I started a thread in another forum and someone suggested I look here and of course this is a perfect place! I was working on a care plan for a patient that has chronic pain and is concerned about advancing her opiate medications. She had originally started out on muscle relaxants combined with very small doses of percocet and or vicodin. There was a whole list of muscle relaxants - and some arthritis drugs like celbrex. but she developed severe esophagitis, had reflux and had to stop all changed to percocet, added prilosec. now she is building tolerance to opiate meds and concerned. someone here said there are some opiates that act longer so you do not get the up and downs and you get better pain management and less likely to need to advance on dosage. The only one that I know of is oxycontin but I was wondering if there are others and do they even start in doses equal for someone that only takes 7.5 mg of percocet, tid? and how to equal out - is the oxy dose the same? I am not sure if she would be open to it because part of her concern was actually trying to reduce her meds but if it actually kept her from increasing, it might work.