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Old 11-12-2002, 07:10 PM   #1
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igy76 HB User
Post So Sorry, but one more question.... (about Dilauded now)

My PM doc gave me a script for Dilauded 4mg today (a shot of it has always helped in the ER), after I was taking about 10 of the Percocet 10/325 a day. Thing is, I can already tell its not working as well as the Percs, I've had 6 already in about 6 hours. I know different drugs have different effects on everyone, but isn't Dilauded supposed to be generally more powerful than Percs? (although it is 4mg vs. 10mg). Thanks all

 
Old 11-13-2002, 07:20 AM   #2
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davidc66 HB User
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Hey Iggy, Slow down on those D's, Dilaudid is about 8 times more potent than morphine. I'm taking the 4mg tabs now myself. I used to take roxicodone 30mg and got much better relief. I talked to my doc and he said that Dilaudid doesn't last as long and has a shorter half life than oxy. But 24 mgs in 6 hours is a dose that would kill most people.

You have a monster tolerance to be able to do this which isn't helped by self medication, Did the doc say to take it as needed as much as you want?Figure out what the directions say and how many days it's supposed to last you. If you go in for an ealy refill after eating D's like candy you may loose your PM doc.

Just follow the directions and know that no amount of pain meds can relieve all your pain. He's trying to take the edge off for you and it sounds like your tryimg to knock yourself out with them.

Many docs won't even prescribe Dilaudid becuase there is already of comunity of IV dilaudid abusers. He's giving you all his trust so you must return that trust by following his guidelines. IF it's not working talk to hime or give it some more time. Where is the pain now. Stones tend to get stuck at the point right before the Ureters empty into the bladdr, that opening is only about the size of a pencil lead.

Don't be fooled by the size of the pill, just because it's tiny doesn't mean it's weak. That dose really would stop an opiate naive person from breathing.

A 10mg perc would be equal to 15mgs of morphine a 4 mg dilaudid is considered to be the same as 30mgs of morphine, so in theory each pill is twice as strong as each Percocet 10. If a patient continues to say their pain isn't being helped even by ever increasing doses it may be an indicator to your doc that your not a good candidate for opiate treatment.

Rememeber, nobody has to prescribe you anything. Those JCOH standards they passed only say your pain has to be measured and treated, If the doc decides to treat your pain with Tylenol he is still following the JCOH guidelines for acredidation. That law that was passed is greatly misunderstood, many folks think it means that your pain will be managed to your satisfaction, that's not in the guidelines, Just measure and treat.

If that much Dilaudid isn't working I would be concerned about an obstructed kidney. No amount of pain meds will take that pain completely away, and your risking respirtory supression.

Just be careful Iggy, and follow the prescribing instructions. I can't imagine a doc increasing your dose 10X in a single day, that is not safe. You could end up loosing a kidney masking that kind of pain with that much Dilaudid. Something is wrong that your needing that much.

Because it has such a high street value, running out early is not OK. Each 4mg pill is worth 40 bucks to a Heroin addict. If you blow through a month supply in a week, my fear is you will be cut off and have nothing to help. Ease off bud, your setting yorself up for some terrible withdrawal and loosing your docs faith by self medicating.

If it says take one or 2 tabs every 4 hours do not exceed that. Some docs wouldn't even believe you could take that much and would think your selling it rather than taking it. I'm sorry your hurting, but when the meds aren't working that's a sign there is a problem more than just passing some gravel.

Dilaudid is actually a very slow mover at the pharmacy
because many docs refuse to take the chance of their script ending up on the street. It's possible the bottle had expired and should have been discarded at the pharmacy, that may explain it's ineffectiveness. But 24 mgs in 6 hours is way too much, it's not safe unless someone is monitoring your breathing.

That's almost 200mgs of morphine in 6 hours where before you were taking 15-30 mgs. Something doesn't make sense. Go to the ER if you find that his prescribed dose isn't working.

Coming off that level of meds is going to be very rough and you may get no sympathy from your doc because you are self medicating and not following the instructions and burning through a script twice as fast as you should. Each script is assigned a number of days supply, asking for early refills is a good way to loose your doc.

Especially a med like Dilaudid which docs know has an outragous street value.If you find your not getting relief from what he prescribed then go back to the ER and make sure your kidney isn't obstructed and causing you pain that can't be managed with oral meds.

Be safe Iggy, what you did was not safe. You also have to look at your tolerance in the long run. If you get through all this mess and break an arm 2 months later, they aren't going to give you dilaudid again and you won't get any relief from the Vicodin the ER doc prescribes. A doc won't understand how you could have such a high tolerance in such a short amount of time.Take care, David

[This message has been edited by davidc66 (edited 11-13-2002).]

 
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Old 11-13-2002, 02:09 PM   #3
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Karla HB User
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I take 15mg of oxycodone twice everyday for ha pain. Sometimes that doesn't help abort the ha. Then I have to go to the ER and get Dilaudid. I get 4mg all the time and it will knock me out for close to 24 hours. It is very potent! One time 4mg didn't take my ha away and the dr gave me 6mg and sent me home. I dont remember leaving the ER. My husband said I was out of it and he had to undress me and put me to bed. He went downstairs with the boys to watch a video and happened to come upstairs for a phone call. The phone was in the office across the hall from our bedroom. He looked on me while he was on the phone and found me blue and not breathing. He hung up dialed 911. I had overdosed on 6mg of dilaudid. They said 15 more min. and I would have been non recoverable. They injected narcan into me and pulled out all the narcotic. I am very gratefull to God to be alive today. Dialudid is very powerfull and nothing to mess around with. Please be very carefull!!!!!!

 
Old 11-14-2002, 05:37 PM   #4
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igy76 HB User
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Well DAVID, I hope you check this thread, because first of all I want to thank you for all the tech info and concern. I have passed some fragments now, and haven't had any 20 out of 10 episodes on the pain scale since last night. And I think until now that's been the longest I've gone without one. There still is some stones up there because I still have pain. But as far as the Dilauded, wouldn't you concede that different drugs affect different people in different ways? That's what I've always heard. That even though on paper this amount of Dilauded is stronger that Perc, the Perc is more effective on me. I don't get it either, but I've gone through it for 48 hours now (though I HAVE NOT taken 6 pills in 6 hours again - you scared the hell out of me there). What sucks is my PM doc is not out til Monday. I WAS going to talk to him today, say I thought it appropriate since the Dilauded wasn't as effective as the Percs, maybe I should hand in all the rest of the Dld. I had, and get another fresh script of Percs again. I thought that might annoy him a little, becuase he recommended the Dld. after I finished the other Percs, but at the pain I was having there was simply no way the Dld. count I had would last me 15 days (the number he said). ANYWAY, an example of the point I was trying to make: I have a 38 year old friend who's about 6-1, 200lbs. (i think), and when he takes just one vicodin 5/500 it really has a strong effect on him. but i'm 5-9, 155, and one of those doesn't really do much on me (and I'm talking about awhile back when I realized this, so at the time I wasn't as tolerated as I am now of course). I stared taking Vicodin in March 2001 for my wisdom teeth, and haven't been able to go more than 2.5 months since then without taking something for various reasons (Vicodin was taken for awhile, then a long streak of Lorcet, and a little of Perc)

 
Old 11-14-2002, 10:19 PM   #5
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davidc66 HB User
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Hey Iggy, I absolutely agree that different meds have different effects on different people.Size and weight have little to do with tolerance. I got much better relief taking 1 30 mg Roxicodone than I do taking 8 mgs of Dilaudid even though on paper the dilaudid should be stronger.

Morphine is the standard to which all other meds are compared. My concern was the huge increase from one day to the that dose of Dilaudid. If you have been taking 2 10mg percs that should have the same analgesic and respiratory effect as 30 mgs of morphine, However 24 mgs of Dilaudid has the same effect as 184 mgs of morphine. You can safely increase your dose 50% a day sometimes even double it every day until you reach a level of comfort with opiates.

However Going from having an average serum level of 30 mgs of morphine to 180 mgs in a 6 hour period it's not the analgesic quality I'm thinking of. It's the respiratory suppression caused by all opiates, saying it has the same analgesic effects also equates to the same amount of respiratory supression. Increasing a dose 6fold in one day is more than even a very tolerant patient should do. You have to look at what your serum levels have been prior to that dose, and you jacked that puppy up there and it is dangerous. I'm very glad I scared you and you didn't do it again.

Just because you don't feel like your getting equivalent pain relief doesn't mean that your not getting the equivalent respiratory suppression as 180 mgs of morphine, Unless you have been taking 3-4 times the 20mgs of oxy every 4 hours I'm calculating, that level of opiates was completely new to you. To go from Lorcet to oxy for a week and then to a whopping dose of dilaudid is not safe.

Even taking 40 mgs of oxyC at a time only sustains 20mgs in your system, OxyC sustains half it's mg strength for 8-12 hours. There is roughly a 20mg release at the 1 hour mark and then another 20mgs at the 6 hour mark with a 40mg OxyC. You basically took more opiate during that 6 hour period than you have perviously in an entire day. That's not safe by anyone's standards. Not even an extremely aggressive DR like DR Hurowitz.

I use 12 mgs of dilaudid at a time for BT pain, But my base dose prior to meth was 600mgs of morphine a day. Proportionately that dose of dilaudid , although high is only 1/6 of my average daily dose. If you average out what your serum levels have been over the last 6-8 weeks at best you might have taken the equivalent of 180 mgs during your worst entire day, not in a single dose or over a 6 hour period.

You are lucky to be alive dude. You could have easily fallen asleep and we would have never heard from you again despite the perceived lack of analgesic strength. It still has that same respiratory suppressant strength to someone not use to that level of opiates.

It's also much harder to bring a high level of pain down than it is to keep someones level of pain from skyrocketing. Continous long acting meds do that.

Hydrocodone is considered equianelgesic to morphine 1:1, So if you were taking 18 lorcet a day on your worst day, you just took that same dose of opiates in 6 hours. I'm not trying to bust your chops or insinuate anything other than that was not safe. Also having gotten use to this level of opiates in your system, discontinuing after several months is going to have consequences. Please be safe and follow the docs instructions, The best he can do is take the edge off.

I'm going into the hospital monday for a pump trial. If the pump reduces my pain 50% that is considered a success and merits implanting a pump into my abdomin and running a catheter to spinal cord to continously infuse morphine. 50% not 100%
LOL

You may have been obstructed and enough pressure built up to move a stone to your bladder. Next time, rather than self medicating, go to the ER where they can observe you when you need that level of pain meds. It's taken me 3 years for my tolerance to get to where it is, I fear you are not as tolerant as you believe, just very lucky.

Be safe Iggy and reserve some meds to taper off when your done or it could get very ugly. Take care, David

[This message has been edited by davidc66 (edited 11-15-2002).]

 
Old 11-24-2004, 12:41 PM   #6
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nickymandy HB User
Re: So Sorry, but one more question.... (about Dilauded now)

Quote:
Originally Posted by davidc66
Hey Iggy, Slow down on those D's, Dilaudid is about 8 times more potent than morphine. I'm taking the 4mg tabs now myself. I used to take roxicodone 30mg and got much better relief. I talked to my doc and he said that Dilaudid doesn't last as long and has a shorter half life than oxy. But 24 mgs in 6 hours is a dose that would kill most people.

You have a monster tolerance to be able to do this which isn't helped by self medication, Did the doc say to take it as needed as much as you want?Figure out what the directions say and how many days it's supposed to last you. If you go in for an ealy refill after eating D's like candy you may loose your PM doc.

Just follow the directions and know that no amount of pain meds can relieve all your pain. He's trying to take the edge off for you and it sounds like your tryimg to knock yourself out with them.

Many docs won't even prescribe Dilaudid becuase there is already of comunity of IV dilaudid abusers. He's giving you all his trust so you must return that trust by following his guidelines. IF it's not working talk to hime or give it some more time. Where is the pain now. Stones tend to get stuck at the point right before the Ureters empty into the bladdr, that opening is only about the size of a pencil lead.

Don't be fooled by the size of the pill, just because it's tiny doesn't mean it's weak. That dose really would stop an opiate naive person from breathing.

A 10mg perc would be equal to 15mgs of morphine a 4 mg dilaudid is considered to be the same as 30mgs of morphine, so in theory each pill is twice as strong as each Percocet 10. If a patient continues to say their pain isn't being helped even by ever increasing doses it may be an indicator to your doc that your not a good candidate for opiate treatment.

Rememeber, nobody has to prescribe you anything. Those JCOH standards they passed only say your pain has to be measured and treated, If the doc decides to treat your pain with Tylenol he is still following the JCOH guidelines for acredidation. That law that was passed is greatly misunderstood, many folks think it means that your pain will be managed to your satisfaction, that's not in the guidelines, Just measure and treat.

If that much Dilaudid isn't working I would be concerned about an obstructed kidney. No amount of pain meds will take that pain completely away, and your risking respirtory supression.

Just be careful Iggy, and follow the prescribing instructions. I can't imagine a doc increasing your dose 10X in a single day, that is not safe. You could end up loosing a kidney masking that kind of pain with that much Dilaudid. Something is wrong that your needing that much.

Because it has such a high street value, running out early is not OK. Each 4mg pill is worth 40 bucks to a Heroin addict. If you blow through a month supply in a week, my fear is you will be cut off and have nothing to help. Ease off bud, your setting yorself up for some terrible withdrawal and loosing your docs faith by self medicating.

If it says take one or 2 tabs every 4 hours do not exceed that. Some docs wouldn't even believe you could take that much and would think your selling it rather than taking it. I'm sorry your hurting, but when the meds aren't working that's a sign there is a problem more than just passing some gravel.

Dilaudid is actually a very slow mover at the pharmacy
because many docs refuse to take the chance of their script ending up on the street. It's possible the bottle had expired and should have been discarded at the pharmacy, that may explain it's ineffectiveness. But 24 mgs in 6 hours is way too much, it's not safe unless someone is monitoring your breathing.

That's almost 200mgs of morphine in 6 hours where before you were taking 15-30 mgs. Something doesn't make sense. Go to the ER if you find that his prescribed dose isn't working.

Coming off that level of meds is going to be very rough and you may get no sympathy from your doc because you are self medicating and not following the instructions and burning through a script twice as fast as you should. Each script is assigned a number of days supply, asking for early refills is a good way to loose your doc.

Especially a med like Dilaudid which docs know has an outragous street value.If you find your not getting relief from what he prescribed then go back to the ER and make sure your kidney isn't obstructed and causing you pain that can't be managed with oral meds.

Be safe Iggy, what you did was not safe. You also have to look at your tolerance in the long run. If you get through all this mess and break an arm 2 months later, they aren't going to give you dilaudid again and you won't get any relief from the Vicodin the ER doc prescribes. A doc won't understand how you could have such a high tolerance in such a short amount of time.Take care, David

[This message has been edited by davidc66 (edited 11-13-2002).]
hi david...... please contact me....... my name is nicole, and i am 32 and have some questions about your opiate expertise... since u have personal exerience..... i just had a major surgery and the percs. 10/650 weren't working so i am trying roxicodone 30 mg. anyway, i don't know if u are still on this site helping people out, but i'd love to hear back.........all the best

nicole

 
Old 11-24-2004, 12:43 PM   #7
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Join Date: Nov 2004
Location: Boca Raton
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nickymandy HB User
Hello

[B] [B] hi david...... please contact me....... my name is nicole, and i am 32 and have some questions about your opiate expertise... since u have personal exerience..... i just had a major surgery and the percs. 10/650 weren't working so i am trying roxicodone 30 mg. anyway, i don't know if u are still on this site helping people out, but i'd love to hear back.........all the best

nicole

 
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