Haha, your doctor recognises you as at risk of abusing substances & then gives you IR Dilaudid?? Must be deluded. Did he come bottom of his class?? Sorry, enough of that.
In terms of pain relief,-Hydromorph in either version, IR or ER, did zero IME. Orally.
Have you tried anything else? I'd gather not since it's only been three mths. In terms of risk reduction usually a long-acting opiate/opioid is prescribed, which is available in most if not all of this class of drug. Someone cmiiw, I'm not in the states.
The ER version would ideally cover your pain well & generally an IR would also be taken in the case of BT pain. This would be what you'd be able to easily abuse if you so wished.
Oxycontin while not the strength of Hydromorphone, the dose simply needs to be recalculated, for myself, is a superior pain-reliever & doesn't give me the lethargy I tend to feel from the Morphine/morphone group. Although I understand Oxy is being prescribed less & less, worldwide.
Fentynal patches are much stronger, & Doctors seem to think less abusable option. For purely pain relief, some ppl find Buprenorphine helpful, though IMHO, depending on the dose needed, the analgesia is not sufficient. Methadone, while now widely prescribed for chronic pain, I won't touch it,- not one to play around with.
I find it curious that your doctor initially began you on Hydromorph, but I guess I'm only speculating as we don't know that. It's kinda middle of the ladder regarding opiate analgesia, there's not a whole lot further you can go. You must have severe pain. Please don't let this scare you though, it's not as though there's a ceiling effect...well, unless your doctor is morally opposed.
Good luck,
Rtp