Morphine Sulfate Er 30mg Duration Effectiveness

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Jay Says:
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I have reduced my pain medication over the past few years from around 8-10 immediate release Percocet a day, (which in retrospect seems kinda crazy for my intractable pain), to 3 morphine er 30's a day, with 2 15mg IR's for breakthrough pain. Desperately trying to reduce them had been MY desire, not doctors. That being said, my constant, chronic pain was hard to manage at 3 ER's a day, so my doctor had raised then to 4 a day. That dosage seemed perfect for me, and after a long time, had enabled me to work and try to get my life back on track after years of suffering. I've moved recently, (which means new doctors, so you know the drill), and he had immediately reduced what was finally working, back down to 3 a day. I should mention that just before moving, I had requested the butrans patch to try and see if I could squeeze out any more physical addiction, or to at least see if it was possible, as I hate having to take anything. So my old doctor had raised my 15mg immediate release up to four daily, just to offset anything until I could see if the patch was successful or not. My insurance wouldn't cover it however, and I was right in the middle of moving, so I had been put back on 4 daily of the 30ER. My immediate release however was kept at four daily. (Kind of accidentally I guess, I'm not sure why).....I didn't need four, but my doctor didn't drop them back down. Anyway, here I was at 4 morphine ER 30mg a day, and still at 4 15mg IR daily.
Upon going to the new doctor, I explained everything to him, and asked if he could deep my immediate releases back down to as little as 2 a day. . .. Ironically, he believed the 30mg ER at 4 a day should be cut to 3 a day, and kept my 15mg immediate release at 4 daily. Which I thought was nuts, and asked why I simply couldn't just adjust it back to dropping 2 immediate release, (equaling 30mg), and raising the extended release, (evenly equaling 30mg), and I could avoid a sudden, (and unnecessary), blast of physically addicting immediate release into my system, (which seemed to cause more pain). I felt I would have an easier time of gently trying to reduce from there if possible by lowering my extended release possibly to see if I could tolerate it. He refused.....it just seems counterproductive to me, and he will....not....listen. He's the type, unfortunately, that he treats his ego and unwarranted fears of patients taking advantage of him, rather then the patient in front of him. How can I present him with information that would show him he's making a mistake? I'm not looking to raise my dose, I'm looking to lower it if possible....but in a safe way I can tolerate. He just seems to only validate legitimate research or clinical trials as opposed to constant and random blogs from patients, who plainly say in many circumstances that it doesn't last as long as it should, or states that it will. I can find those online all day long, showing people who complain it's a common thing, but because the bottle says every 8 hrs, unlike my prior pain specialist, I believe he lacks knowledge. Of course, NOT being able to say that to a doctor without him thinking I'm being argumentative, I'm kind of stuck. Am I wrong for feeling this way? I can survive, it's just that the added constant pain had been heightened. And is kind of impeding my ability to work.



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