Opioids Comparison of time release morphine....patterns in timing.

[Sentience]

One thing I have noticed.....some SR opiates seem to come on shortly after ingestion with a peak closer to the time of ingestion, while others seem to have a VERY delayed effect with almost no immediate effects whatsoever.

My only experience with SR morphine is MSContin, which in my opinion have the drawback of having a VERY delayed effect with a very strong peak lasting about 2-3 hours.....In my opinion this is DANGEROUS for somebody who has chronic pain and is not able to wait it out, as somebody could reach the desired level and then continue to get higher and overdose due to using the time release....some doctors feel strongly about encouraging the time release and not giving you enough immediate release because they believe that the lack of instant gratification will prevent abuse....I feel this may be misguided and may actually contribute to harm in some patients depending on the release patterns and the patterns of pain some patients experience...I dont like drugs which unpredictably suddenly get stronger hours later...it makes it difficult to gauge dosage, and its not a very steady long acting medicine if it has 2 hour peaks like MSContin.

This is very much a harm reduction question.


For educational purposes, if I were in the future to obtain some other forms of time release morphine specifically.....like Oramorph or Evinza...are there others?.....what are the release schedules like? Do some of them tend to come on more quickly? About how long until the peak?

Also, what about other time release opiates?


I feel this is important knowledge if somebody needs to predict their dosage, rather than find out the hard way that the peak isnt coming on for a few hours.

 

[Nortyy]

I think most time realease medications release 20-40% of the dose right away and then the rest at a slow constant pace for the next 8-12 hours.

 

[Sentience]

I dont think it is that simple. I get NO effect for the first few hours....absolutely nothing noticable, and then I seem to get a big rush all at once about 3 to 5 hours into it, sometimes making me uncomfortable because Im floored and nodding too hard, then I fall asleep for 2-3 hours and wake up in pain again.

Its really not anything close to as neat and nice as a small bump of immediate release and then a gradual release until its gone....nope. Its nothing, nothing, nothing, fairly rapid onset which can be too strong when mixed with my dosage of oxy for acute pain, then it craps out way before its advertised duration of effect.

Unfortunately I cant really use less of my immediate release because any less in ineffective for pain. I would just get rid of the time release entirely, which would leave me more functional, but my doctor seems to think this is better.


The assumption here is that I am going to try other time release options regardless of what advice I get here. Im not asking which ones to try and I intend to try them regardless. I just want some experiences on the ACTUAL patterns in vivo for medication release.

 

[Nortyy]

I don't know about MS contin but I do know that some SR medications work exactly like I stated above. But I guess that doesn't sound to relevant in your case.

 

[Sentience]

There is also the fact that people metabolize drugs differently.


However, MSContin was developed specifically to change how morphine was delivered compared to previous SL formulations....the intention was to give a more continuous dosage compared to Oramorph or the other ones....I am not sure it was effective though....it only lasts longer because the initial onset is more delayed. According to their own rationale which they presented to the FDA, the time release patterns were intended to be different from other formulations, if only slightly.