Opioids Morphine -- how much is dangerous?

[Foreigner]

I'm in a lot of pain these days as my body fails me once again. I started with 5mg morphine sulfate 4 times a day. Then went up to 10mg. Now I'm at 20mg. Normally I start taking hydromorphone at this point because it's more efficient, but my current doctor is a moron and won't give me any.

I want to know how much morphine is actually dangerous, considering I am building tolerance? I'm just going to keep increasing the dose every time the pain becomes intolerable again. Some sources say 200mg is OD territory, and I've never taken that amount in my life.

 

[MsDiz]

Uhhhh, it’s not an easy question to answer really. Morphine OD for someone naïve can come in at 60mg, 200mg would definitely be in OD territory.

 

[Branggen]

Some people are prescribed 2000mg per day so its really all down to tolerance. If a slightly lower dose doesnt provide analgesia you are probably not in od territory, but yea you should definitely be good at your 20mg I think a first timer could do that without any problems, in the past their was a prescribing limit of I think 100mg per day but that has since been removed and like I said their are people on 2000mg/day. I was personally on 600mg per day at one time as an opiate replacement therapy

 

[MsDiz]

It’s super unwise to suggest that 2g of morphine is an amount that is “safe” due to the fact some people take it. I can’t imagine any dr would prescribe that amount to a person. Ever. It’s usually due to someone abusing it.

The people who are taking 2g a day are very tolerant to opioids and even still, it’s dangerous territory, they are risking their lives taking that amount.

 

[JessFR]

There is no upper limit. Your tolerance can keep increasing to extremely high levels.


Back when I was heavy into heroin I have no doubt I could have taken way more than 200mg without issue.

And morphine not like tramadol where it has other effects and those eventually become dangerous regardless of tolerance.

So yea, you kinda gotta go by how you feel, you definitely wanna be careful from an overdose perspective. When your tolerance is low, like now, that's when the risks are highest. So don't go taking huge increases before you've built up tolerance

Also be EXTREMELY careful touching anything like benzos or alcohol while using morphine, especially when your tolerance is still fairly low. Taking that stuff together drastically increases the risk of death. Way more than just taking a lot more all of a sudden.

If you can, and if you have someone else with you, it would be very smart to get a naloxone kit and training someone you're with to use it just in case. This is often not realistic for people, but if you can it's well worth it. Not just for you but also so you can help if you see someone else OD.

I have a naloxone kit for this purpose. More for others than for myself because the doses I take could easily kill an opioid novice person.

OK so, now that I've gone into the risks of overdosing, which provided you don't suddenly go doubling your dose or something stupid like that, and so long as you don't go taking it with benzos or alcohol or other depressant drugs, isn't too dangerous and doesn't have an upper limit that I've heard of.

Now it's time to talk about the other major risk, addiction. If you keep using opioids, eventually you'll become dependant in them. And if you haven't had an opioid dependence before and especially if you haven't had any drug addiction before, then it's extremely easy not to appreciate the danger this poses to your life and well being.

Taking opioids is highly risky. If you think this is something you'll be doing longer term, and haven't done so already, I highly advise you to take advantage of the experience of the people here in the recovery forums to learn more about what opioid addiction does to people.

Never thing it can't happen to you, no one can know that for sure in advance.

Take care man, and if you have other questions please feel free to ask them.

 

[Foreigner]

I already got addicted last year from taking morphine. I had horrible withdrawals. Thankfully cannabis helped me through it.

I take 20mg or less of morphine at this point. The pain in my body is just so intense, I need a break or I can't sleep or eat.

I thought that if the body is genuinely in pain, opiate addiction is less likely because it's not euphoria seeking but just pain relief. Is that wrong?

 

[JessFR]

I already got addicted last year from taking morphine. I had horrible withdrawals. Thankfully cannabis helped me through it.

I take 20mg or less of morphine at this point. The pain in my body is just so intense, I need a break or I can't sleep or eat.

I thought that if the body is genuinely in pain, opiate addiction is less likely because it's not euphoria seeking but just pain relief. Is that wrong?

Well addiction is different to dependence.

You'll definitely get dependence regardless, as you did last year. If you use them every day I mean. Meaning you'll experience withdrawal when if you stop abruptly. Exactly when dependence starts is unfortunately also variable. Generally though it takes less time each time you become dependant. So if you've been dependant before it'll probably be even easier to become dependant again.

Addiction on the other hand is where you lose the ability to control your use, where you feel like you need to have more and have an impaired ability to stop yourself continuing to use. Not just because of the pain. And not just because of withdrawal.

I think you're right that people in legit pain are a little less likely to become addicted in the short term. But all in all a lot of people have still ended up addicted as a result of opioid use for legitimate pain.

Also some people are just less prone to addiction to opioids for some reason.

All I'm saying is it's something to be on the lookout for. Noone can be sure if and when they might find they're addicted. Which is why opioids should generally be used for as short a time a realistically possible.

 

[tubgirl.jpg]

I'm in a lot of pain these days as my body fails me once again. I started with 5mg morphine sulfate 4 times a day. Then went up to 10mg. Now I'm at 20mg. Normally I start taking hydromorphone at this point because it's more efficient, but my current doctor is a moron and won't give me any.

I want to know how much morphine is actually dangerous, considering I am building tolerance? I'm just going to keep increasing the dose every time the pain becomes intolerable again. Some sources say 200mg is OD territory, and I've never taken that amount in my life.

20mg x 4 daily?

I started with 30mg twice daily, but was quickly up to 250-300mg daily.

How much that is dangerous is impossible for any of us to say.

But increase with caution, is my advice.

Do you take any other CNS-depressants?

 

[Foreigner]

Well addiction is different to dependence.

You'll definitely get dependence regardless, as you did last year. If you use them every day I mean. Meaning you'll experience withdrawal when if you stop abruptly. Exactly when dependence starts is unfortunately also variable. Generally though it takes less time each time you become dependant. So if you've been dependant before it'll probably be even easier to become dependant again.

Addiction on the other hand is where you lose the ability to control your use, where you feel like you need to have more and have an impaired ability to stop yourself continuing to use. Not just because of the pain. And not just because of withdrawal.

I think you're right that people in legit pain are a little less likely to become addicted in the short term. But all in all a lot of people have still ended up addicted as a result of opioid use for legitimate pain.

Also some people are just less prone to addiction to opioids for some reason.

All I'm saying is it's something to be on the lookout for. Noone can be sure if and when they might find they're addicted. Which is why opioids should generally be used for as short a time a realistically possible.

I don't tend to get addicted to things, for some reason. I can drop things fairly easily. Last year it was hard because I had weird neurological symptoms from stopping opiates. I wasn't "craving" them, but I couldn't all asleep without convulsions. Until I figured out how to use cannabis to help myself, I had to take 5mg maintenance doses of morphine at bedtime just to go to sleep. Only at bedtime. I would not have convulsions at any other time.

I'm guessing dependency is more the physiological side?

 

[Foreigner]

20mg x 4 daily?

I started with 30mg twice daily, but was quickly up to 250-300mg daily.

How much that is dangerous is impossible for any of us to say.

But increase with caution, is my advice.

Do you take any other CNS-depressants?

I use CBD oil with the morphine. It has less than 0.1% THC in it, but I suppose that still counts.

 

[Juniper Bruhmomentius]

The argument exists for that at some point nevermind your tolerance your body just cant take it anymore. The average life expectancy after starting opioid maintenance in my country is 8 years.

 

[MsDiz]

I don't tend to get addicted to things, for some reason. I can drop things fairly easily. Last year it was hard because I had weird neurological symptoms from stopping opiates. I wasn't "craving" them, but I couldn't all asleep without convulsions. Until I figured out how to use cannabis to help myself, I had to take 5mg maintenance doses of morphine at bedtime just to go to sleep. Only at bedtime. I would not have convulsions at any other time.

I'm guessing dependency is more the physiological side?

Dependency is physiological yes, your body gets used to a drug and when it doesn’t have it then you will go into withdrawals. Putting it very simply.

I wouldn’t start in 20mg x 4 times a day if you’ve not been taking it for a long time. You’d need to build yourself up again. 5mg x 4 the. 10mg x 4.

I would advise you to look into ways to reduce your pain that isn’t drug based. Hot baths, cold baths, massage, Epsom salts, exercise and diet are two major things that help people in chronic pain, ice packs, heat packs, essential oils etc etc.

 

[Foreigner]

Dependency is physiological yes, your body gets used to a drug and when it doesn’t have it then you will go into withdrawals. Putting it very simply.

I wouldn’t start in 20mg x 4 times a day if you’ve not been taking it for a long time. You’d need to build yourself up again. 5mg x 4 the. 10mg x 4.

I would advise you to look into ways to reduce your pain that isn’t drug based. Hot baths, cold baths, massage, Epsom salts, exercise and diet are two major things that help people in chronic pain, ice packs, heat packs, essential oils etc etc.

My entire colon is inflamed and lined with bleeding ulcers. There's no way to quell that kind of pain without drugs, unfortunately.

I will take your advice and start smaller.

 

[MsDiz]

My entire colon is inflamed and lined with bleeding ulcers. There's no way to quell that kind of pain without drugs, unfortunately.

I will take your advice and start smaller.

Ulcerative colitis? Opioids are going to make you constipated so I hope you’re taking a good osmotic laxative as well, movicol is what I always suggest. 1or 2 sachets every other day depending on how constipated you get. None obviously if you’re not constipated at all. Obviously only take it after consulting with your dr but it’s so important to have osmotic laxatives with opioids.

Diet is going to be a big factor. I have UC also and went on an elimination diet to see what I reacted to. I haven’t had a flare up in ages now but I do take mostly liquid feeds that are digested.

It is very painful so I’m sorry you’re going through that.

 

[Burnt Offerings]

I use CBD oil with the morphine. It has less than 0.1% THC in it, but I suppose that still counts.

I've been going through some chronic pain issues too...I recently had a rather painful orthopedic surgery and the pain afterwards was searing intense, so intense in fact that I needed to get returned to the hospital and get put on morphine iv and anesthetics

Anyway, what I found helped quite a bit was combining a low dose of THC with my prescribed pain medication. I have these capsules which contain 5 mgs of THC each, and I take one with a tablet of oxycodone, plus alternating tablets of an anti-inflammatory and gabapentin before bed. I've always been a big believer in THC-opioid synergy and I've been reminded of why lately, it really seems to help with my pain levels.

Personally I wouldn't worry too much about addiction, if you're in "real pain"...not to say that it's impossible, or maybe shouldn't be a concern generally-speaking, but...the warm fuzzy feeling you get if you take opioids at a baseline-level of pain/discomfort doesn't really make much of difference when your thoughts are constantly being dominated by the pain that you're in.

Anyway, I hope you get some relief and feel better soon

 

[JessFR]

I don't tend to get addicted to things, for some reason. I can drop things fairly easily. Last year it was hard because I had weird neurological symptoms from stopping opiates. I wasn't "craving" them, but I couldn't all asleep without convulsions. Until I figured out how to use cannabis to help myself, I had to take 5mg maintenance doses of morphine at bedtime just to go to sleep. Only at bedtime. I would not have convulsions at any other time.

I'm guessing dependency is more the physiological side?

It's possible you're less prone to getting addicted. It's also possible that you still will. It's weird. Like dependence some people seem to end up having a problem so quickly while others seem to take ages.

It's also definitely worth keeping in mind that even if you don't get addicted to opioids easily, or even at all, I dunno if you do other drugs, but you can be not prone to opioid addiction but be VERY prone to addiction to other drugs. For instance I've done meth a bunch of times but never ended up having any issue stopping. Opioids I couldn't seem to stop after the first time I tried them. I don't know when I became dependent cause it was years before I even tried to take a break. While others have little issue with opioids, using on and off year after year and not losing control, but meth completely fucks them up.

Opioid withdrawal physiologically does wreak havoc with sleep so what you describe isn't surprising.

I consider to be mostly the physiological side yes. Some people also use terms like physical addiction vs psychological addiction, I prefer the terms dependence and just addiction. Mainly because there are things that are dependency inducing, antidepressants for instance, that have no addictive potential. And gambling for instance could said to be the reverse, all addiction no dependence.

Of course there's overlap. Being physically dependent on something affects your thinking and so has a psychological side,

 

[Xorkoth]

I thought that if the body is genuinely in pain, opiate addiction is less likely because it's not euphoria seeking but just pain relief. Is that wrong?

When opiates are prescribed for pain relief, physical dependence is exactly the same, ie, it will happen with regular use, but as Jess mentioned, dependence and true addiction are different. Generally people prescribed them for pain and are not taking them to get a high/euphoria are much less likely to develop full-blown opiate addiction. You will develop dependence, but you will be much more prepared to taper and come off of them once they are no longer needed for pain, if you are just using them for pain and not seeking the high.

As for danger, 20mg of morphine is a low dose. 5mg 4 times per day is not in any way dangerous, even for a totally opiate naive person. 20mg 4x per day might not even be too dangerous for an opiate naive person (though it may be and no one should try to start at that level), since it is spread out, but given that you are taking more as your tolerance has raised, 20mg 4x per day for you now is probably similar to how 5mg 4x per day was for you when you started. If you keep slowly increasing dosage, you are unlikely to encounter any danger of overdose. Just don't suddenly take a lot more one day.

I'm very sorry that your ulcer condition is acting up again, I know how horrible that has been for you. Sending you positive vibes.