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Are Morphine, Dilaudid And Fentanyl Stronger Than Oxycontin?

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Posted on Thu, 7 May 2015
Question: I currently take oxycontin and oxycodone for breakthrough pain. I have been taking it for several yrs. I Suffer from advanced rsd/crps and L4L5 spinal root nerve damage. Given the reputation for Abuse of this me many Drs encourage changing me to Dilaudid or morphine pump or patches. Isn't morphine and dilaudid and fentynol stronger than oxycontin and isn't there the Very Same Potential for abuse and dependence? I went through a 9 wk intensive outpt pain management program and tried those meds and they made me very nauseous and experienced levels of sedation. Oxycontin helped my pain and I experienced no sedation. I did not and still do not get a "feeling of euphoria or that of being high" as some people do. I did " come out of my shell a bit" according to my family and that is the only mental change I experienced. I don't know how people get "high" unless they take extra doses or snort in their nose. Not everybody abuses this medicine. Its Too Important for me to have evey single scheduled dose for Pain Relief, so there is No Way I will take extra to see if I get "high." I was even able to return to work in the emergency dept where pace is fast, unpredictable, and multitasking is a must. Wouldn't people get "high" if they abused morphine or dilaudid? if so, Why wud a Dr feel like its better to write for those? Im very frustrated as I have been through two Drs that ended up moving or retired and to find another Dr to write for the medicine that gave me my life back is more than Difficult, its near impossible. I have been embarrassed, belittled and treated like I am the most horrible person when I tell them that I take Oxycontin. I have left Drs offices crying because of the way I was spoken to. I did find a pain man Dr that continued my medicine, however, he is obviously not truly interested in my health and only takes cash payment. I don't feel real comfortable with him but I certainly cant call Drs or keep making appmnts with Dr after Dr until I find one who isn't against Oxycontin. I have had every known treatment from surgery, spinal nerve stimulator implants, nerve blocks, different non narcotic meds, and so on by Drs at XXXXXXX Clinic and University Hospital XXXXXXX My condition is legitimate which any Dr can see as the visual one sees with RSD are grossly evident. I have been through so much over the years dealing with chronic pain and I just don't understand Why its okay to change me to a different opiod or a stronger narcotic med just because its not called " the dreaded Oxycontin". I guess my question is.... How do I find a Legitimate Dr who is not Afraid to prescribe Oxycontin? Sure I could continue with Dr I have now but like I said he takes cash only and that seems like a RED FLAG. What to do????
doctor
Answered by Dr. Goswami Debopom (42 minutes later)
Brief Answer:
Oxycontin is more powerful than morphine and not the other way round.

Detailed Answer:
Welcome to Health Care magic. Thank you for posting your query.
I can understand your concern.

I have gone through the entire post . I can understand that you are a bit disappointed with the present scenario. Let me help you out.

We actually have a 3 ladder pattern to follow while opioid dosing.

Step 1 Mild to Moderate Pain

Non-opioid ± adjuvant agent


Step 2 Mild to Moderate Pain or Pain Uncontrolled after Step 1
Short-acting opioid as required ± non-opioid around the clock (ATC) ± adjuvant agent


Step 3 Moderate to Severe Pain or Pain Uncontrolled after Step 2
Sustained release/long-acting opioid ATC or continuous infusion + short-acting opioid as required ± non-opioid ± adjuvant agent
Sustained release , morphine, oxymorphone or transdermal fentanyl is indicated

The exact opioid is prescribed after proper examination and after consideration of adverse effects , pain intensity , type of pain state , acuity and chronicity of pain and abuse potential.

Oxycontin is much stronger than morphine . Oxycontin is Schedule II controlled substance with abuse liability similar to morphine. Hence, it is prescribed with great care and not used in regular practice.


I would suggest you to not worry much.
Follow as your doctor has advised as this is a long term process .
Talk to him about the financial constraints as well so that you can reduce the number of visits.

Hope this helps.

Write back to us.
Regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Goswami Debopom

General & Family Physician

Practicing since :2013

Answered : 484 Questions

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Are Morphine, Dilaudid And Fentanyl Stronger Than Oxycontin?

Brief Answer: Oxycontin is more powerful than morphine and not the other way round. Detailed Answer: Welcome to Health Care magic. Thank you for posting your query. I can understand your concern. I have gone through the entire post . I can understand that you are a bit disappointed with the present scenario. Let me help you out. We actually have a 3 ladder pattern to follow while opioid dosing. Step 1 Mild to Moderate Pain Non-opioid ± adjuvant agent Step 2 Mild to Moderate Pain or Pain Uncontrolled after Step 1 Short-acting opioid as required ± non-opioid around the clock (ATC) ± adjuvant agent Step 3 Moderate to Severe Pain or Pain Uncontrolled after Step 2 Sustained release/long-acting opioid ATC or continuous infusion + short-acting opioid as required ± non-opioid ± adjuvant agent Sustained release , morphine, oxymorphone or transdermal fentanyl is indicated The exact opioid is prescribed after proper examination and after consideration of adverse effects , pain intensity , type of pain state , acuity and chronicity of pain and abuse potential. Oxycontin is much stronger than morphine . Oxycontin is Schedule II controlled substance with abuse liability similar to morphine. Hence, it is prescribed with great care and not used in regular practice. I would suggest you to not worry much. Follow as your doctor has advised as this is a long term process . Talk to him about the financial constraints as well so that you can reduce the number of visits. Hope this helps. Write back to us. Regards.