Oramorph vs Opana

[enduser2941]

Hey all new to these forums but I have learned alot from here so I am looking for some advise. To start I do not overly abuse my medications as I am one that definitely need them do to my condition, however I was wondering if you guys can advise which medication would be best for my pain and at the same time be the most enjoyable to take I am currently on Oramorph ER 30MG 3 times a day and dilaudid (love snorting it) 2 mg PRN but I only get 20 a week n. Some one was telling me that I should take Opana instead of the Oramorph (morhine sulfate ER) which I cant snort. Would someone advise which of those 2 you feel would be better for the pain as well as give me a high as well??

Thanks!

 

[kokaino]

Personally, I would choose to stay with the morphine. There is nothing like morphine as far as pain relief goes - no opioid that has been compared to it in a clinical double-blind trial has been proven to be more effective than it. Almost all opioids, synthetic and semi-synthetic have been compared to it and none of proven superior.

 

[enduser2941]

Thanks for the advise kokaino, BTW, I just wanted to quantify the reason I do actually snort the dilaudid and that is because if you take it orally it has very low bio-availability where as when you snort it you actual obtain upwards of 80% of the active hydromorphone, if it weren't for that I would not be snorting it at all and with my pain, I wont to get as much of it as possible with out slamming it as I would never slam anything and I am not desperate enough to plug anything either.

I asked this question because I want to make sure I can get the most amount of pain relief possible as where I live there is such a high street value for opiates that the Feds are coming down VERY hard on the Dr's so much so that they prescribe the absolute minimum they can to be in compliance with the indications for the meds. What that means to people like me who are truly in chronic pain, we have a hard time getting our medications, if at all Thanks again and I encourage anyone to respond to this as I know everyone hurts differently and everyone can get relief differently.

Thanks!

 

[kokaino]

All three of those drugs - morphine, hydromorphone, and oxymorphone - have poor oral BA. But your best bet for good long-term pain relief is morphine. As I've said earlier, no study has shown any other opioid to be superior to it (morphine). Either they are as effective, or less effective than morphine, but never more effective.

Morphine has a higher incidence of side effects than all the other opioids, which some people can't tolerate so they go with other drugs such as oxycodone or hydromorphone or oxymorphone, which tend to have less incidence of side effects.
It's the reason that they continued to look for new opioids back in the day, when it was just morphine and it's salts like morphine diacetate (heroin), morphine hydrochloride, etc. They wanted improved stuff, with less effects and they got it in codeine related drugs like hydrocodone/oxycodone and morphine related drugs like hydromorphone/oxymorphone, etc.

Morphine's side effects tend to be more intense at equianalgesic doses compared to pretty much all opioids, synthetic or semi-synthetic - everything from constipation, to sedation, to euphoria, to nausea and vomiting, and of course, histamine related effects. It all tends to be amplified with morphine.

 

[enduser2941]

Excellent kokaino, you are very knowledgeable with regards to this and I thank you very much for explaining all this for me. I think what I will do is keep with the oramorph (morphine sulfate) ER at 30mg's and the 2mg Dilaudids for break through pains. If I find that the oramorh is just not cutting it at 30mg's Ill ask him to up me to the 60's, and still stick with the dilaudids (2mg's) for break throughs. It sounds like from what you have explained, that the morphine for the long term pain relief is the best option for me. HEH all this stems btw in case your interested in the history here is from when I first got ill 2 years ago, they put me on dilaudid, and as time went on I built a tolerance for them and the PA that was covering for the Dr kept increasing the dilaudid. At the end I was on 8mg's every 6 hours. But I would find myself dope sick every morning if I missed a dose at night (I didn't know it was dope sickness because I had never had any experience with pain meds prior). So when the orig Dr saw me he had a cow that I was on such a high dose of dilaudid because as he stated, the D's are short acting and since your pain is so chronic you should be on a long acting med and a short for break throughs. So he switched me from all that D's to the 15mg ms-contins
(same drug as oramorph) and lowered my D's to 4, 2mg's a day. The 15mgs of ms-contin were not working so he upped me to the 30mg's of oramorph and the same small amount of D's. Long story short (to late for that I guess lol) is that with the current regiment 30mg's oramorph 3 x's a day and 2mg's D's 4 times a day as needed seem to be working great. So I am very happy that my pain seems to be under control at this point. Let's hope it stays that way. Again I can't thank you enough for helping me understand much better on whats best for me. Much appreciated!!