Understanding the medications you're taking is important. Why? Preventing an accidental overdose is one good reason. Avoiding a mixture of the wrong medications is something you can't leave to your doctor or pharmacist. They see hundreds of people every week and although they are trained and responsible for avoid mistakes, that's not going to do you much good when you're in a coma or the grave.
Doctors don't like to be questioned. Pharmacists are much more open. Whether people like to be questioned or not shouldn't figure into your questioning them. It's your life and you're responsible for protecting it.
Derivatives of opium are broken down into two groups, those derived from opium and those derived from morphine. A third generation, synthetics, is fairly new and the fourth category is semi-synthetics, which contain part opium or morphine and part synthetic material.
Derived From Opium
Codeine, Morphine, Heroin.
Derived From Morphine
Methadone, Fentanyl, Propoxyphene, Butorphanol, Levorphano, Meperidine, Oxycontin, MSContin
Oxycodone, Hydrocodone, Hydromorphone.
Many medications contain ingredients you are not aware of. Most meds have a lot of buffers in them, such as Tylenol or aspirin. Often these buffers cause their own problems. Tylenol can cause its own overdose and aspirin can cause ulcers. Here are some examples of common pain medications and what they actually contain:
Damason P, Lortab
Codeine and Aspirin
Fiorinal with Codeine
Codeine, Aspirin, Butalbital, and Caffeine
Dihydrocodeine, Aspirin, and Caffeine
Endodan , Percodan, Roxiprn
Hydrocodone and Aspirin
Pentazocine and Aspirin
Darvon Compound, Propoxyphene Compound
Propoxyphene, Aspirin, and Caffeine
How Pain Medications Work
Methadone mimics morphine, but since it's not actually morphine, it's very effective in getting heroin addicts off heroin which is pure opium (from which morphine is derived) and as I understand from watching shows, etc., is usually melted down and "shot up" directly into the body through the veins. I
Heroin addicts need more and more to achieve the same high, need it constantly, use it purely to get high; hence those opium dens. Heroin merely became a highly portable and easily administered way of dispensing opium.
Morphine was developed from opium as a pain killer and was considered a medical breakthrough and blessing. During war time, it was a definite blessing, but it soon hit the streets, too, where it became abused and dangerous.
The various drugs developed from opium are: "Raw Opium, Opium, Codeine, Morphine, Heroin, Hydromorphone (Dilaudid), Oxycodone (Percodan), Oxymorphone (Numorphan), Hydrocodone (Vicodin), Meperidine (Demerol), Fentanyl, Methadone (Dolophine), Darvon, and Talwin."
All are opiate-based but are broken down different ways and contain varying levels. While they're all opiate-based, they're not necessarily morphine-based.
Pain Patients' Needs Misunderstood
The important distinction -- not always made by physicians and the Department of Drug Enforcement (DEA) -- is that the vast majority of people in pain are NOT drug seekers. We are "relief from pain" seekers. Many maintain that we do not become addicted because our bodies absorb the medicine not to become "high" but for pain relief.
We don't actually get high because the medications go for pain relief. We may get drowsy or suffer other side effects, but we don't get high.
The idea of withholding pain medication from a terminal patient for fear of their becoming addicted is ludicrous. They are DYING. What does it matter if they DO become addicted? It's not like they're going to have to go through detox.
If our pain were cured, we could also cure our need for pain medications.
Until Relief Is Achieved
So it's a matter of choice with doctors whether they use MSContin or oxycontin or fentanyl for constant pain -- all are opiate based but do not necessarily morphine-based -- or methadone or oxycodone for breakthrough pain. Methadone and oxycodone are short-term and fast-acting which make them good for breakthrough pain.
Increasing medications until they control the pain is called "titrating" them upward. The understanding and truly dedicated doctor will titrate the pain medication until relief if achieved.
Physicians should be allowed to do this without fear of the DEA picking on them as an easy target instead of going after drug dealers and importers on the street. Illegal drug importation is not a white-collar crime. and is completely different from a doctor prescribing medication for pain.