Seriously speaking I don't have chronic pain and I feel sorry for anybody who does. I think if i had it I would have to move to a chronic pain state. Meaning a State that has laws to protect drs in prescribing chronic pain prescription. illinois where i live isn't one. I know cal. is one Texas is one and Boston mass is one. I'm not sure of the others. Can anybody post the states which have laws protecting drs in writing chronic pain prescription.

You didn't know that Opie Yates. I don't have any link. But absolutely without question. Its a law that states a M.D. can prescribe anything he wants to treat pain without the dea harassing him. WoW I seen that years ago On 60 minutes. California definately has it. Texas definately has it. Boston Mass. Definately has it. I'm not sure about florida but maybe. I think there are other states but not 100% sure. Maybe contact Dea and ask them. If they could give you a list of states which have the law protecting drs in the prescribing of Controlled substances for Chronic pain. They had a dr from california on there. He was prescribing for chronic pain But being threatened by dea. Legislature step in passed law basically saying leave drs alone. Had another dr on there who was doing same thing dea arrested him and he beat it in court. Because patients had chronic pain legislature step in and passed law in that state to.I'm sorry i can't tell you more. I thought all you guys new about that law in a hand full of states.

most drug abusers crush up dilaudid and shoot it up.
This causes a very big rush like herion. that is why people that take it orally like perscribed do not understand why people pay so much to get it on the streets.

Since each state's laws vary so widely, you'd really just have to check the law of a given state before considering it. In other words, I don't think a bunch of states got together and enacted the *same* law.

I learned something reading up on this that I didn't know about my state, Virginia: "In 1988, Virginia enacted a law allowing physicians to prescribe heroin for treatment of terminally ill cancer patients ("Virginia Enacts Law," 1988). (Note: This occurred despite the fact that legislation at the federal level was necessary to make heroin actually available and that Congress had already soundly defeated such a bill.)"

Here's the link: http://www.medsch.wisc.edu/painpolicy/publicat/95apsip.htm

One might get the impression that Va is a state where pain meds are liberally prescribed and/or there's no pressure from LE on physicians and if so, that assumption would be wrong.

If you're a doctor who believes in high doses of pain meds for your patients, you better be very careful. The DEA will pretty much do whatever it wants to no matter what state you happen to live in, unfortunately.

Florida has a law called the intractable pain act that protects doctors who treat patients in pain. It also says that a doctor can get in trouble for not helping a patient in pain.

Florida and other places may have a law.. But the DEA (citing Federal law) likes to break up what it thinks are illegal operations. That means that the DEA will lose in court but, in a way, still WIN. Asset forfeiture is very important to them. I hope that if pain doctors are very careful, they will have no problems, only a hope.

OPIE YATES HERE YOU GO A LIST AND INFORMATIVE INFORMATION OF WHAT I MEANT...www.medsch.wisc.edu/painpolicy/publicat/95apsip.htm.

Hi All,

Well I am a old time member, 20001, new VIP. Just to add to the thread, I have been on pain management for awhile. I have been on Methadone 20mg, then Kadian 100mg(morphine) 4 times a day and now Palladone 32mg 3 times a day. I have tried Oxycontin 80mg 3 times a day but the side effcts (dark eyes, tired, and very hard to understand). Oxy is a killer and I warn anyone who thinks they can go off after a year is in for a big surprise. Its so addictive I wish it for no one. Palladone is very smooth and easy on the body. No more morning sickness and pain melts away with ease. I suggest this med as IT WORKS. Be careful, its very strong. Next time in I will ask for the BT med at 4mg. Norco bwoks the best for this but never tried the non-ER form so wish me luck. I am the first ever for this med here and must say again. Purdue learned from their mistake with Oxy, its nearly fools proof if you know what I mean. If anyone wants to message me, I would be happy to answere any questions you may have.

God Bless

PS.

The 32mg Palladone I take does not make you sick or tired. You are very alert, unlike methadone and oxycontin, you are not sleepy with headaches and stomach aches like morphine. It feels like an extended dose of hydro with faster and longer acting effects.

Thanks

Got to warn all taking Palladone! It has been recalled by the FDA because of deaths related to alcohol and too much med being absorbed. it can be as low as 4% to cause this reaction. I got my first script of 24mg yesterday and no pharmacy in Harris County Texas will fill it and are removing it from thier shelfs.

My great mom and pop pharm said even my cough med could kill me if combined. Just warning, so you can ask your Doc for something different. I tried t tell my neuro, but he wouldn't listen and prescribed it anyway. My hubby was so mad, he said we are never going back to him again.

Deb

You mean your Dr Rx'ed Palladone AFTER the recall?

If so, what a dufus

Yeah, that's interesting about the Palladone recall - what a bummer. Apparently alcohol interferes with the time-released aspect of the drug, causing it to dump a dangerous amount of hydromorphone into the body. (See below) I have to wonder if Purdue Pharma's other big seller - Oxycontin - which is another time released pain med - is affected. If not, why not? Does Purdue use a different time-release mechanism in Palladone than they do Oxycontin? I've often read that when Purdue was asked to re-formulate Oxycontin so that it couldn't be broken down, snorted and/or injected, Purdue responded by saying it was too difficult to mess with the time released aspect of Oxycontin. Anyhoo, here's the unfortunate poop on Palladone:

www.fda.gov -

"07/13/05 - After acquiring new information that serious and potentially fatal adverse reactions can occur when Palladone (hydromorphone hydrochloride) extended release capsules are taken together with alcohol, the U.S. Food and drug Administration has asked Purdue Pharma L.P., the makers of the drug, to withdraw it from the market.

Palladone is a once-a-day pain management drug containing a very potent narcotic. New data gathered from a company-sponsored study testing the potential effects of alcohol use shows that when Palladone is taken with alcohol the extended release mechanism is harmed which can lead to dose-dumping. Dose-dumping is a term that describes the rapid release of the active ingredient from an extended release product into the blood stream.

The consequences of dose dumping at the lowest marketed dose (12 mg.) of Palladone could lead to serious, or even fatal, adverse events in some patients and the risk is even greater for the higher strengths of the product. As a result of this potential serious safety risk, the FDA has asked Purdue Pharma, and they have agreed, to suspend all sales and marketing of Palladone in the U.S. pending further discussions with the agency.

"All powerful pain management drugs have serious risks if used incorrectly, but the current formulation of Palladone presents an unacceptably high level of patient risk" said Dr. Steven Galson, FDA Acting Director of the Center for drug Evaluation and Research. "Although we have not received reports of serious problems, this product has so far been used in a relatively small number of patients. We are concerned that as more patients take this drug, safety problems will arise since even having one alcoholic drink could have fatal implications.”

The current labeling for Palladone, approved in September, 2004, already includes the standard opioid warning against the use of alcohol and Palladone. However, the FDA does not believe that the risk of serious, and potentially fatal, adverse events can be effectively managed by label warnings alone and a risk management plan."

I am on oxy 80's and percocet. I have had a few spinal surgeries and I am in chronic pain. I went to the er a few times b/c of the severe pain and the doc wanted to put me on a Dilaldid drip, I opted for a few shots of the same medication b/c I didn't want to be in the er all day and night, but the dilaludid didn't help a bit! And the doc gave me a pretty strong dose. Has this happeneds to anyone else?

Yes he did, and I told him about the recall!

It shows they do not listen to us doesn't it. He just wanted to prove I am a lying drug seeker, even if he thought I was in severe pain and needed surgery. I won't let him touch me ever. I am writing a letter and returning his scripts. He made another mistake by trying to prescibe 2 different dosages of cymbalta on the same script that could not be filled either. I will be asking for all notes, diagosis and everything he has written about me.

I will not sue, but just want some supporting evidence of my condition for the next Neuro. If I ever see another, this was the 3rd one!

Deb

Dear DWS1,

Different opiates often work best on different types of pain (bone pain, nerve based pain, etc.) I don't remember which works best on what, but the Merck Manual has a Pain Management chapter which has a list & explanations. Interesting reading for all in pain.

Jon

Hi All,

Back from vacation to find my Palladone, dilaudid CR, 32mg has been completely recalled. Even Purdue Pharma called me to say they were sorry. Sooooooo, my doctor said their was an old better med even stonger. He put me on Levo-Domoran, compounded due to the strength (they only make a 2mg dose). Thus a 100mg of Palladone(dilaudid) was equal to 50mg of the Levo. Folks, this is the best for pain I have ever found!!! 2mg equals 4mg of Dilaudid or 30mg of hydro. It is purly the strongest oral pain med ever made. It is at the top of the list fo oral med. I have had nearly all of them and this is the most effective I have ever been on. So, if you have issues with Dilaudid, need 450 4mg's of it a week. Ask your doctor for 225 of these 2mg or ask for a compounded at 12 per day or 2 every 8 hours.

Best Regards To All
I hope I have helped my friends in pain
Blaster69

Is it true that they have have already withdrawn palladrone(sp?) off the market because of deaths already associated with it due to people drinking when prescribed it. Must leave to go to methadone clinic but will post later on why dilaudid is reffered to as street herion and no matter what they do to it people will find a way to break it down and it will make the death toll from oxycodone look like a anthill. If we used to be able to break down paregoric to fix the morphine it will not take somebody long to figure out how to fix the time release dilaudid.

Hi Folks,

My Doc changed my D4's to 8's. My pharmacist gave me both generic and name brand, ran out of the generic. Anyway, the name brands are so much stronger!!! Try name brand as it seems stronger. Anyway, my pharmacist said he was out of the bulk powder of my other,great med, levophanol and looks like I will need a bunch of pills a day of the 2mg to equal th mg of the compound. Thats alot. My doc won't give me a ful I'm sure, but 2mg is equal to 1 1/2 of Norco's thogh I think its just 1. So, if you are looking for a D replacement, this is the best and much stronger!!

Be pain free my friends!!
Blaster69

Blaster, My husband had been taking the 4mg generic Dilaudid for almost 2 years when one day, they were out of the Generic when he went to get his prescription filled. He got the name brand and he, too, said that it was much stronger and worked much better than the generic. The only thing that I can surmise is that the generic companies must not put 4mg of hydromorphone in the 4mg tablets, or that the fillers in the generic interfere with the absorption of the hydromorphone. Any thoughts on why this is?

Also, thanks for the Levo-Dromoran (Sp) information. I had not heard of this before. I looked it up in my nursing drug guide and didn't see any difference in the therapeutic actions of this med vs hydromorphone. It acts on the same opioid receptors in the CNS as those mediating the effects of endogenous opioids such as enkephalins and endorphins. It also has the same contraindications and adverse effects. The only difference I can find is that hydromorphone has an IV administration, but I don't see one for the Levo-Dromoran. The Levo-Dromoran, according to the drug guide, is only available in the 2mg tablets. I'm going to look into it further so thank you for bringing this drug to my attention.

I have been on Dilaudid and demerol tablets both and they have never seemed to work for me. I know that the demerol in tablet form partially destroyed by stomach acid, therefor it is not really effective. Still my oral surgeon insists on prescribing it to me he will give me that or maxidone, version of hydro, so I opt for the demerol at least it helps me sleep. Now I can not figure out why dilaudid does not work for me I guess my system is just different. I am on oxy 80mgs and they seem to work pretty well.

Hey dwi1,

Question, your oral surgeon prescribing 80mg Oxy, Dilaudid, and Demerol? Or is the demerol just from the oral surgeon and the big guns from yourr Pain Management Doc? Curious. Looks like the gov would frown on a surgical dentist give Oxy 80's and Dilaudid as both are on the special enforcement. Which means, too many scripts from the doc on these and a visit will be made. I can tell you though, some states have more local help to the feds than others. In CA the locals see everything up to Mary Jane, so the feds like the legal stuff more than the other. Also, I believe CA, if the doc is a registered pain management/Anesthiologist(sp), well they pass on theirs versus the local dentist or Family Doc. CA requires a triplicate and most docs don't even have then. Also, nor do the ER's. Hydro is all anyone will prescribe except the PM

Just curious dwi1, seems like a lot from a surgical dentist.

Take Care,
Blaster69

OK. Read my previous posts about my ortho Dr and the confusion I experience with him. ** I just went to see him again on Monday 8/08. I took my wife this time-- as a extra set of ears. We asked about alternative to drugs via surgery or whatever. I am ready to go under the knife or whatever is necessary. Bottom line-- there isn't anything except drugs or the $3,000 Prolotherapy procedure. I asked about the quantity of (4mg) Dilaudid he was prescribing. The Qty is HUGE, and I couldn't figure out the reason (again, see my prev posts). I get a 'script for 448 at a time. When I 1st got in the exam room, one of his nasty staff wanted to know why I never came back in for the last script on July 12. It's been in my folder, but I did not KNOW I had one. I knew there was one for Avinza, but I stopped taking it as it wasn't helping and I don't want to take something-- just to take it. So, there being a new Dil scipt was news to me. I told her-- and the Dr-- that I still have plenty from the last one in June. I hope that convinces them that I am not taking it FOR FUN. I asked him how long it was supposed to last, and he said the 448 was for ONE MONTH. However, I am to take it every 3 hrs. Do the math. I'd have to set my alarm and take it constantly. I think it comes to something like 5 pills every few hrs. That's nuts. I was trying to do the math in my head while he was talking, but I was busy listening to other things. He offered to lower the qty, but as goofy as they are, I don't want to have to deal with a potential shortage later... so i had him keep the amount. As I told him-- better to have it and not need it than the other way around. When he left, my wife and I figured it up, and its no wonder they think I could be abusing it. He gave me yet another one (and they tossed the unfilled July one) which I have not filled, yet. Days later, I STILL have plenty from June. The whole thing is odd... but proof that they're not running a tight operation. Like I said, and repeated to my wife-- "NO WONDER THEY'RE CONCERNED ABOUT IT-- IF THEY THINK I AM TAKING 16+ A DAY!!". They have written down that I NEED that many, but they've done bad math. Until I can find someone to pay for the procedures, I am stuck treating just the pain. If anyone's curious, CVS wants approx $350 for that amount, while it's only $78 at Walmart. Both are the generic. HUGE difference. I had to switch to "cash", as my new insurance won't cover pre-existing. Nice.

I have had several experiences with Liquid Dilaudid injected by way of intramuscular & intravenous. 2mg per ml ampule doses provided extreme narcotic effects, especially when injected directly into the veins, intramuscular onset was around 10 minutes from beginning of onset to around 25 minutes before full effect. 2mg doses taken either way then repeated again within a 2 hour period followed by one more half dose an hour later for a total of 5mg produced nodding out so extreme it was scary. I had to assist in the revival of another person for 20 minutes who took 6mg within a 5 hour period intravenously before paramedics administered narcon to bring him out of it.
Orally I have taken 4 - 8mg tablets and snorted 1 - 8mg tablet at the same time and it produced a very disappointing low level body hum without any real substantial euphoria. I don't quite understand this. But I can attest to it...

socal~while we appreciate your informative post, be careful mentioning things like snorting, etc. they violate DB Rules and can get people banned... editing is a wonderful thing that i use often... jmo~faerie

What please is the difference between Lortab and Dilaudid?
The Dr. just switched me from Lorcet 10/325 to Fentanyl 50mcg every 3 days, with nothing prescribed for peak pain time. Thanks for the help.

Lortab is hydrocodone, Dilaudin is hydromorphone. Is it possible to order Dilaudid from an ROP with the proper paperwork?

i beleive it is schedule 2 so NO.