"i have been on ms-contin for 15 years.  in that time, only one dose increase!  i take 2x60 mg daily.  every 2-3 months, my doc changes medicine.  i used to be able to get opana, 40 mg 2x per day, and it worked great!  even better was efalgo, 16 mg 3 x per day.  2 in the morning, one at night.  now, insurance will not pay for either.  the only medicine i can tolerate is opana, 80 2x per day, and they really don&#039;t work well.  it is so frustrating that the medicine that is the hardest to tamper with, efalgo, is the hardest to get and most expensive! if i don&#039;t switch every few months, i build up a tolerance. i suffer from degenerative disc disease in my lower back, arthritis etc."