Morphine Tolerance? Anyone?

TarheelMichelle
TarheelMichelle Member Posts: 871
edited November 2014 in Pain

hello ladies and gentlemen, I have stage IV breast cancer and in 2 1/2 years have been on fentanyl patches, oxycodone and now morphine. I've been on morphine for about 6 months. For the past two weeks, the pain in my ribs and lungs has gotten really bad, and I have been thinking that perhaps my cancer has progressed, which of course has caused me much anxiety. But I'm starting to wonder if my body has built up a tolerance to morphine. Within fentanyl and oxycodone the tolerance I developed resulted in really horrible withdrawal symptoms when the medicine was wearing off. I'm not having any withdrawal symptoms, it's just that my pain doesn't seem to be diminished by the morphine like it used to. I'm seeing my doctor in a couple of weeks and of course will be talking to her about it, but I would just like to know if anyone has experienced this -- a diminished efficacy -- and if they were able to remain on morphine. It's been a good pain reliever for me because of the lack of withdrawal symptoms and if upping the dose is all I need to do then no worries. But if this signals a need for a complete switch to a different pain reliever, I want to do some research before I make a choice. Thanks in advance for sharing your morphine stories. 

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  • Teen22
    Teen22 Member Posts: 79
    edited November 2014

    Hi Tarheel,

    Did you say you had withdrawal symptoms on Fentanyl and Oxycodone? Is there a stronger drug than morphine? I am curious because I thought that morphine is the strongest pain reliever :( I hope your doctor found you a solution? I tooam worried that I may be taking too much oxycodone, to which my MO always says "You don't get brownie points in the BC world if you take less".

    I hope you are getting some relief....((((Hugs))))

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  • TarheelMichelle
    TarheelMichelle Member Posts: 871
    edited November 2014

    I don't know of any stronger drug you can get in pill form. I've been told not to worry when death is near, there are other stronger drugs that can be administered in hospital.

    my withdrawal symptoms when the drug was wearing off were much worse on fentanyl and Oxy than morphine. I shied away from morphine when my pain management doctors first recommended it to me because of my own prejudices. But it was not only the best pain reliever, it helped my breathing (which requires effort because of cancer in my ribs and pleural effusion.) Even doubling my morphine dose had no effect on the pain. My body is just that way!

    I'm still struggling with pain management. I'm back on the fentanyl patch at a higher dose with Dilaudid and Toradol for breakthrough. Dilaudid makes me weepy and depressed.

    Some of my side effects may be related to my cancer treatment which has changed over time. For instance, I felt extreme hot and cold flashes on my first go-round with fentanyl. But in hindsight, it could have been the Lupron shots, which monkey with your pituitary gland functioning.

    I start radiation treatment tonight on my spine in effort to lessen the pain. Yes, tonight at 7. Hospital added 7 radiation patients the same day as me, and that was the only time slot.

    I hope I can try morphine again. My doctor was reluctant to try methadone (cardiac side effects) but I've read a few women here say it has helped them so that might be my next weapon.

    Thank you for hugs. Much needed and appreciated!

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  • leggo
    leggo Member Posts: 3,293
    edited November 2014

    Hi Michelle. I'm so sorry about your pain. I so hope the rads take the edge off. I suffer from hyperalgesia due to severe nerve damage, and pain drugs, any of them,  just don't work for me. Wondering if that might be the case with you. More a syndrome than a diagnosis, but sometimes, it can be treated with a drug change or addition, but I never had any luck in that regard. I thought I'd mention it just in case you do have nerve damage and doctors haven't connected the dots. Apparently, it can also happen when you've been on opioids for a while. I've added a link to the wiki pages about it because it can explain it way better than I can. I sincerely hope you find relief. More hugs for you.

    http://en.m.wikipedia.org/wiki/Hyperalgesia

    http://en.m.wikipedia.org/wiki/Opioid-induced_hyperalgesia


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  • Teen22
    Teen22 Member Posts: 79
    edited November 2014

    TarheelM, It is around 7 in the evening and I am thinking of you getting your rads right about now. i hope it alleviates some of your spine pain.

    You mentioned your withdrawal symptoms were worse on the fentanyl and oxycodone treatment. I can't imagine what sort of pain "withdrawals" feel, but I shudder and weaken thinking what it might be. I too have the intense hot and cold feeling of flushes and the frustration of just waiting for it to pass. These flushes are "painful" to me and when I try to explain this to my MO, she gives me that look of " I never heard that before". Lately though, she has been most compassionate with me when she found out my marrow was packed and inflamed. Yes, it was the culprit. She upped my meds (Oxy60 every 8'hrs, round the clock with percocet for breakthrough). When I asked her what dosage was too much, she said that "THE EFFECTIVE DOSE WAS THE RIGHT DOSE". So I am thinking of you, of me and many others who are hoping for the right pain relief. I know (first hand) how pain paralyzes us. I just stare at the clock and wait for relief. I bet you can relate. Keep us updated. Hopefully, someone chimes in with some experience in morphine.

    Leggo, thanks for the link on hyperalgesia. Interesting to read that it can happen when you are on opiods for a while. What are you doing for pain relief since you mentioned nothing works?

    Best to both of you...

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  • leggo
    leggo Member Posts: 3,293
    edited November 2014

    Hi teen. I'm using marijuana now. It doesn't do much for the bone pain itself, but it certainly helps with the inflammation and pain in the surrounding muscles. Enough to take the edge off and get me moving anyway. It also decreases the constant liver spasms too, which I found quite painful and nauseating. 

    It was just such a roller coaster to find an opioid that might work. I either felt high as a kite, barfed, or was constipated and then took drugs to counteract those effects. In reality, none took away my pain so it just wasn't worth it to me to be swallowing all those pills or patching myself up for very little relief.

    I hope you can find some relief as well.

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited November 2014

    Yikes, leggo, that sounds awful that you have hyperalgesia. Glad the M works for you. That M makes me so silly and talkative, but I don't notice the pain too much for a little while. I have been on percocets since after surgery, and they are still effective for me. Dilaudid and Morphine and methadone are almost chemically exact. Morphine, from Morpheus the God of sleep, was derived from the opium poppy, and believe me they ALL have withdrawal symptoms. Methadone was actually made during hitlers regime, by the company we now know as Bayer. Morphine is still extracted from the poppy (the red one you cannot buy in the USA, papaver somniferum), and the dilaudid is entirely a laboratory process. But none of this is helping with the pain of Michelle! I am so sorry Michelle. I know my friend was on morphine, and they would escalate how much they would give to her, she had lung cancer that metastisized pretty much every where eventually. And yes your body can build up a tolerance to any painkillers, but they shouldn't have a problem giving you a higher dosage, I hope! I have never tried fentanyl so i don't know anything about it, havent looked it up yet.

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  • TarheelMichelle
    TarheelMichelle Member Posts: 871
    edited November 2014

    thank you everyone. Truly.

    My iPhone is acting weird (freezing up) when typing replies on the boards. I have steroids and Afinitor in my system first time ever and just got radiated in 4 different places. And I still hurt but the 100 mcg fentanyl is helping. So I can't write more right now but please know how much I appreciate your advice, experience and compassion. Just to be understood helps.

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  • leggo
    leggo Member Posts: 3,293
    edited November 2014

    Geez. I just noticed your original post is from September. I'm so sorry you've been struggling with so much pain all this time. Glad to hear the fentanyl has been helping. I hope the rads take care of the worst of it. Hugs.

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  • blondiex46
    blondiex46 Member Posts: 5,712
    edited November 2014

    It seems  that is where i am goung, first percs not oxycodone,  i am only on 15 mg they dont have 20s, i use m also it works some, morphine,  not at all. Neck n back pain is geting bad , took myself off chemo in july cause of the side effects

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