I would strongly recommend discussing with your doctors the use use either dextromethorphan HBr (DM) or "low dose naltrexone" (LDN) to "potentiate" the effect of the opioids you are already on, i.e., doing more with less. And as far as DM is concerned, we've had a couple of good thread on this. Check out Dextromethorphan working for burning pain http://neurotalk.psychcentral.com/sh...d.php?t=140566 and Dextromethorphan for pain?? http://neurotalk.psychcentral.com/sh...d.php?t=135535

I believe there have been threads on LDN as well, but this is a relatively new article worth the look: Ultra-low dose naltrexone attenuates chronic morphine-induced gliosis in rats, Mattioli TA, Milne B, Cahill CM, Mol. Pain 2010 Apr 16; 6: 22, FULL TEXT @ http://www.ncbi.nlm.nih.gov/pmc/arti...-8069-6-22.pdf:

Abstract

BACKGROUND: The development of analgesic tolerance following chronic morphine administration can be a significant clinical problem. Preclinical studies demonstrate that chronic morphine administration induces spinal gliosis and that inhibition of gliosis prevents the development of analgesic tolerance to opioids. Many studies have also demonstrated that ultra-low doses of naltrexone inhibit the development of spinal morphine antinociceptive tolerance and clinical studies demonstrate that it has opioid sparing effects. In this study we demonstrate that ultra-low dose naltrexone attenuates glial activation, which may contribute to its effects on attenuating tolerance.

RESULTS: Spinal cord sections from rats administered chronic morphine showed significantly increased immuno-labelling of astrocytes and microglia compared to saline controls, consistent with activation. 3-D images of astrocytes from animals administered chronic morphine had significantly larger volumes compared to saline controls. Co-injection of ultra-low dose naltrexone attenuated this increase in volume, but the mean volume differed from saline-treated and naltrexone-treated controls. Astrocyte and microglial immuno-labelling was attenuated in rats co-administered ultra-low dose naltrexone compared to morphine-treated rats and did not differ from controls. Glial activation, as characterized by immunohistochemical labelling and cell size, was positively correlated with the extent of tolerance developed. Morphine-induced glial activation was not due to cell proliferation as there was no difference observed in the total number of glial cells following chronic morphine treatment compared to controls. Furthermore, using 5-bromo-2-deoxyuridine, no increase in spinal cord cell proliferation was observed following chronic morphine administration.

CONCLUSION: Taken together, we demonstrate a positive correlation between the prevention of analgesic tolerance and the inhibition of spinal gliosis by treatment with ultra-low dose naltrexone. This research provides further validation for using ultra-low dose opioid receptor antagonists in the treatment of various pain syndromes.

PMID: 20398374 [PubMed - indexed for MEDLINE] PMCID: PMC2862024

http://www.ncbi.nlm.nih.gov/pubmed/20398374

Hope this is helpful.

Mike


ps Would pulled the LDN threads, but we're going out of town for a week, the cab is due here in an hour and 20 and I'm neither showered nor packed. Yikes!!!