Dilaudid is one of the strongest pain killers out there. But, taken orally it doesnt produce the euphoria some people enjoy like hydro or other narcotic PK's. It's like morphine, just not effective taken orally. But if one was to IV dilaudid, they could easily OD because taken this way it is extremely euphoric, addictive and dangerous like heroin.

As a nurse, I administer this medication quite often. It seems as though many doctors are migrating toward using this medication more often and using less Demerol then as before. Use to be, when a patient was administered one of the stronger pain meds, it was usually morphine or Demerol. I think doctors are realizing that Demerol can be quite dangerous due to the accumulation of normeperidine, a toxic metabolite of Demerol that remains in the system much longer after the pain killing properties have diminished.

Dilaudid is a wonderful medication if it's administered in a dosage high enough for the pain experienced by the patient. The problem arises when the patient gets less than what is necessary to manage his/her pain. And, as discussed earlier in this thread, IV administration allows more medication to circulate in the bloodstream before being metabolized and excreted. The major hazards of Dilaudid, like most narcotic analgesics are respiratory depression, apnea, circulatory depression, respiratory arrest, shock, and cardiac arrest, and therefore IV Dilaudid should be administered very slowly and the patient should be monitored closely (especially if it is given by IV route because once it's injected into the bloodstream, it's not like you can "take it back").

Yeah, ya just don't see demerol much anymore. Maybe this explains why. Personally I'd rather be rxd the dil anyway. Demerol was huge in the 70s but has receded in popularity. (across the board) Thanks for the explanation. I had heard that the med community just didn't feel it's analgesia was worth the risk. Or that the analgesia was that pronounced. Which of course it is with dil. Now that we have fentanyl, oxymorphone,and other analogues of morph, we'll probably see less and even less of meperidine.-I see it added as a historic footnote next to barbs and ludes. J
PS to eclipse. as U know U can indeed "take it back" with nalazone-but that's hard on the patient and dangerous. (I'm certainly not recommending that) Thanks for your input.

I had demerol for this weird thing I had (reaction to breakout meds) it was called geographic tongue and none of my doctors could figure out what it was and finally I went to the dentist they gave me demerol. Everything I ate burned my tongue even ice cream. It was wonderful I lost 10 pounds cause I didn't eat for a week, I layed on my butt watched daytime tv and had demerol. Man that stuff was great! It gave me tingles all over!

Sorry, you're right. I knew that. Naloxone. But it's best if it's just given properly to begin with...right patient, right time, right dose, right drug,,,etc. Best to do it right the first time. Naloxone will not only reverse the adverse effects, but it will also reverse any pain relieving properties of it leaving the patient in pain. I hate to see patients hurting, but even worse, I also don't want to see the patient die. You are absolutely correct.

There's such a bias in the mindset of nurses. If a patient complains of pain, they're almost automatically thought of as a drug abuser. Many nurses just don't get the fact that the patient really could actually be hurting. I've come on shift and the first thing a patient usually says to me is "can I have something for pain?" I find that 9 times out of 10, after assessing my patients and reading their charts, it's been well over the q3-4hrs as needed for pain. When the doctor writes the orders "as needed," most nurses tend to think this means "as needed if I think that they need it." Many patients trust their doctors and nurses to managed their pain in a logical manner and trust that if the doctor writes the order to administer as needed, this means as "needed by the patient." If the first thing my patients requests from me is something for pain (and there's been enough time since their last dose), I will go straight to the Pixis and get it for them. If I can help them manage their pain, they become more relaxed and most times they will be able to sleep which allows me more time to do the other things that I need to do (Alterior motives aren't always bad).

Anyway, thanks for correcting me.

You sound like a very competent nurse, thanks for taking care of us. I've dated a few nurses and there are some horror stories out there. Nurses are generally as knowlegeble as the drs, without the attitude. All the work, none of the pay. Good luck in your endeavors and we appreciate the compassion. J

Recently I had the pleasure of dealing with severe post-op pain. I agreed to a same day surgery - double hernia open incision. Oral medications included usual 90mg of MS Contin per day and at first I substituted my normal b/t med (hydrocodone) with (oxycodone 5mg/500mg APAP). This regimen did not touch the main though I bumped up the oxycodone to 20mg every 3 hours. At some point I decided to go back to the hydrocodone (Norco 10/325) which I took 30mg every 3-4 hours. Even this generous dose did absolutely nothing to control the pain.

Finally, I gave in and called the surgeon. I told him that if I was not given something stronger I would have to return to the hospital - worn out from the pain. He said I will write a prescription for Dilaudid 4mg and if that doesn't help I will have to re-admit you. Within 30 minutes of taking the first pill I realized the pain starting to fade from me. In my case the hydromorphone worked very well in oral form. It saved me from returning to the hospital. I called it a gentle giant - no dizzy feeling, no nausea, no cheap buzz feeling. Just a calm, warm steadfast sensation that Dilaudid would not fail me and it didn't. Hydrocodone and oxycodone were like candy compared to it.

Now, I'm back on the hydrocodone for b/t pain and it works well for my back. But if I face another same day surgery I will not come home without Dilaudid.

this, and the oxy you were looking for in another thread, is extraordinarily difficult to find online. it is prob easier to find it from a local street dealer, and prob cheaper to. most of the time you do "find" it online it is a scam where you will be out the money with no meds or fake meds. the rest of the time, it costs an arm and both legs. i believe for oxy going price is just over $1 US per mg. depending on where you are at, you may find it cheaper...but i don't order it, so i'm not sure exactly where. good luck and welcome~faerie

man i am heavy set and i overworked myself cause of the fentenyl i was on well 6am in the morning last weekend i had to call 911 then got zipped to the hospitol iv and all due to havin seizures ... when the doc saw me they gave me 1 shot of dilaudid not even 20 mins later i am screamin for the nurse so she gave me double the amount docs orders and not even a half our later i was still in pain but high as a kite so i told the nurse and they gave me a tripple dose then that knocked me out but i woke up like 3 hours later in pain and couldnt move and they started over again all in all i like it better then oxy .. but when the nurse freaked cause my body could handle so much ..

it makes me think... but ohwell i am home and back on norcos again wich i refused oxy due to the refill policy and i think hydro is better then endocet

sys I had the same thing recently. Went to the hospital and they gave me dilaudid for the first time and it was either 8 or 10mg later that I still felt the pain and they had given me the max dose. I think they were freaked out that I wasn't sleeping but they told me they understood because I was on oxy and percocet and my tolerance was pretty high. They were very nice to me tho. I did not have surgery my back had just gone out and I had to call an ambulance cause there was noone here to take me.

I have a friend who has severe back problems. He isn't even 30 yet but when his back goes out he can't even walk. He has to crawl to his bed even with pain meds. I feel so sorry for him. To top it off he works as a cook so his job doesn't make things any easier.

Thankfully, its spontaneous and when its not out he doesn't have any trouble with it all, however, when it is he can't even walk. He is going to have to have surgery if it keeps giving him problems. I forgot what the doctors said he had (I think a ruptured disc).

When I used to be a street junky I would get the 4's for $30.00 and IV half of one. Believe me the buzz is so intense quick and clean it can only be compared to fentanyl. Best buzz you can get if that's what you're after. Years later my brain doesn't produce endorphins as well as it used to so I'm on permanent subutex.

It's true that orally the 4's are almost completely worthless.

These tabs are extremely rare, you probably won't find them available anywhere.

I wish more nurses were like you! I've has nurses refuse to honour the Dr's prescription because they were 'not happy giving IV'. I also had one lie to me about the max daily dose to prevent me from getting pain relief. Even though I knew she was fobbing me off, I didn't say anything at the time because they would have been suspicious of me. It's a lose-lose situation.

On my wishlist is my own personal 24-hour Nurse to constantly administer IV hydromorphone once every 30 minutes and IV carfentanyl for breakthrough pain every 10 mintues.

The easiest way to get carfentanyl is to disguise yourself as a distressed pregnant giraffe.

Just imagine if that stuff got into the wrong hands!

Although I've never done IV opiates recreationally, I've done enough orally to take out just about all of my receptors. It's a drag not to be able to have a buzz again...I, too, am on SUBOXONE for life.

Regarding dilaudid, I have only had it orally and found it to be pretty poor.

I have not received a buzz from any opiates in years, I guess because I have been on the oral opaites in one form or another weekly if not daily for at least 2 years.

The good thing is that they still work for pain control!!!

For me that is a plus, I am not trying to judge anyone else and what they may have done in the past, but I am glad I don't get a buzz so that I don't get psychologically addicted and wind up drug seeking. The added benefit is that they still help with the pain, even just good ole hydro helps wonderfully, espcially when I take it with an nsaid.

Having said that, I am very very careful with benzos, they do make me feel "high". I don't want to go that route and wind up taking benzos recreationally so I try to stay away from them and when I have to take them, I try to get the doc to give me something less euphorogenic like valium or klonopin rather than xanax or ativan.

Just my $.02

Great post, Jimmy. I hear that the withdrawal from benzos is Hell, too.

First post to DB. Really interesting and helpful.

I was in the hospital, and they were testing my heart with pumping dye into my thigh artery and taking pics of my heart. This later turned into a double bypass heart operation at 48 years old. Am doing very well.

Anyway, my point here, ist that they gave me a shot of Valium, a benzo, and I had one of the most terrific, euphoric rides in my life! Even though the tests on me was drop-dead serious, I was laughing and joking with the nurses and doctors and enjoyed the whole thing fully. It lasted an hour, and I was sorry to see it end.

I have taken valium orally, but have never had this feeling. I don't think it is possible to get this by pills, and how much mg's. But I wanted to share the fond memories of that injection with you all.

hydro..i have had sciatica for about 2 weeks now..i have had bouts with it before but suffered thru it with out any kind of meds except advil..which did nothing for me..anyways my husband got ahold of some hydro 7.5 i think..i took one yesterday afternoon and about an hr later i slept for about 3 hrs..(it also of course took the pain away).after a while the awful pain came back..i took another one about 12am with 1mg of xanax and 2 10mg of ambien and was up all night..just could not sleep..when i took the first hyddro it was on an empty stomach..the one i took at 12 am was about 2 hrs after i had eaten a meal..would eating a meal before taking hydro cause me not to be able to sleep...i just cant figure out why i was unable to sleep even with the xanx and ambien..sry this is so long of a story..if any one can help me out on this i would really appreciate it.best to all..angelica..ps..i am having alot of pain now but am afraid i will be up all night from the hydro..dont know if i should eat something or not...

Ambien should be taken on an empty stomach. But two hours is plenty of time.

You asked if you could get Dilaudid without a Rx? What planet are u from?

Nephro, what most people don't understand is that there really is no "max dose" on the strong IV pain medications that are given in the hospital. Nurses are only limited by the physicians in how much they can dose a patient in any given period of time. More time than not, the patient is undermedicated because many doctors and nurses rely more on medical journals and personal experience than they do on assessing their patient's response to pain control. I just think that if a person continues to complain of pain, and their respirations and heart rate are within normal limits, they should be believed and given the benefit of the doubt and dosed again or given something different. People are different and not all respond to the same dose, the same way.

I mostly work on the post surgical unit and by the time we receive the patient from the recovery room, their pain is ususally under control. We set and connect the pca (patient controlled anesthesia) and show the patient how to use it. More times than not, the doctor has already written in the patients chart, extra doses for breakthrough pain even with the pca. Nurses are taught to look for objective data-resp rate, heart rate, etc.- when assessing the patient before administering all drugs, but a lot of them seem to forego real patient assessment when it comes to pain control and dose (or not dose) based on unfounded stereotypical and/or unjustified personal beliefs about the patient or the drug.

Another thing that gets my goat with alot of nurses is their attitude when dealing with addicts. Are not addicts people too? When did we become the narcotic police? Suffering human beings are suffering human beings and just because someone has an addiction doesn't justify withholding pain control when it's needed. The excuse, "I don't want to be the one to contribute to his/her addiction," is just lame.

The unfortunate position I was in was having renal colic made worse by morphine (which has no limit) and being switched to pethidine, which has a 600mg/24hour limit due to its active metabolite norpethidine. But the nurse told me the limit was 400mg, so what do I do, knowing she is BSing me? If I recite her the formulary she will wonder who the hell I am and if I don't I'll suffer needless pain.

Also the consultant said I could have 100mg 3-hourly, which is unlicensed but that is his responsibility. But of course consultants don't stick around to defend you when the nurses decide they know best.

In fact I've just come out of hospital and was written up for 100mg pethidine 4-hourly due to severe abdo pain and received the first 3 doses no problem. But, unknown to me, the 4th dose as reduced to 50mg not by the doctor but by the nurse giving it. I thought my pain was escalating as the subsequent 4 doses were only 50mg. I only found out when I read my drug chart.

So I spent 20 hours in unnecessary pain just because a nurse halved my dose and the rest followed suite. I had to literally try each nurse until one understood my prescription was for 100mg and would increase it again, but not for 4 hours after the 50mg dose. Which meant 2 hours without any meaningful pain relief at all.

It wasn't as though my pain was a mystery; the CT scan showed it clearly. I'm totally fed up with battling and bartering for adequate pain relief.

No one should have to battle, bargain or beg for pain relief when they are in the hospital. They shouldn't have to do this out of the hospital either.

Ok, I'm sold. How do I get a script???? I don't know if I experience enough pain for this item since it looks pretty hardcore.

I just got scripted dilaudid today and now I'm reading that it isn't very effective taken orally. Is it just that the high is less intense or is the pain releif not good enough? I don't want to be bombed out of my mind, I just want to have a reasonable quality of life and be able to raise my kids. So, my question is, does it still work on pain taken orally? My pharmacist acted like this was some strong stuff. I hope it works!!

Sure, it still works on pain -- it works extremely well. The thing that you need to remember is that the oral bioavailability is about one-fifth of the same dose IV or IM. Therefore, if you've had 2mgs IV in the ER or post-surg, taking it orally isn't going to be ANYTHING nearly as potent. But it still works very well orally.

Thanks Fiver! I've never had it IV or IM so hopefully it will work well. My brother just told me that druggies put this pill in a syringe with a little water, shake it up to dissolve and shoot it in a vein!! Apparently, heroin users like this in a pinch. Scary stuff!! I am amazed at the things people will do to get high!! This is definitely going in the gun safe with my other meds and I'll never tell a soul that I have it!! Well, except for the few people that read this forum!!Ya'll wont tell right?? LOL!!