You may not necessarily need a higher dose, sometimes a change in medication can do the trick and rotate every year or so, that can help keep your tolerance down a bit. As for Opana, it will either work great for you or not at all. It's bio-availability is only around 10-15% so it really just depends. But, like I said, some people respond really well to it and some don't. Its worth a shot if you have insurance, it is really expensive, even the new generic is expensive. Good luck to you!