least here in the US.

I had a huge problem with this after my third open heart surgery. Right after I got out of the ICU they wanted all patients off of opioids and on Tylenol within 5 days. My family used to get into huge arguments with the pain management doctors.

Has your mother expressed how poorly her pain is controlled to the doctor and allowed the doctor a chance to compensate? There are plenty of other great pain medications besides opioids that work great in conjunction with the two medications you mom is on - some manage the pain even better.

If so, maybe a second opinion is in order here?

 

[ghostandthedarknes]

only way i see is through the doctors. imo morphine taken orally @ 15mg, even if it IR is a worthless dose and 10mg oxy is a very small dose compared to 60 of methadone

 

[Deru]

The 10 mg of oxycodone is more than likely just for breakthrough pain with the Morphine ER for continuous pain, but even when you factor in everything, it still was a reduction for sure

 

[nznity]

@ivorymoon There could be a couple reasons for this. With the opioid epidemic they changed the way they treat pain and really forced doctors to change some of their prescribing habits, at least here in the US.

I had a huge problem with this after my third open heart surgery. Right after I got out of the ICU they wanted all patients off of opioids and on Tylenol within 5 days. My family used to get into huge arguments with the pain management doctors.

Has your mother expressed how poorly her pain is controlled to the doctor and allowed the doctor a chance to compensate? There are plenty of other great pain medications besides opioids that work great in conjunction with the two medications you mom is on - some manage the pain even better.

If so, maybe a second opinion is in order here?

They actually changed the formulations More cause ppl we're crushing AND snorting/shooting up the pills...

 

[Deru]

They actually changed the formulations More cause ppl we're crushing AND snorting/shooting up the pills...

Yeah. When I got discharged they wouldn't give me a prescription to Morphine ER but instead Morphabond which was so much worse than Morphine ER.

But, you almost can't blame the doctors. They spent over a decade getting their medical license, it's not fair to them they can lose it because so many are abusing their medication.

This is a systemic and societal issue that is to blame. And everyone loses because of it.

 

[nznity]

Yeah. When I got discharged they wouldn't give me a prescription to Morphine ER but instead Morphabond which was so much worse than Morphine ER.

Fked up man, er pills are shitty as fuck

 

[Painful One]

Try cutting the 15 mg ER morphine in half and have her put the half under her tongue and letting it melt.
then do the same with the other half.
(push the half down on that big vein under the tongue with your tongue and hold It there, keep it moist so it melts.
rub It against that vein)

I have found stronger pain relief when done this way and they still last almost 12 hours.
overlap the halves a bit so that the pain control is continuing without a break.
When a break in pain controls happen it is much harder to get it back under control.
Keeping the pain “managed “ is key.

Use 800 mg ibuprofen every 4-5 hours on bad pain days.
It really helps in conjunction with the morphine.

Caffeine also seems to give the morphine an extra push.

I also use the extended relief morphine and when I use them cut in half and under the tongue it makes me fall asleep.
It really seems to relax the muscles and body quickly and stronger.
Heat pad also helps and breathing exercises and meditation.
meditation really is useful once you get the hang of it.

I hope this helps.
I send my love to you both and hope she can find some comfort.
You are a good kid!

❤

 

[ghostandthedarknes]

They actually changed the formulations More cause ppl we're crushing AND snorting/shooting up the pills...

they gel up when wet. got wax in them or something.

 

[Branggen]

60mg methadone is equivalent to around 300mg of oral morphine per day so thats pretty fucked that they would drop her down to what sounds like about 100mg morphine equivalent daily, I know a lot of states have some shit about not going over 90mg morphine daily equivalent. If you cant find a doctor after looking everywhere then maybe the methadone maintenance is the way, she would have to go in daily for a while though to get the dose which would be pretty awkward as someone who isnt an addict

 

[Deru]

I have found stronger pain relief when done this way and they still last almost 12 hours.

Morphine extended release taken sublingual would not maintain the drug in the matrix - I'd be very cautious about doing this because it may be better in the beginning but the drug won't last as long and then pain will become uncontrolled and cause bigger problems trying to bring it back under control. Unless you could split it in quarters and take 1 quarter every 2 to 2.5 hours I suppose.

 

[Painful One]

Morphine extended release taken sublingual would not maintain the drug in the matrix - I'd be very cautious about doing this because it may be better in the beginning but the drug won't last as long and then pain will become uncontrolled and cause bigger problems trying to bring it back under control. Unless you could split it in quarters and take 1 quarter every 2 to 2.5 hours I suppose.

yes, you are right but this person has a high tolerance and I have strangely found that it does last almost as long.
I thought the same thing.
I do break it up into four pieces and take it every 2.5 hours on really bad days.

I am only Recommending this for serious chronic pain and just for times where the pain spikes and flares up really badly.
This poor lady cannot even walk right now due to pain so I think this under the tongue, sublingual method would be helpful.
I do it myself when necessary.
I have a lot of experience with the extended release morphine as I have been a chronic pain patient for 12 years now.
You have to do what you have to do at times!
Life is hard living in constant pain!

 

[Painful One]

they gel up when wet. got wax in them or something.

Depending on the brand.
I get some that do not gel up at all or have was in them.

 

[ivorymoon]

Is the Oxy instant release

Wont taking the 2 together help with instant pain relieve and then the morphine ER for pain throughout the day. Or can they maybe swap to Hydromorphone ER? or increase dosages

I mean, she says that they both help a little bit but only to the extent of like "it's better than nothing", you know? She was on a high dose of methadone for pain for well over 20 years and even the methadone didn't completely control her pain, but it helped enough that she could get out of bed each day and do very light cleaning, like dishes, wiping down counters, things like that so the shit she's on now hardly touches her pain and her pain management doctor isn't keen on raising her dose. I don't think she has an appointment anytime soon. Not soon enough, anyways.

She's been super sick the past half a week to a week and whatever she's sick with is causing horrible joint pain and she's been throwing up. Last time she was at the hospital, they gave her a covid test and it came back negative so idk wtf is going on. I've been up literally all night taking care of her and I feel so fucking helpless. She's hardly been able to sleep and when she does fall asleep, she wakes up crying because the pain is more than she can bare.

I finally convinced her (after several hours of fuckin begging her) to call 911 to get a ride in an ambulance back to the hospital and the EMTs who came were the same ones who picked her up a few days ago and they swayed her into "staying home and seeing if she feels better after a while and if not, to drive to urgent care" even though she's way too fuckin sick to drive herself and I don't have my license. My mom has always been "too nice" and she didn't wanna burden them so she told them she would stay and idk wtf to do.


I just need to know if her oxycodone can be taken sublingually so that it'll have a little stronger of an effect and so that maybe she can actually fall asleep for longer than 10 min without waking up sobbing.


Please can someone just tell me if she can do this? I'm seriously at my wits end, frazzled as fuck after being up all night and feel helpless beyond words that there's not a goddamn thing I can do to help her.
Please, someone.

 

[ivorymoon]

Depending on the brand.
I get some that do not gel up at all or have was in them.

The kind she gets are small and pink and and have K 56 on them. Will those ones gel up or will they help her if she lets them melt under her tongue?

 

[ivorymoon]

yes, you are right but this person has a high tolerance and I have strangely found that it does last almost as long.
I thought the same thing.
I do break it up into four pieces and take it every 2.5 hours on really bad days.

I am only Recommending this for serious chronic pain and just for times where the pain spikes and flares up really badly.
This poor lady cannot even walk right now due to pain so I think this under the tongue, sublingual method would be helpful.
I do it myself when necessary.
I have a lot of experience with the extended release morphine as I have been a chronic pain patient for 12 years now.
You have to do what you have to do at times!
Life is hard living in constant pain!

Oh fuck, thank you so much. I wish I would've read your post before typing out that longass reply reiterating everything and losing my shit lmao.
Do you know if she can take her oxycodone under her tongue, as well? They're small pink round pills with K 56 on them

 

[Painful One]

The kind she gets are small and pink and and have K 56 on them. Will those ones gel up or will they help her if she lets them melt under her tongue?

I would give it a try.

Mine say ABG on one side and 30 on the other.
I have found that brand to work way better than some of the other brands for me.