Good to hear somebody had a good experience with hydromorhone without IV'ing it. I have been prescribed 4mg tablets, x4/Day for break through, after a recent surgery and found absolutely no pain relief. Useless to me.
I will never IV and oral BA is very low. Insufflation did not seem to offer any additional relief either. I have unfortunately spent ample time in the hospital due to multiple surgeries but let me just say - Hydromorphone 4mg IV every few hours has been a fantastic help. I much prefer it over morphine and find that combined with my normal oral meds (Roxi 15) it was a huge help.
Quick amazing experience side note - I had to go back to a childrens hospital where my surgeon was located. (I'm 22) The chidrens hospitals do not use the automatic IV dispenser for pain meds due to the possibility of small kids ODing. They would bring the ampules in with 4mg of Dilaudid (hydromophone), use a small syringe and barely dilute with 1cc-ish of saline. The nurse would put it on a small machine set to five or so minutes time lapse and leave the room until I buzzed them back. Well I was able to pop the syringe right out and push the plunger on the syringe my self. The nurses couldn't tell and I was able to do this for over three weeks. AMAZING relief to say the least. I know why people IV and I am proud of myself for having the willpower to resist shooting pills.