# Morphine milligram equivalents (CDC 2022) Morphine milligram equivalents ## Also searched as - MME calculator - morphine milligram equivalent - morphine equivalent dose - CDC opioid MME - hydrocodone MME - oxycodone MME - fentanyl patch MME - methadone MME factor Status: LIVE Price: $0.005 USDC `GET /api/calc/mme` HTML: https://magentlab.com/docs/mme Markdown: https://magentlab.com/docs/mme.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute morphine milligram equivalents from a CDC 2022 table opioid and daily dose (or transdermal fentanyl mcg/hr). ## When to use When an agent needs published CDC 2022 MME arithmetic and must not invent conversion factors or convert one opioid to another. ## When not to use - All doses are mg/day except fentanyl_transdermal, which is mcg/hr. - MME values are estimates only and do not account for individual variability. - Do not use MME to convert one opioid to another or to choose a replacement dose. - The methadone conversion factor is an estimate; it increases at higher methadone doses. - Transdermal fentanyl absorption can increase with fever or heat. - Buprenorphine is not in the CDC 2022 table and is rejected. - Not for opioid use disorder (OUD) dosing of methadone or buprenorphine. - Analytic MME only; not a taper protocol, diagnosis, or dosing recommendation. ## Formula ``` mme = dose * conversion_factor (dose is mg/day except fentanyl_transdermal in mcg/hr) ``` ## Citation [CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022](https://doi.org/10.15585/mmwr.rr7103a1) Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R MMWR Recomm Rep. 2022;71(No. RR-3):1-95 DOI: [10.15585/mmwr.rr7103a1](https://doi.org/10.15585/mmwr.rr7103a1) ## Worked example ### CDC hydrocodone 20 mg/day Given: `dose=20, opioid=hydrocodone` 1. CDC 2022 conversion factor for hydrocodone is 1.0 2. mme = 20 * 1.0 = 20 ### CDC oxycodone 20 mg/day Given: `dose=20, opioid=oxycodone` 1. CDC 2022 conversion factor for oxycodone is 1.5 2. mme = 20 * 1.5 = 30 ## Parameters - `opioid` (string, required): CDC 2022 MME table key (case-insensitive exact match). Not a brand name or alias. - `dose` (number, required): Daily opioid dose in mg/day (0.1-5000), or fentanyl_transdermal patch rate in mcg/hr (12-300). ## Bulk (POST) POST the same path with a JSON items array. Price is n times the GET unit. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/mme` Max items: 25 Price: unit_amount * n (unit 5000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "dose": "20", "opioid": "hydrocodone" }, { "dose": "20", "opioid": "hydrocodone" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/mme Example 200: ```json { "count": 2, "path": "/api/calc/mme", "items": [ { "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R", "doi": "10.15585/mmwr.rr7103a1", "id": "cdc-mme-2022", "source": "MMWR Recomm Rep. 2022;71(No. RR-3):1-95", "title": "CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022" }, "formula": "mme", "formula_expression": "mme = dose * conversion_factor (dose is mg/day except fentanyl_transdermal in mcg/hr)", "conversion_factor": 1.0, "dose": 20.0, "dose_unit": "mg/day", "mme": 20.0, "opioid": "hydrocodone" }, { "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R", "doi": "10.15585/mmwr.rr7103a1", "id": "cdc-mme-2022", "source": "MMWR Recomm Rep. 2022;71(No. RR-3):1-95", "title": "CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022" }, "formula": "mme", "formula_expression": "mme = dose * conversion_factor (dose is mg/day except fentanyl_transdermal in mcg/hr)", "conversion_factor": 1.0, "dose": 20.0, "dose_unit": "mg/day", "mme": 20.0, "opioid": "hydrocodone" } ] } ``` ## Response fields - `formula` (string): mme - `formula_expression` (string): mme = dose * conversion_factor with CDC units note - `opioid` (string): Normalized CDC 2022 table key - `dose` (number): Parsed dose (mg/day, or mcg/hr for fentanyl_transdermal) - `dose_unit` (string): mg/day, or mcg/hr for fentanyl_transdermal - `conversion_factor` (number): CDC 2022 table conversion factor for that opioid - `mme` (number): Morphine milligram equivalents, 4 decimal max - `citation` (object): CDC 2022 MMWR MME table - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R", "doi": "10.15585/mmwr.rr7103a1", "id": "cdc-mme-2022", "source": "MMWR Recomm Rep. 2022;71(No. RR-3):1-95", "title": "CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022" }, "formula": "mme", "formula_expression": "mme = dose * conversion_factor (dose is mg/day except fentanyl_transdermal in mcg/hr)", "conversion_factor": 1.0, "dose": 20.0, "dose_unit": "mg/day", "mme": 20.0, "opioid": "hydrocodone" } ``` ## Errors - HTTP 400 `invalid_opioid`: opioid must be codeine, fentanyl_transdermal, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, tapentadol, or tramadol. Returned before settlement; you are not charged. - HTTP 400 `invalid_opioid_dose`: dose must be a number in range for that opioid (mg/day, or mcg/hr for fentanyl_transdermal). Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [Glucocorticoid dose conversion](https://magentlab.com/docs/steroid-conversion) — Convert a glucocorticoid dose among hydrocortisone, prednisone, and dexamethasone using Meikle 1977 equivalent doses (20 mg : 5 mg : 0.75 mg). ## Payment Required query parameters must be present and valid. Invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign EIP-3009 (scheme exact, assetTransferMethod eip3009) with validBefore = now + accepts[0].maxTimeoutSeconds (600 seconds). That window starts when you sign and must cover wallet confirmation plus CDP verify and settle. Magent retries transient facilitator 429/5xx before answering. Do not send upto or batch-settlement payloads; magent does not offer those schemes. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON echoing accepted, payload, and extensions when present). - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. Settlement happens before the tool runs. HTTP 503 settlement_uncertain or settle_failed: retry the same PAYMENT-SIGNATURE. Mint a new nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. - not offered `batch-settlement`: Not offered. Payment-channel vouchers claimed later in batches. Not the same as POST {items} bulk (that is still exact). Same-path POST {items} is still scheme exact: one EIP-3009 authorization for n times the GET unit. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - Invalid query parameters return HTTP 400 before settlement. You are not charged. - Settlement finishes before the tool executes (paymentFlow upfront). Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.