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Are There Any Alternative Painkillers for Those Who Cannot Use Morphine?

By J. Beam
Updated Mar 03, 2024
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Morphine is a highly potent narcotic pain reliever that is derived from one of three classes of opioids. Though a true medical allergy to morphine is rare, there are some people who are allergic to morphine and many others who suffer severe adverse side effects from morphine. Typically, morphine is prescribed to manage moderately high to very high levels of pain such as following surgery or a serious injury. For people who are either allergic or suffer severely adverse reactions, doctors can provide a morphine alternative.

There are three different classes of opioids: phenanthrenes, phenylpiperidine, and phenylheptane. Morphine, along with codeine, oxycodone, and hydrocodone all belong to the phenanthrenes class. As a morphine alternative, a patient may be prescribed a drug from another class of opioids, such as fentanyl, which is from the phenylpiperidine class. Often times, a patient who suffers adverse reaction to morphine or codeine will not exhibit the same symptoms from a drug in one of the other opioid classes.

Non-steroidal anti-inflammatory drugs (NSAIDs) are also a morphine alternative. A patient who has exhibited a true allergy to opioids can have their pain managed with NSAIDs. Ibuprofen is an example of a NSAID that can help control pain. Acetaminophen is another non-narcotic analgesic that can be used as a morphine alternative. The problem with NSAIDs and other non-narcotic pain relievers is effectiveness. While they can be very effective at managing mild to moderate pain and are often well tolerated, they can be very ineffective at managing severe pain and can be toxic in high doses.

In most cases, when a doctor seeks a morphine alternative for a patient, they evaluate prior medical history and any previous effects of morphine. In many cases, adverse reactions are related to dosing rather than the drug itself. In the event that controlled dosing of morphine is ineffective, a switch to a drug in another class often relieves the problem.

If you are concerned about prior experiences with morphine or other opiates and are scheduled for surgery, talk to your doctor beforehand about the various methods of controlling pain post-procedure. If you have been prescribed a narcotic pain reliever for acute or chronic pain and believe you have an allergy, call your doctor immediately.

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Discussion Comments

By anon935816 — On Feb 26, 2014

Everyone experiencing severe allergic reactions and breakthrough pain from all opiate class drugs should try Talwin or Tramadol Ultram.

I shattered my leg doing martial arts in 2005. I couldn't even get a doctor in northern Ontario to diagnose the injury for three years, and the cast had not healed it by the time I got to a fracture clinic.

About 14 years later they put me into the perpetual paperwork loop where I had no family doctors to get the X-rays to get a referral. Then they pull the “your old medical history of 20 years of sports injuries is invalid” even if they did not heal.

So, after doing every opiate on the planet trying to self maintain through this debilitating nightmare, they dumped me into methadone "for chronic pain." I asked about side effects and they said a little dry mouth and gain a bit of weight. Except my body went into reverse and within one year I've been though extreme dental surgeries, 20 horrible "restorations" and now the breakthrough pain is so severe they try to dose me on all the drugs I'm allergic to. Well, honestly, I think the drug companies are just trying to justify these extreme reactions like sinus headaches, searing dental agony, a bowling ball bursting from behind your eyes by saying, “Oh, hey. That's totally normal” because they’re too lazy to actually invest in safer alternatives for people experiencing these issues.

Talwin will work to pull the opioid from the cells to help your body recover, while offering considerable chronic pain options. However, Talwin is only kept at Canadian ERs for people allergic to all other pain meds and who are also having kidney stones issues. I had to call three pharmacies to find one that even had it in stock.

Methadone will eat through your teeth like battery acid. Above the gums, right through the teeth, they shatter and break like chalk balls. It will feel like you are chewing on metal ball bearings while trying to eat much.

If you do not believe this information, better look up how the UK pioneered methadone in the 1960s to handcuff people into staying in their version of “help,” as they call it. Yet it has become abundantly clear that pretty much everyone in the UK who has been on a methadone program has lost all their teeth. So our American and Canadian Big Govs are going to deny there is any substantial evidence to support this because they really don't want to be held accountable for paying for dental repairs and surgeries for all these victims. I mean, the Nazis invented methadone.

Also, get a medical alert bracelet for those allergy issues because, if you ever black out in an accident, they will likely resort to those drug classes first. Anyone reacting to morphine, demerol, oxys, codeine, the patches, etc. don't realize all major narcotic classes will likely make the breakthrough pain worse then it gets critical. I don’t believe in this junk about the proper dose. It's your body's way of telling you I don’t want that drug!

Also, they started me off on those 600mg ibuprofen orange footballs and it made my stomach bleed out to where I can barely even take one of those anymore. So be careful with these options. And be realistic about what will happen on drugs that severe over the long term. No one wants to be in pain but losing your teeth is not worth it. Also Oxys and patches make your teeth fall out like chalky clumps as well. Little pieces of teeth break off every time you eat and the sensitivity is off the hook.

By anon353500 — On Oct 30, 2013

There needs to be an alternative. My mom, who is in end stage renal failure, is allergic to all opiates, as I am. We both found out through surgery. She had knee replacements, and I had a total hysterectomy. We need to serve those in pain better. My poor mom is now suffering and I know it. She also has neuropathy.

By anon340062 — On Jun 29, 2013

My mum is 84 and has had arthritic pain in her knee and hip. The surgeons decided to operate on the hip doing a full hip replacement. She is still suffering terrible pain in her knee. So they started giving her morphine. This has led to her blood pressure suddenly falling and a black out. She also has raging thirst, feeling really unwell, tired all the time, getting constipated. They also put her on a drip. They keep stopping it, then started it again. They have also been trying a cocktail of other medicines.

Today I asked them to stop this and to put her back on paracetamol and nortriptyline, rather than the other neuropathic pain medicines for her knee (which may be also part of the problem with the blood pressure as she blacked out after a few days of being on Amitriptyline). I think it is better to suffer and die of pain that get dehydrated by dammed morphine - which is certain death by the sounds of it. Poor thing. I wish I could find and suggest an alternative drug that will work! Any suggestions?

By anon315778 — On Jan 25, 2013

Everyone here needs to look into pstim. It's non narcotic and very useful.

By anon313202 — On Jan 10, 2013

I told the ER doctors I was highly allergic to morphine, so they gave me synthetic morphine. After power puking and itching to death, I had the determination to refuse all meds other than the IV for antibiotics. They were treating me for diverticulitis. It was a bad infection, but the migraine, vomiting and sores on my body were way more severe than the cramps from my belly infection.

I now know to at least scream that I cannot tolerate morphine, morphine anything. Are there any other pain options? I really wanted to die.

By anon146379 — On Jan 26, 2011

Since 2007 when I was diagnosed with secondary Sjogren's Syndrome, peripheral neuropathy and osteoporosis, my rheumatologist has literally tried every pain medication available on market today. That is, every morphine or morphine derivative available today. The pain is chronic and I am in most pain during the evening hours, making sleep very difficult. I simply try to squeeze in as many naps during the day to maintain some energy. However, this is not the answer if you want to hold down a job!

So, I am now collecting SSDI and am in a state program for pharmaceuticals. Fortunately, I do not pay more than $7 for brand drugs and 2.50-5.00 for generics. This cost-savings would certainly be a benefit to me if these drugs worked.

It is obvious to my doctors and to me that I am immune to morphine-based pain meds. Now I am looking for alternatives and the only one presented to me has been methadone. My sister, who suffers from Gaucher's disease (rare and genetic) has been on methadone for 15-plus years and told me last night that she only wished she had spent more time doing research than taking methadone. It has had so many negative physical side effects such as her once beautiful teeth, now just falling out of her mouth, that she has become very much home bound.

Knowing side affects such as this, isn't it curious that Medicare approves this drug (because it is cheap), yet does not help with the havoc that this drug can cause (i.e., oral maintenance).

From 2007-2009, I was given the fentanyl patch which literally did nothing, and then started with the fentanyl "lollipop." To date, this is the only narcotic that has worked, perhaps because it is a lollipop and the patient locks it in between the teeth and the gums. Obviously, it is being metabolized differently. And of course, the "pop" is very costly. On average, a month's dosage is approximately $3200.00 and since the introduction of Medicare D, my state plan has changed how it works.

In the past, (pre-Medicare D), if a drug was part of the formulary, and the Medicare company declined you, the state agency would automatically take over and without question pay the entire amount so that I could have the lollipop. In October of 2009, I was notified by the state that they would only help out if a drug was in the formulary and it was FDA-approved for your condition. So, what they did to avoid paying for the lollipop was to simply cite the FDA's approved usage for it: "Breakthrough cancer pain". So, if you don't have cancer, unless you can afford to pay for it yourself, you are not allowed the drug. Trust me when I tell you how many appeals I have filed and the pile of boilerplate letters of refusal.

Who decided that cancer was the most painful illness in this world? In many cases it can be, but in many cases where we can treat many cancers successfully, pain is not even an issue. For example, if my doctor filed an appeal and told them I now had thyroid cancer (95 percent cure rate), they would approve the lollipop without question! And yet, with all of the chronic illnesses that I have, and the immense amount of pain that I am in, I am refused this drug.

The Fentanyl patch which does not help me, but is absorbed through the skin, but also has the same component active drug as the lollipop, is approved for non-cancerous conditions. Why? Because it is so much cheaper to manufacture and one patch lasts three days!

By greenrings — On Aug 23, 2010

If you are unable to take any pain medications, as I am, you could look into holistic medicine. I have back issues after being rear ended last year. My doctor tried several prescriptions, but they all made me nauseous and very sleepy.

I started looking into alternatives and found two things that take my pain away enough so I can function a little more and even continue physical therapy. The first is acupuncture, done right and 1-2x’s a week, it helps with pain. The second is reiki; this one is kind of new to me, but it is amazing. The healer draws your pain & negative energy into themselves. Good luck.

By RockinGranny — On Jun 18, 2010

There are two prescriptions which you can talk to your doctor about. They are both helpful in taking away pain, but have different side effects. Oxycontin will make you sleepy and you will have to take it exactly as directed. You cannot take any other sedatives and must notify your doctor of all other prescriptions you are taking. This is the painkiller you read about when celebrities accidentally overdose. But taken correctly, it can help with your pain.

The other promising drug is called Opana. It has been around the market but has recently been prescribed to more patients. It is known to cause less sleepiness, but that will depend on how your body reacts to the medication, just as with Oxycontin. A patient has quoted “My mobility is increased while on Opana versus turning into a “zombie” on Oxycontin.”

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