badnights wrote:It's great that you can manage your own care like that. More physicians should encourage opioid rotation, I wonder why they don't? simply not aware of the potential benefits, or too complicated to administer for most patients?
I don't seem to need it, myself; I've actually reduced my hydromorphone dose since eliminating gluten, casein, & sugar and adding other good stuff - - don't know which changes were critical to the dose reduction, though.
Probably physicians simply don't believe in opioid rotation and think that it will only increase tolerance and potential for abuse.
Maybe they simply don't know about the possibilities and don't know how easy it is.
When I rotate, I stop taking opioid #1, wait until moderate RLS symptoms kick in and then I start opioid #2.
There are many lists who give adivce how to select the appropriate equivalent dose.
Right now I am on ~ 150 mg of Morphine after 74 months of opioid treatment.
After 3 months I was on 80 mg of Oxycodone which equals 160 mg of Morphine. So nothing really has changed.
I can't see any tolerance and my strong opinion is that opioids are a safe long term treatment option for many RLS patients, suffering from mild to very severe symptoms. Makes me sad when I read that physicans won't increase the dose over 20 mg of Oxycodone of tolerance. Every individual has its own needs. Opioids can be dosed very high. Stopping at 20 mg Oxycodone when the drug has proven to work is in my opinion simply stupid. I consider myself lucky having a physician who is listening to me and values my input.