Opioids Opioid for my dad on hospice - least constipation? Also gut antagonists

[yaesutom]

My dad has COPD, cancer, tons of stuff going wrong at once. Long story but he’s home, we set up hospice… the end is near.

They gave him Tylenol 4 with 60mg codeine, although one of the hospice people said they have morphine.

He is so weak that taking a #2 bathroom is nearly impossible. Just to take a dump he’s gotta be in severe pain.

He did well without pain meds (just lot of THC) for so long but it’s getting bad. I’m wondering.. out of the stronger pain opiate options do any of them produce less constipation? Does codeine cause more of it even while being a “weak” pain reliever?

Also curious if anyone has tried the newer guy opiate antagonist meds, supposedly blocks opiates in the gut but not the CNS where it can still give euphoria and pain relief. Hospice sometimes pays for everything so if any of them actually work I’d like to bring it up to them.

There’s no reason people should suffer with constiption if these gut antagonists have existed. Also wondering if oxycodone ve hydrocodone… does oxy have more pain relief per “unit” of constipation effect?

 

[Ds]

Sorry to hear about your father.

Opiates cause constipation, regardless.
You could have him take a stool softener or something to aid,
But yeah, there isn't anything you can do about the good ol opiate constipation, besides treat the symptoms.
Best of luck .

 

[Snafu in the Void]

There are several things they can give him for the constipation other than methylnaltrexone.

It's good for you to advocate for your father's care especially if he can't speak for himself.

As for opioids they all cause similar levels of constipation, but the atypical ones like fentanyl and tapentadol tend to cause less, iirc.

 

[wirkdy]

codeine from my experience caused almost no constipation.

Also from my experience opioids that have agents against constipation don't have pain relief/euphoria effects.

You could try by making your dad follow a fruit & veg diet, especially figs, prunes that you can find dehidrated, moist them in water and are ready to eat, this should counter the constipation effetc. Drinking much water, juice is also important.

Honestly I find the constipation effect of opioids not a problem.

 

[Madrus]

High-fiber foods, 80-90% vegetarian.
Triphala, 1 spoon, daily, morning time, with warm water.

 

[lovemissile66]

Sorry to hear about your father.

Opiates cause constipation, regardless.
You could have him take a stool softener or something to aid,
But yeah, there isn't anything you can do about the good ol opiate constipation, besides treat the symptoms.
Best of luck .

So sorry to hear about your Dad. Just went through this almost exact scenario with my Aunt two years ago. Same disease, issues. The cancer was in remission. The
complications of COPD killed her. Hospice also came in, but in my opinion, they did not have her on enough. She had been given six months, but didn't make it that far. And for that, I am relieved for her. She was supposed to die in her home, as my brother and Uncle had. But the 'powers that be' had other ideas and put her in a fucking nursing home. She felt 'dumped' of course, and just gave up on life. Made sure her last days were just soaked in morphine. FUCKING TRAUMATIC AND SAD, bastards. I hope it goes a better way for you. But, yeah, you are almost always prescribed a stool softener when taking opioids because of the constipation.
Good Luck to you

 

[Nas47]

Targins(oxy&naloxone)tend to lead to less constipation,cause naloxone in it antagonized constipation only without to prevent pain killing properties of oxy..but it's a choise of dr.Tool softeners also,foods rich on fibres...hope that the man can overcome the ilness.Hope!