So I'm guessing you're taking 2 x 10 mg Kadian (ms-contin) per day? If so, that's the lowest dose made. From here, there are a number of options including stopping entirely, stretching out the dosing, switching to lower dose IR morphine, switching to another medication, etc.

What is the ultimate goal here—to eliminate pain medications altogether because you no longer need them, or to find another medication that doesn't give you the same side effects, or what?

If you still have nerve pain that requires medication, there are other medications that may address it better than Kadian. Some are narcotic and some are not, but all medications have side effects, and some may produce dependence (which is not the same as addiction). The goal might be to find the best one for you that addresses your pain (reduces the sense of suffering and improves your quality of life) with the least obtrusive side effects.

I see you found the Thoracic Outlet Syndrome forum. Some folks there may have similar experiences.

Doc