Toe: I have some concerns with your current medication. Morphiene is not well metabolized by anyone via oral administration. In fact over 70% is generally lost in pill form. So when you start dosing you are guessing at how well you will metabolize it. If you are a perfect candidate you may actually use 30%, but suppose your GI is not working right or your liver function is poor, well then it will work very poorly for you.

I think rather than trying to up the dose (yes I'm sure you are fairly tollerant) you ought to see if another med works better. There are several choices. To me the best choice is Oxycontin as the dosing is very similar in that it will last 8-12 hours but it is much more effective orally. In fact you could likely drop your dose and get better relief. You could try 40mg 2x day and it may work well for you. But, it is expensive. Methadone is considerably cheaper, but it is likely harder to have a GP prescribe it because of the connotations even though it was created to reduce the "pleasant" effects. It also takes quite a bit longer to take effect.

My recommendation is, if you feel you need to stick to the MS, is to try a different med for "breakthrough". You said you thought 5mg of oxy would be way too low. Is that from actual experience or simply due to the dosing with MS? If you haven't tried Oxy, you may be surprised at how well even 5-10mg would work. So let me suggest you simply ask of oxyfast or Oxy-IR. if it works great - then suggest moving away from the MS. If it doesn't work, then maybe it is a tollerance thing and you should think about the patch or something else.

Good luck - Farmer