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  • BDD Moderators: Keif’ Richards

Extreme Suffering With An Incorrect Dilaudid Dosage

T

tolerantmind

Greenlighter
Joined
Aug 22, 2011
Messages
18
Hi, in a situation where a person on pain management gains a tolerance for oxycodone to the point where taking 30-40mg of instant release tablets doesn't help at all is moved to hydromorphone 2mg tablets what is a safe dosage? When converting doctor used the IV bioavailability % for hydromorphone therefore he came to the point that one 2mg tablet every 4 hours was enough. I've spent the weekend in pain because the dose is much too low and even taking 4mg at once didn't help at all. Until I can get ahold of him what dosage would be appropriate to use tonight to get rid of the pain? I just want the pain to go away and I've spent months in suffering because he doesn't seem to know what he's doing. I tried a pharmacist but of course they tell me I need to talk to my doctor but I haven't been able to reach him because of the weekend.

Note: I'd been on Oxycodone daily for months and the last 3-4 its been useless. I have bad anxiety so I don't trust the online converters. Please help me Bluelight.
 
Dilaudid has a very low oral BA. Insufflating is higher, IV having the highest. I would not recommend either as it can lead to a nasty nasty habit I would recommend trying 8, and work up not going higher than 12 mg. I also had a tolerence to oxy, and 18-22mg got me straight taken orally. You could also try plugging a low dose. (Maybe 2-4mg.) That might do it for yyyou. Rectal administration has a much high BA than oral. Dilaudid is a much stronger opiate then oxy and morphine.
 
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I understand you're in pain, and have been experiencing pain for quite a while, but what scares me is your statement "I just want the pain to go away and I've spent months in suffering because he doesn't seem to know what he's doing."

The pain will never be removed completely, no matter how much you try to take. So don't overdo it trying to be "pain free". You just have to deal with some level of pain.
 
tolerantmind, I'm so sorry you are having such a bad time. Using the IV potency to calculate an oral conversion is complete incomepetence.. you need to go back and tell them, and ask them to make an oral - to - oral conversion. If they don't, this is clinical negligence. Is there any way you can get to another doctor?

For temporary relief rectal would increase the bioavailabiloty but be very careful as it is a lot more potent (oral 30% ish, rectal tends to be nearer 80-90%) and I don't want to encourage you to start abusing your pain meds, it's not a fun road to go down..

I'd check out The Dark Side forum for help managing your pain and for general support, it's a fantastic place, and go back to your doctors ASAP to get your prescription altered..
 
I left a message explaining the situation to him this morning and he had a nurse call me this afternoon and tell me to take 2 at a time.... I told her I had taken 4 at once and still received no relief so 2 obviously wasn't going to work. She just got pissy and said she'd pass that back to him but I never got a call back. I'm not trying to get all of my pain to go away either. I'm trying to get it to a level where I can eat and keep food down. It's so severe. That's what I mean when I say I want the pain to go away. He said he wanted to get me down from a 10 to a 2 on the pain scale.
 
I fucking hate doctors. I have snorted 8mg of Dilles, nothing, they are useless unless IV'ed.ANd for a doctor to say2-4mg when 40mg of oxy(much stronger orally) did nothing shows such complete ignorance he deserves to be thrown under a bus.Ok, that's extreme but at least he shouldn't be practicing medicine if he is really that stupid...
 
ok so I've steadily worked up to taking 18mg at once and still NOTHING. I mean NOTHING. Should I try snorting? I just can't believe that 18mg isn't even doing ANYTHING I mean I literally can't feel ANY difference. I took 18mg an hour ago and I feel exactly like I did then pain wise. Oh and something weird is happening with my Oxycodone since I started the Dilaudid. A few days ago instead of taking Dilaudid when I woke up I took 3 10mg oxy tabs and they like sedated me SO bad. I didn't feel any pain relief at all. It was just like they sedated me. Before I started Dilaudid 4 oxys at the same time wouldn't even make me the tiniest bit tired even when taken first thing in the morning. Shoud I try to snort the dilaudids?
 
"The pain will never be removed completely, no matter how much you try to take. So don't overdo it trying to be "pain free". You just have to deal with some level of pain."
(quote button is acting up haha)

I agree with this, i recommend trying to find ways to strengthen how you perceive and handle the pain. In no way am im trying to undermine your pain, i have no idea how you feel. but the brain is extremely powerful and if you can find a way to use it to help your pain maybe you wont need to dose so high or much and eventually not have to rely on the opiates to cure your pain. good luck man, hope you find something that helps.

I dont know why this comment is giving me so much trouble.
 
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tolerantmind said:
ok so I've steadily worked up to taking 18mg at once and still NOTHING. I mean NOTHING. Should I try snorting? I just can't believe that 18mg isn't even doing ANYTHING I mean I literally can't feel ANY difference. I took 18mg an hour ago and I feel exactly like I did then pain wise. Oh and something weird is happening with my Oxycodone since I started the Dilaudid. A few days ago instead of taking Dilaudid when I woke up I took 3 10mg oxy tabs and they like sedated me SO bad. I didn't feel any pain relief at all. It was just like they sedated me. Before I started Dilaudid 4 oxys at the same time wouldn't even make me the tiniest bit tired even when taken first thing in the morning. Shoud I try to snort the dilaudids?
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That's awful, tolerantmind. I'm really sorry you are still in so much pain <3

Bioavailability for hydromorphone (Dilaudid) - 5-8 times as potent as morphine, intranasal- 52.4%, Rectal administration 33% ,Oral-30-35%

So intranasal would be stronger.. I wouldn't usually encourage someone with chronic pain to start using their pain meds other than as directed, but it is really horrible that you are still in so much pain. Perhaps hydromorphone just doesn't work for you? Were you were well controlled on any opioid? Some pain just isn't opioid-responsive..

Not sure why oxycodone isn't working anymore either unless your tolerance has gone up, but this isn't as common with the analgesic effects..
 
^ I was just about to say the same about some types of pain not responding as well to opioids.

What is the cause of your pain? What all have you tried to treat it? What else are you on?

I have RSD causing nerve pain in my leg and it got to the point that I was going to the ER (a&e to our english friends) weekly until I started taking gabapentin and then lyrica. To successfully treat pain, you generally have to address it from all angles - I was taking lyrica, oxycontin, norco, lorazepam, celecoxib and lidocaine patches when it wasn't well controlled as well as doing physical therapy, meditating, seeing a counselor and more.

Lastly, you absolutely have to get your anxiety under control. Pain and anxiety/depression both feed off each other and have the propensity to *greatly* exacerbate the other.
 
So I got up to 20mg and somehow just the change from 18mg to 20mg was very drastic. 20mg at once would knock out the headache completely and 18mg at once would have absolutely no effect on the pain at all or the effect was so small that it was imperceivable. Now 22mg isn't doing anything.... in fact it makes me get this burning feeling. I don't know what to do.... I want the 10 to go to a 5.... I just want to be able to shower without having to bite down on something to keep from screaming my lungs out and scaring my neighbors. Can depression/anxiety cause the pain medication to be less effective? I know this pain can be helped by opiates too. This stuff just makes me feel like I should just commit suicide so at least I wont be able to feel anything. I'm 23.... I've been to all the places for undiagnosed problems. I've been to all the top clinics and doctors. They can't find out what's wrong. The headaches progressively got worse and worse long before I ever took any narcotics for anything at all. When doctors don't know what's wrong they blame the pain meds. Well I've gone off them various times for months and months. The last time I did this each day I was off them for 3-4 months the pain got worse. I mean literally got worse on a daily basis. Started the PM again and now here I am facing this strange problem. It's safe to assume that with the 22mg I'm at least getting a full 6mg of the med in my body. How in the hell does that not even make me tired? How does it do nothing now to the point where it's like taking sugar pills. For the last time too I'm not trying to get all the pain to go away I'm trying to get the pain to a level where I can function.
 
tolerantmind said:
I left a message explaining the situation to him this morning and he had a nurse call me this afternoon and tell me to take 2 at a time.... I told her I had taken 4 at once and still received no relief so 2 obviously wasn't going to work. She just got pissy and said she'd pass that back to him but I never got a call back. I'm not trying to get all of my pain to go away either. I'm trying to get it to a level where I can eat and keep food down. It's so severe. That's what I mean when I say I want the pain to go away. He said he wanted to get me down from a 10 to a 2 on the pain scale.
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Next time you talk to him, see if he can prescribe you Opana or Fentanyl.
 
Ok like I told you guys 20mg of the Dilaudid tablets does nothing for me orally now. I want to try snorting since the b/a goes up. Should I just do that with all 20mg? That would apparently be like 10mg. Should I go higher than 20? The thing is a neuropsychiatrist recently diagnosed me with a rare form of depression that opiates actually CURE in the brain while they're at a certain level. He's like the 30th most cited psychiatrist in the world and knows some pretty amazing things. For people with my condition chronic pain goes hand in hand with it. The good thing is we don't have to take pain meds all day under certain circumstances. Our pain can literally be stopped for 12 hours to days but to do this the pain has to be completely eliminated all the way. The doctor said a good way to tell this is when you experience the euphoric feeling you know you've achieved this. When I used to be able to take 1 hydrocodone 10mg and destroy all pain because I'd experience some euphoria I ended up only having to take two 10mg pills a week. My opiate usage increased to multiple times a day when I could no longer knock out the pain 100% because I didn't know how much it would take to do that and I was afraid of an overdose because something a stupid doctor said to me. My doctor had me on Percocet 10mg pill every 2 hours 8 times a day so I'd so I'd be taking 80mg of percocet a day. One time a neurologist suggested that I take 3 pills at once and see if it helped better. When I did that it just blew my pain away. It knocked it out and I didn't have to take any more percocet for 6 days. After 6 days when the pain came back I just took 3 again and wham same thing happened. This kept up until I eventually over a couple years just built a tolerance for oxycodone and was afraid to take above 40 at once. The neuropsychiatrist said if I can take enough of the Dilaudid for it to do what those 3 percocets used to do the same thing will happen and for me personally this will be a much better course of treatment than what I'm doing right now. Can some directed me to a good beginners guide to insufflation too? Like what the best way to crush up the pills is and how snort them the correct way? I'd also appreciate if someone could tell me is 20mgwould be a good dose to start at or if that needs to be increased or decreased. Thank you!
 
It seems like Oxycodone worked a lot better for me. According to the conversion tables taking 20mg of Dilaudid is like taking 53mg of Oxycodone. My question is in 4 hours when it's time for my last dose of pain medication for the day would it be ok for me to take 55mg of Oxycodone IR instead of taking the 20mg of Hydromorphone? Please tell me if this is a safe thing to do or not.
 
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