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On oxycodone and Hydrocodone. Have major pain stressors. Quit morphine and had withdrawal symptoms. Should I get the pain stressors handled?

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Posted on Tue, 12 Nov 2013
Question: My doctor is going to put me on oxymorphone. I have been on oxycodone and Hydrocodone plus 120 mg of morphine a day. 8 each of the other two at 5mg daily. I have 3 major pain stressors . In XXXXXXX I took myself off morphine. Took 63 days of withdrawal symptoms. Horrible hell. Should I get some of my pain stressors handled, will it be jut as hard to go off Opana? I had been on morphine plus the other for 12 years.
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Answered by Dr. Ram Choudhary (6 hours later)
Brief Answer:
reassess the pain and use opana at lowest dose

Detailed Answer:
Hi XXXX,
Welcome to Healthcare magic.
It is painful to know that you have such pain stressors as to need years of opioid support.
Actually the drugs you are using, Morphine, Hydrocodone, oxycodone or the proposed one the Oxymorphone all are opioid class drugs of high potency.
They should be used for moderate to severe pain relief. Efficacy and side effect profile is almost the same.
Dose and modes of delivery differ.
They tend to cause dependence and waning of efficacy over time and withdrawal has to be slow otherwise severe life threatening symptoms may develop. The withdrawal has to be done under the supervision of a local expert physician.
You should get additional drugs like paracetamol or amitryptiline especially effective if there is neuropathic pain.
These drugs have opioid sparing potential.
Optionally you can try Fentanil skin patch also which is 100times potent than morphine and is easy to use and relatively safe.
Opana is also an opioid an hence stopping will cause withdrawal symptoms.
I hope the advise will be helpful for you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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On oxycodone and Hydrocodone. Have major pain stressors. Quit morphine and had withdrawal symptoms. Should I get the pain stressors handled?

Brief Answer:
reassess the pain and use opana at lowest dose

Detailed Answer:
Hi XXXX,
Welcome to Healthcare magic.
It is painful to know that you have such pain stressors as to need years of opioid support.
Actually the drugs you are using, Morphine, Hydrocodone, oxycodone or the proposed one the Oxymorphone all are opioid class drugs of high potency.
They should be used for moderate to severe pain relief. Efficacy and side effect profile is almost the same.
Dose and modes of delivery differ.
They tend to cause dependence and waning of efficacy over time and withdrawal has to be slow otherwise severe life threatening symptoms may develop. The withdrawal has to be done under the supervision of a local expert physician.
You should get additional drugs like paracetamol or amitryptiline especially effective if there is neuropathic pain.
These drugs have opioid sparing potential.
Optionally you can try Fentanil skin patch also which is 100times potent than morphine and is easy to use and relatively safe.
Opana is also an opioid an hence stopping will cause withdrawal symptoms.
I hope the advise will be helpful for you.