How is it best to transition from tramadol to ms contin (morphine) ? is it necessary to wean down on tramadol before starting ms contin (morphine) ? i fear pain escalation

Ask your doctor: Generally, a trial of short-acting opiate drugs is appropriate, together with non-opiate drug treatment and non-pharmacological treatment. If your doctor is not expert in helping you taper the tramadol (which should be done first, since they may interact with poor results), and in starting long-acting morphine, you should get consultation from a pain physician who is expert. A taper can be rapid.