It is disturbing,to say the least, that you have recounted the very reason why people in chronic pain have such a hard time (even with reputable Drs.). Friends selling drugs? Cheating on tox screens? A PM Dr. Who dispenses narcotics and takes cash? At the very least he needs to be sanctioned. Typically in Pm an extended release opiate is used along side breakthrough meds. It would help if you kept a pain journal. A good Dr. will then know how to properly adjust your meds. The key is transperancy and possibly coming across as "desperate" with an already "sketchy" Dr. Is not going to help you get what you really need. Report the SOB and move on.
I am having much the same problem as my doc is refusing to prescribe Oxycontin 120mg tabs despite my pain levels (58 yrs old) being far highef than ever. I disagree with the MST Continus being stronger; I think you may be confusing strength/potency with the much higher sedation level. Oxycontin (except the pseudo-Oxy sold in the USA which are garbage compared with real 'OC') last roughly six or seven hours and not the claimed 12 but it is ILLEGAL for a doc to prescribe them other than twice daily.
Morphine last around the same in m/r formulation.
US patients should refuse Kxycontin as it bears little resemblance to the pills as sold everywhere else thanks to "plastinated' anti-abuse formula which givez roughly half the analgesia oc the real thing, & stick with IR Oxycodone - capsules are far stronger subjectively than tablets as binders inhibit bioavailability, a 20mg Oxynorm original brand being more effective than any 30mg TABLET.
As for rescue meds I have to get Palfium from Netherlands and Oxynorm from Romania as they refuse to give me any at all despite what I said above!
But I am sure you are confusing analgesia with other effects when comparing with MS as the dosages you give indicate your oxycodone is in fact stronger by around 50%.