Hydromorphone is also known as Dilaudid, Hydal, Sophidone, Hydrostat Hydromorfan, Hydromorphan, Laudicon, Hymorphan, Opidol, or Palladone; depending on what country you live in.
Since most of my readers are here in the states, we'll just call it dilaudid.
Dilaudid is a pretty heavy hitting narcotic pain medication. It's ten times stronger than morphine and five times stronger than heroin, with roughly half the side effects.
Dilaudid was invented by german scientists at Knoll in the 1920s. It was discovered after they added a few extra hydrogen atoms to regular old morphine. Knoll was later bought out by Abbot, who now produces the drug. I own stock in Abbot, btw.
Dilaudid is very versatile, it can be taken orally via a pill, through a shot, into an IV, or even rectally. One of the major side effects though, is euphoria. So it is popular among drug seeking type people throughout the US and abroad.
The pronunciation is
DIE-LAW-DID. Say it out loud.
DIE-LAW-DID. Dilaudid is
not pronounced DILL-AW-DA.
It is common for health care workers to find half-educated patients demanding dilaudid for pain control. If you are one of those people, there are a few things you probably shouldn't say. I'll cover a few of the common statements that will give your physician or caregiver pause.
"The only thing that controls my pain is DILL-AW-DA" Especially if you just got to the hospital and start spewing this out. Why are you here again? Difficulty breathing? Why the sudden development of severe back pain? You don't even take anything at home for your severe back pain. Trust us, we know this. We know your entire medical history. The medications you take or don't take. If we think you're lying, we'll call your pharmacy and confirm. And trust me, pharmacists are more than happy to discuss this information. In fact, the ER physician probably called the last ER you were at and spoke to the last physician that took care of you. You know that little piece of paper you signed when you got admitted? In the fine print it says we can do all this if we want to.
"How many milligrams?" or, "One milligram won't work, only two will control my pain." Saying these things before you've even received any type of pain medication at all will instantly get you branded as a douche. The logic is if you haven't had anything for pain at all, how would you know that the standard dose won't work today right now? In fact, why are you so familiar with dosages anyways?
"It only works good through the IV, I don't want a shot because it won't work." What the physician hears, "I love the euphoric feeling I get when I get IV dilaudid." You think you're the first person that's said something like that? In a perfect world everyone would get IV dilaudid but it just doesn't work that way.
"It doesn't work as good when you dilute it." Its being diluted because you're probably already receiving a huge dose. The goal is to control pain, not kill you or make you sick. People can end up on a ventilator with brain damage thanks to too much dilaudid. Just like a heroin overdose. The person administering the dilaudid to you has probably had this happen before, and doesn't want to see it happen to you. Its no fun to walk into a room and see someone blue, covered in vomit, and foaming at the mouth.
"I need you to call my doctor and get me more dilaudid." Please, just go through the steps with us. The steps being, We give you something for pain, it doesn't work, we try something else. Eventually if your pain isn't controlled, you'll finally get around to the coveted 2mg of IV dilaudid every three hours. Don't start right off the bat constantly demanding huge doses of pain medication. We don't know you, we don't know if you can handle it or not. Everyone taking care of you has a license to protect, and if you die, then they're fucked. Take that into consideration if you're planning on being an asshole about not getting enough dilaudid.
"I just want my shot of dilaudid, so I can/then I will go to sleep." This isn't a good idea. You see, one of the dangerous adverse affects of dilaudid is respiratory depression and unconsciousness. Putting you to sleep is precisely what we're trying
not to do. I have yet to meet anyone who says this that actually slept. In fact, I've known people to set their cell phone alarms to wake them up and remind them that its time to get their dose again.
"I'm all itchy, I need something for itchiness." No, you don't. That itchy feeling you're having? That's an early symptom that you are being overdosed. What you need to do is lighten up on the dilaudid. Getting a drug to stop the itching will only mask the symptoms of overdose, leading to the more dangerous part where your nervous system is so depressed you actually stop breathing. Drugs like benadryl (anti-itching) also have the added interaction with dilaudid of amplifying the nervous system depression. Complaining about itchiness is a good way to get the physician to take the drug away altogether.
"I'm nauseous! I need phenergan!" OH they think they are so tricky with this one. Phenergan + Dilaudid = High as hell. Phenergan is also another drug that amplifies and masks the symptoms of a dilaudid overdose. Like itching, vomiting means you're getting way too much and toxicity is looming (like when you drink too many beers). Speaking of phenergan, the physician is probably wondering how you know about phenergan anyways? Fortunately most hospitals are eliminating phenergan altogether so this is less of a problem.
"If you won't give me dilaudid, get me someone that will!" or "I want to see the physician NOW!" First of all, if the first person taking care of you isn't giving you dilaudid, there is a reason. Second, the physician already saw you today. Unless your actively dying then the person taking care of you is functioning as the physician's eyes and ears. If the physician didn't up your pain medication earlier, then they probably won't do it now. Trying to get the physician into the room so you can take out your frustration on them will not work.
"If I can't get dilaudid here, then I'll go somewhere else!" This is probably one of the dumbest statements ever. If you walk into some other hospital they'll be even less likely to treat you with dilaudid if you leave a hospital against medical advice. However, you are at liberty to leave. In fact there are tons of people lined up behind you that would like to be treated. You're in a hospital, not McDonalds. Making statements like that don't work. At the most, if you're unhappy with your care, you might get a fruit basket or something. Needless to say, if you jet over to the hospital across town, at some point the physician there will more than likely speak to the physician at the hospital you just came from.
All in all, remember that everyone in the hospital taking care of you specializes in what they do. More than likely, the nurse taking care of you has a bachelors or masters degree and years of experience dealing with people in pain. The physician has years and years of training dealing with health problems exactly like you have. You're not a unique snowflake. The goal is to help alleviate your symptoms and help you get better, not harm you or get you high. Believe me, the physician is more than happy to prescribe pain medication. So if you walk into a hospital and your pain is disproportionate to your diagnosis, alarm bells will ring. Just remember, being hospitalized is not a game and psychological manipulation will rarely work, and physicians HATE it when people try to manipulate them. In fact, its a good way to get kicked out of a hospital altogether. Not only that, but someday you may actually have a legitimate need for huge doses of pain medication. Unfortunately, by that point, if you exhibit the above behaviors, you'll already be labeled as a drug seeker.
