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  • Baclofen pump and morphine for pain

    Sorry if this question is on the system somewhere but I'm really lost with this new format on CareCure and I tried to do a search and came up empty handed. I have a baclofen pump and my pain management doctor says that low doses of morphine through the pump will help with my pain. He said it would help with spinal pain. Will this help with nerve pain? Are any of you using baclofen plus morphine in your pump? Is there any negative reasons I would not want to be mixing the baclofen and morphine together?? Thanks in advance for the time Evonne
    I have a spinal cord injury...a spinal cord injury DOES NOT have me!

    walking quad-Central Cord Syndrome

  • #2
    I don't find that opiates make a big dent in my nerve pain, so I would doubt it would help much. There is someone here who has it, hopefully they will chime in, I don't remember who. I don't like the idea of mixing it, as my baclofen dose varies a lot during the day, and when I need the baclofen, isn't necessarily when I would need the pain meds. (I am going on the assumption that the meds are mixed, and the computer can't split them up - always getting purple, not sometimes red and sometimes blue, but I may be wrong on that.)
    T7-8 since Feb 2005

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    • #3
      I have baclofen and morphine in mine, actually have a 3rd drug too but we are backing it out. I can't say that morphine has helped me much, I have bad neuro pain and muscular/skeletor(sp?) pain that ramps up as soon as I get in my chair, so got all kinds of variables to hit. My pump NP says she has numerous pump patients(she has a shitload of pump patients) who do get relief with morphine added, I just don't appear to be one of them.

      The drugs are mixed together externally and manually, before the refill "shot" is injected into the pump, so no, the pump cannot give varying drug pushes. My NP has to do long calculations to get the right mixture, and shifting your baclofen doses during the day would shift the morphine dose too.

      It can't hurt to give it a try, you can always back it back out. But it does reduce the time to next "Alarm Date", as the pump only holds a set amount, and you reduce baclofen amount by amount of morphine added. I am going to try another combo, I hurt too much not to try something.
      "a T10, who'd Rather be ridin'; than rollin'"

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      • #4
        Thanks for the response McDuff- did you get any itching or nausea from the morphine in the pump? I get my pump filled every 5 wks now I hope with the addition of the morphine it does not change much. He said it was going to be a very low dose.
        I have a spinal cord injury...a spinal cord injury DOES NOT have me!

        walking quad-Central Cord Syndrome

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        • #5
          You're welcome. I did not have any adverse reactions to morphine. They will give you a scrip for an oral round of morphine first to see if you have a bad reaction, easy to recover from a pill timeframe, don't want a pump full to find out you can't tolerate it.

          I'm at ~5 weeks myself, high dose of baclofen plus ramped up morphine, my round trip is ~60 miles so would like to get a longer timeline back.
          "a T10, who'd Rather be ridin'; than rollin'"

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          • #6
            A couple quick comments, as noted if you have neuropathic pain morphine and other narcotics may not help, I tried and encourage you to try.

            Regarding the oral trial, while valid, it does not mean it won't work intrathecally. The dosage via pump will be micro grams vs milligrams for oral. E.g. I could not tolerate enough baclofen orally to "semi" manage my spasms/spasticity. I now have a pump and have been titrating up for a year, and while not controlled I have reached an "endurable" level.

            That said I tried a variety of narcotics in my IT pump trial and while I still did have side effects the lower dose was much easier on my system and I might have tried to work into them, but I received no benefit so do not have it in my pump.

            Ket

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            • #7
              I am somewhat concerned now because my doctor did not talk to me about the oral trial, he just asked if I was allergic to morphine. I am just supposed to show up in a week and get my mixture of baclofen and a low rate of morphine.
              I have a spinal cord injury...a spinal cord injury DOES NOT have me!

              walking quad-Central Cord Syndrome

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              • #8
                If you told him "no I am not", he would probably assume you have had it before and had no issues, then I could see them maybe just going ahead. If you said "I don't know" then they damn well better do an oral trial first. Mine did not even ask, their protocol is to do oral trial first, period, as tolerance could change over time.
                "a T10, who'd Rather be ridin'; than rollin'"

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                • #9
                  I tried Dilaudid which is a stronger version of opiates then morphine and it would work for a month or two and then we'd have to turn it up and it kept going like this for about a year or so. It really screwed me up and I guess I spent a lot of time in a daze. I got my pump replaced and then had some problems and had to have it removed for a month and spent the first couple of those weeks hallucinating. It wasn't any fun. I don't have it anymore and I don't think it's any different. We use bibucaine now and I do notice a difference when we increase that. Narcotics do very little for central pain. Hope this helps you. I've had my pump for 11 years and have tried all sorts of things to get rid of my pain
                  C-5/6, 7-9-2000
                  Scottsdale, AZ

                  Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

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                  • #10
                    Rybread- thank you
                    I have a spinal cord injury...a spinal cord injury DOES NOT have me!

                    walking quad-Central Cord Syndrome

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                    • #11
                      I went in and got a really low dose of morphine in my pump....it does not seem to work on my nerve pain. I have also noticed that my walking has really declined in the last few days and I seem to be a lot sleepier. In 2 wks I'm going to go back to just straight baclofen.
                      I have a spinal cord injury...a spinal cord injury DOES NOT have me!

                      walking quad-Central Cord Syndrome

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                      • #12
                        Try bibucaine or something like it. I think you'll have better results
                        C-5/6, 7-9-2000
                        Scottsdale, AZ

                        Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

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                        • #13
                          I was given morphine for spasms and pain back in 1986, It works great however the dosage has been increased many times. This is pill form and i must be careful with alcohol consumption.

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