I am taking 40 mg of Opana ER three times a day. It is not working. I am waiting for a permanent cervical SCS. My PM says this is the Cadillac of pain medication and there is nothing else he can prescribe. I have been on this dosage for several months. When I started taking it, I was very nauseous but after several weeks my body adjusted. Before I was taking Oxycontin. My question - has anyone switched back to Oxycontin from Opana ER? This is why I need the SCS! I think everyone's tolerance builds and it gets to a point where nothing works anymore. I have read prior posts regarding the bio availability of Opana ER. I just need some relief.