Dilaudid

I know that Dilaudid is not a psych med, but I have a question about it because of my 15-year old's jaw surgery.

She's on other meds (including another narcotic), but the Dilaudid is the med she is prescribed the most.....4 mls (liquid) every 4 hours for at least a month. If she needs more, they will get her a refill since it wasn't quite a normal jaw surgery and there's a lot of pain involved in her recovery.

Is this enough to cause a physical dependence? I don't think she would have a psychological addiction to it simply because it is relieving so much pain, but I was wondering if there will be a weaning process when she doesn't need it anymore. How awful if she has to go through physical withdrawal symptoms after everything else. Does anyone know? Thanks.

God bless,
Sandy

Hi Sandy. I wish I could be more helpful, but I'm scared of Dilaudid. My doctor prescribed it to me for herniated disc/pinched nerve pain last summer and after I read about it ("drugstore heroine"), I decided not to take even one pill. Apparently, it's 5x more addictive than morphine. I had a friend who was on morphine when she had a spinal tumour and watching her go through withdrawal when the pain was gone really scared me.

My brother was in a residential detox program for alcholism a few years ago and most of the men who were in the program with him were fighting addictions to Dilaudid or Oxy-Contin, so I decided I would stay away from anything with such a high potential for addiction... because I have enough problems already.

I wish your daughter's doctor could prescribe something less addictive for her pain. I was surprised that my doctor was so quick to give me a prescription for a heavy-duty drug like Dilaudid before trying something less addictive first. I have read that part of the reason Dilaudid is so addictive is because of the euphoric feeling users get. It also acts quickly, but doesn't last long... and the pain comes back with a vengeance when it wears off, so you need to take more.

I took it last summer while in the hospital and then a bit at home after major abdominal surgery. I asked to be given something less potent and was Rx'd Tylenol with Codeine, but that didn't work as well. It wasn't potent enough to relieve the pain for me to sleep well. So I went back to the Dilaudid for a while longer then switched back to the Tylenol.

It's potent and very effective pain med and it's been prescribed because it's needed medically so you can feel comfortable about her using it. There's no reason to worry about addiction if the prescribed amount is being taken on schedule. I assume the doctor will wean and/or switch her to a lesser pain medication when it's time.

Please do talk to the doctor if you aren't comfortable with it. He/she is fully aware of the need for it's use as well as the potential for narcotic analgesic addiction. I think weaning should be done when any narcotic medication is being discontinued after weeks/months and I would guess that is the plan.

Hi,
Dilaudid is the new Demerol. It is used for postop pain and her doc will reduce to less potent pain med when it's time. I would not keep her from taking it for worry of an addiction. It's a medical necessity at this point.

Best wishes for a speedy recovery to her!
Okie

In a situation like this, pain management is so important so that the proper healing can take place and less stress/anxiety is felt by the patient which would in turn slow down the healing process.

As long as she is taking it as prescribed, there should not be an issue. If she gets to the point where she can go longer amounts of time in between doses, then maybe it's time to substitute every other dose of dilauted with a less potent pain killer.....that would be the way to extend her time on the dilauted and wean her off and still be keeping her comfortable.

I was caring for a good friend after major surgery back in January. She was given dilauted also and was very concerned about it. I explained that right now, she needed that kind of pain control in order to get through the day and sleep more comfortably through the night so that every time she moved, it would not wake her up in pain. Within 2 weeks, she was to the point of taking it only at bedtime and supplementing percocets during the day then to ibuprofen and then totally off everything within another 2 weeks.

I hope your daughter gets through all this as easily as possible. I wish you both luck!

Hugsssss
J

hydromorphone is probably the most addictive narcotic, but also very effective. If she does not have terminal cancer I would think this is not the med to be on.

I found Hydrocodone quite effective at relieving intense nerve pain... and its addictive potential isn't as high. If you're concerned about Dilaudid, maybe you could ask your daughter's doc about other options.

SandyWeb - Dilaudid™ (hydromorphone) is a potent analgesic. As with any opiate-like drug, if it is being used for the relief of severe pain, there is very little risk of becoming addicted to it. When one starts using opiates or opiate-like drugs to "feel good", rather than for pain, the risk of addiction is a real concern.

As your daughter heals, which can take several months depending on the extent of her injury, the doctor should be reassessing her dosage. Your daughter should also be monitoring her dose as well. If her pain is not unbearable when she is due for her next dose (ie. 4 hours after the last dose), maybe she could wait an hour or two before taking that dose. This gradual lengthening of the time between dosing is the way to wean on off of the drug. She would go from 6 doses a day to 5 doses a day to 4 doses a day. This should be done slowly (eg. over several weeks) as dictated by the pain that she is feeling.

The above is one way to wean off of painkillers after surgery. You could ask your daughter's doctor as to how he plans to wean her off of the Dilaudid™. Every doctor has a method of weaning with which they feel most comfortable. Your daughter's input is essential in this process. As her pain diminishes her daily dose of Dilaudid™ should be decreased, only if her doctor is in agreement.

I hope that this is of some help. - Cam

An orthopedic surgeon prescribed it for me after I had, literally, smashed my ankle. I was so concerned about taking it that I called my ex-husband, a surgeon, and he said pretty much the same thing that Cam said. And I gradually eased off it. I talked to the Orthopod and he listened to my concerns and if I could get by for even 30 minutes without it, I would wait to take the dose. The pain was so bad, for awhile, that we slowly shifted downwards to another med.

Something else to note is that when I worked in ER, you could tell what a drug addict wanted by what they said they "weren't" allergic to. We had an awful lot of people that weren't allergic to Dilaudid.

Thanks, everyone, for all your responses. I thought that morphine, which they gave her in a continuous drip in the hospital, was the big bad guy. I didn't realize that Dilaudid was even more addictive, although I knew people stole for it.

I wouldn't ever have my daughter on morphine again because it made her horribly nauseaus. Even with Gravol being given with it, she still was sick to her tummy most of the time....even after all the throwing up of the blood in her stomache. But Dilaudid is so much more gentle on her system. I have never had to give her a dose of Gravol, and it has never made her feel sick.

Even with the Dilaudid and Naproxen (for inflammation)...and other meds as well....she has been in constant pain except for when she is asleep. But the Dilaudid DOES help. It just seems to wear out after 2 hours, and even though I was told I could give it to her every 2 hours for break-through pain, I've only done that once (and at a lower dose). I just can't imagine giving it to her every 2 hours. I don't want to get her too used to it.

I've tried various combinations....from the lowest dose to the highest dose, from the shortest time to *trying* to get to the longest time. We could only go every 4 hours before she really was in need again, but I've been trying to get her to every 5 hours during the night when she's sleeping. She can't quite make it to 5 hours yet, but ALMOST. We can only go down in dose and up in length of time between doses.....so I think she will wean off it easily. I told her that once this bottle is gone, we may be giving her a different pain med....depending on how she is dealing. If she needs more Dilaudid, then so be it. She is DEFINATELY an anti-drug girl, and most times won't even take a pill for a migraine. She doesn't even realize that these meds she is on now are the BIG ONES (lol)......probably because she's still in pain. But the meds and TIME will help her heal. She's got a little road in front of her still.

I must say that today has been her best day yet. YEAH! She *finally* is not burning hot (she's been a furnace since coming home from the hospital), and she even said when she went to take a nap this afternoon, "It's cold", and then snuggled under the covers. That's a GOOD sign. Her body has been working hard. She also was more alert today, and she didn't need any help getting out of bed or chairs. She still is in pain in many different places, but I have a feeling we're about to reach the 5 hour dosing schedule now. That's good too! I think I may have made her suffer needlessly when she first came home from the hospital because I was scared to be giving her so much, but now I know better. Healing is a process, and pain will dimenish with time. Whatever meds can give her some comfort and restful sleep, USE THEM.

She's still very weak and doesn't have much of an appetite, but she's been drinking a lot of chocolate milk. Lol. Better than just plain water for nutrients! She can feel bones shifting and cracking, but the surgeon said that is normal. Yikes! We see him again on May 2nd, and then another 4 weeks after that. We'll see how she's progressing and if we should continue with the Dilaudid at that time. She'll certainly need some sort of painkiller, but if she's going to return to school in a month, we can't have her falling asleep in class on Dilaudid!! I find Codeine to be very mild, so maybe that is what we'll use at that time.

Again, thanks for ALL your comments. This is a new drug for me to research. I've never even known anybody who needed it. I appreciate everybody's responses. They've helped me a lot.

God bless,
Sandy