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My 74 YO mother has a bad hip and they cannot do the surgery. She has been on 15mg extended release morphine 2 times a day for 4 years. We ‘ve been told that this is a very low dosage. She understands that she might be addicted, but she is doing great. Aside from often being sleepy, she is happy, not loopy, and functioning well.  She uses a scooter to get around, but is living independently. In the beginning she had been on a higher dosage, but then started taking 500mg of Turmeric 2 times a day along with the morphine. She was able to then cut back the morphine by 1/3.  
Find a provider who will work with your mother to lower her pain levels. She will be a new woman. Good luck.
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sunshinelife Aug 2020
Thankyou...Ive been saying the same regards tumeric Pain is caused by inflammation. which is in turn (in chronic cases) causes by systemic acidity. Tumeric works nicely to reduce inflammation. Thereby reducing/eliminating pain. Comfrey root tea works nicely also. Tumeric is a food, not a drug..so you can use as much as she needs to be comfortable with no risk of side or after effects. You could include Kratom powder to wean her off the tail end of morphine if she wishes. And Potassium Broth (avail on google) to alkalize the body & give lots of much needed easily absorbed minerals.
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No, addiction to pain meds is not now the question. It does not now matter if your mother is addicted to painkillers. In fact she may benefit from a fentanyl patch. Back pain can be very very severe. Think of it as end stage cancer pain, with no near relief of "release" on the way.
Does your mother speak to you about how long she wishes to fight on hard to live ? Did she want tube feedings? (I live in such terror someone would force me to go on with them that it is clearly written in my advance directive that I refuse them and all forms of artificially administered nutritions). Does she express and exhaustion with the constant pain of living now with no relief in site? Are you considering hospice care at any point for her? For me this sounds an utterly fearsome way to go.
If your mother always expressed a wish to go on at any cost, and still does, then I understand. Some people will tolerate any amount of pain to live. Most, however, will not.
I am so sorry for your Mom. If her doctor is speaking, at THIS point, about addiction please request a pain control specialist consult at once. This is the wrong doctor for her. Also consider palliative care, hospice consult may be an option in the near future.
I am so dreadfully sorry. When I started in nursing we did not control pain when we feared its relief might hasten death. Thank goodness this is no longer the case. I could stand ANY amount of blood, guts, sputum, and such, but when my patients writhed in pain I could not relieve it made me dizzy and ill. I have ZERO fear of death, but I know what pain is, and I dread it.
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worriedinCali Aug 2020
This makes no sense. Mom has a poor quality of life so opioid addiction shouldn’t even be a consideration. and you suggested a hospice consult may be in the near future. Well what do you think hospice will give her? MORPHINE. Hospice should probably be contacted now.
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Let her have the morphine. At some point, you have to let go, If the morphine works, well, at least she will have some comfort. I sense you have done the best you can.
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Yes I would agree to anything that makes her pain bearable. Good luck and all the best at this awful time. xx
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Just want to add that any medications, including methadone, could be dangerous to the elderly. My mother had very competent medical care who knew what they were doing and very experienced with medications. I went in with my eyes open and also did much research myself.

Having my mother on methadone gave her two years of a comfortable life. There were no adverse reactions for her. I know it is different for each individual. I was happy to have had her pain free for those two years. She still would have been here if it wasn't for the Covid virus that took her away in May.

It is a personal decision and as long as you can trust the people who are taking care of her.
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I would ask what is her quality of life without the pain medication? If she’s able to be pain free and happy, is that more important than the worry of her being addicted to pain medication? Best wishes.
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I Have a friend on the morphine drip and it seems to help her with chronic nerve pain. She also has morphine lollipops and for some reason I continue to find that funny (I have an active imagine). I believe in making our LO as comfortable as possible.
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Seems that your mom may need 3 different types of doctors to help her: a primary care doctor for her chronic physical conditions, a psychiatrist to deal with anxiety and depression, and a pain management doctor. Since she has a lot of musculoskeletal issues, pain is not uncommon. She needs to understand that the goal of pain management is to drop her pain levels to one that make it easier to function, and that usually means feeling a little pain throughout the day. She needs better pain medication management to achieve this - long-acting pain medication and short term pain medication. A pain management doctor is good at prescribing and managing this. Do not be afraid of opioids. Yes, she can develop physical dependence and emotional dependence on these drugs. She is not taking them for the "high" or to cope with stress. Also suggest that non-medication pain management techniques: heat or cold pads, supporting body parts with pillows, more frequent position changes... can all be helpful. I use those as a nurse and do not need a doctor's orders for these.
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Be mindful the more narcotics and psychotropics a person takes, the more likely they will fall and get complications which may even include bowel incarceration (twisted bowel)--they can die from all of those things. It sounds she is headed straight for DNR/hospice route. Get funeral pre-arrangements done, if not done already, Power of Attorney, and estate planning.
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I wish you had a pharmacist who you trust to confide in. I know younger adults who needed oral morphine to control back pain but then ended up on fentanyl pain patches, a high level controlled prescription. The morphine can suppress respirations.
Reading below I agree with some injections at a pain management clinic to start with. My dad had terrible trauma to his back, had injections and was fit with a wonderful supportive back brace that he loved. Her back needs to be immobilized when she is up and moving. The best of luck to you and mom. My dad also was on anti anxiety meds and a mild anti depressive that helped.
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Dear Rebeccaal
My mother also had immense pain due to very bad arthritis. After she broke her hip, it added to her pain. She couldn’t communicate her pain in words because of her dementia and instead lashed out and became aggressive. She was in an assisted living and then in nursing home. The facility first prescribed Tylenol 1000 mg 3 times a day, and Gabapentin 600 mg 3 times a day. It worked at first but she was still wincing in pain. The facility recommended methadone. I first didn’t want to put her on that but did agree after talking to doctors and nurses at the facility. They started off with 1 mg two times a day and reduced it to .5 after she was getting too sleepy. Eventually it was increased to 5 mg two times a day and her body got used to it in her system. After she was on it for a while, we noticed a tremendous difference, she was calm and comfortable and a lot happier than before. It took a lot of trial an error because she could not tell us what was wrong. I finally accepted the methadone and happy I did. It is so hard to accept these drugs, but sometimes they do work wonders. 

Maybe you could ask about methadone instead of morphine, which is much stronger.

My best to you.
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cetude Aug 2020
Methadone is very dangerous for elderly people, but I'm sure doctors will prescribe it without batting an eyelash.
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So happy that you are included in the decision-making process. So many times we are left out. That shows her current living arrangements are in her best interest!

Does it really matter if someone is addicted to a medication if it works? We talk about addiction to opioids, but leave out all the other addictive meds. My granny was addicted to a med, and when the doc changed it all hell broke loose - we argued and my stance was "Who cares - at her age what harm is it really doing?" The doc relented and put her back on the med.

Your mom should be as pain-free as possible. I fractured my back in three places and can tell you back pain has an effect on quality of life and I do not worry about being addicted to the opoid - better to be addicted and comfortable than not addicted and totally miserable!
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Why is your mom on a feeding tube?
I would discuss the pros and cons of getting on morphine with your mom.

To be placed on Morphaned is used for dying patients to try to keep them as comfortable as possible.

If that is not the case and she wishes to continue living, then I would switch to her having therapy, massage, using a heating pad, sitting and sleeping with her feet propped up. Ect.

If she has no major health problems then she could live another 20 years but not on Morphine!

Tall to the Dr again, Di your Homework and let your mom make an informed decision as it is her life.

She may want to live linger and agree to not take pain pills for a month and do other things instead and see how it goes.
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Isthisrealyreal Aug 2020
Morphine is not just used for dying patients.

It is cost effective and many times is the 1st drug used for chronic pain.
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You've gotten some good suggestions here; I would also make sure that her depression is being treated adequately.

There are certain antidepressants that are used specifically for folks in chronic pain; in addition to seeing a spinal specialist to see if her back can be better stabilized, consider seeing a geriatric psychiatrist and/or a pain management specialist who can coordinate with her other doctors.
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Isthisrealyreal Aug 2020
A good pain management doctor will address the pain, anxiety and depression. They know that they go hand in hand in many cases.
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My questions are, has she tried spinal injections to deal with the pain? And if she does morphine what comes after it loses its effectiveness? The spinal injections can be highly effective, done by the right doctor, guided by live X-ray to target the exact source of the pain. It can take a couple of tries to find the correct placement but the injections can be done 2 weeks apart and it’s a quick procedure in office or outpatient facility. My concern with going to morphine isn’t so much addiction, but considering her relatively young age and lack of other health conditions, it may not leave much room on where to go next when she’s addicted to it, but it’s also built up a tolerance
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I have no personal experience but people on the forum have mentioned pain patches as being very beneficial.
Although 78 may be old for some people many, many seniors are living well into their 90's so she could have many years ahead of her, I think I would be focusing more on getting a consult from a spinal specialist to see if there is anything that can be done to treat the root cause - I've learned here that there are treatments (Vertebroplasty and kyphoplasty) that can be used to stabilize the spine in some cases.
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MaryKathleen Aug 2020
I had Kyphoplasty. It is an outpatient procedure and painless. It did help the problem I had. It helps fractured vertebra. Mine fractured but didn't heaI. I would find a good Neurosurgeon to do it. If someone is thinking about it, I recommend do your homework. Everyone seems to feel it is safer than Vertebroplasty. I still have a LOT of pain if I stand very long. A walker or rollater helps, but I am having a problem with my ego. I have backpacked, done a little climbing, jumped out of helicopters. I just have a hard time walking in my neighborhood (with in my mind anyway, people peeking out their windows looking at me) even with my super fancy, penstripped, Nitro, Fire Engine Red, Drive Rollator.

I agree treat the root cause. Physical Therapy might help.
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