Dilaudid Lethal Dosage?
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I am a stage IV cancer patient and member of an invitational research and survey type website.

Members primarily consist of other stage IV cancer patients, but in some cases, may be the caregiver of a stage IV patient.

A little over a month ago, a caregiver launched a blog-like diary of sorts. He states his wife has end-stage, metastasized, breast cancer. His postings started with news his wife had to be hospitalized when she began the dying process and indicating shut-down. However, many of his statements do not sound clinically correct or even possible. For example, after she was admitted to the hospice section of the hospital, he stated she emerged from days of a coma-like state to experience what he called a rally. This rally consisted of engaging in conversation with himself and hospital staff...only to sink into another coma-like state after being administered IV anti-biotics for a major infection due to compromised immune system (an extremely low, chemo-caused low white blood count). During this time, he also stated that both kidneys shut down...then...a week later, miraculously regained normal function. In still another posting, he describes she emerged from yet another coma-like state to devour a huge meal, although she had and was still on a PEG feeding tube!!! (All patients I know had to slowly acclimate over a period of several days to oral feeding with jello, puddings, non-spicy soups, etc.) He now states he has moved his wife back home where she can die in the comfort of familiar surroundings. Now at home, he described another coma-like experience, followed by yet another rally of low-level activity as if she had no health issues at all. Today, (July 23) his posting states she was in great pain the night before and her doctor increased her Dilaudid pain medication to 7mg/hour. If you had read between the lines of every post since this person started about 6-weeks ago, you'd quickly get the idea this person has the capacity to cause a faster than normal passing of his wife. For what reason?...so he can start re-establishing his social life! More than one prior comment had this type “social life” focus, though subtle. Far more troublesome are comments I feel would cause any perceptive person to wonder if he is capable of engaging in deliberate acts to cause his wife to expire sooner than later. In hopes a professional monitors this board, I have a quick question: Under her circumstances, does 7MG/hr of Dilaudid seem appropriate and correct...or...is does it sound more like an accumulative, lethal dose? I apologize for the length of this post, but am somewhat bothered by what may be the abuse (or worse) of a person that cannot defend themselves. Thanking you in advance, Nodawgs

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Re: Brynn (# 13)

You are so spot-on, I've been saying that my whole life as I watched my dad suffer and die of cancer... we have the mercy to put a dog down peacefully but not a human... dr. Kevorkian was the way to go

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Hi, I must comment on this discussion about Dilaudid. Unfortunately, I have suffered with chronic pain for over 25 years. During that time I have been on every known pain medication available.
I am presently under the care of a pain doctor and I live in New York. A few years ago a drug attic robbed a pharmacy in my area and killed the pharmacist and all the patients in the store . As a result New York and the insurance companies have begun to punish those patients with true pain syndromes from getting their necessary medication. Once a week I get a A letter from Aetna telling me that a dose of Dilaudid above 30mg a day is not effective and that he will start paying for it .This is completely unfair to patients they truly need it.. As many other readers have said unfortunately you build up a tolerance to all of these medications . I presently take 16 mg of Dialaudid every four or so hours. Up until eight months ago my pain doctor instructed me to make sure I took my pain medication on a regular basis to prevent my pain from becoming intolerable.So I have been doing that and now she has suddenly changed her and told me that I must less medication less often because the insurance company will no longer pay and the state is watching each dose we take. Having chronic pain is one of the worst things to live with . I recently was in the hospital for kidney stones. The pain was unbearable . I explained to the doctor that I was a chronic pain patient and presented him a letter from my pain doctor explaining the medication that I am prescribed.
The ER doctor says you're my wife oh my god this dose would kill an elephant! As you can imagine my wife became so alarmed . The doctor would give me no more than 1 mg of morphine as I was crying in pain. He didn't believe that the letter that I always carry with me and my wallet was legitimate and try calling my doctor at 1 AM. As is always the case my doctor was not on call and the doctor on call said I don't know the patient so I can't comment. So next 15 hours I screamed in pain until the stone moved. As you might expect I always have pain medication with me and the doctor scared my wife to such a point that she refused to give me any additional medicine.

I bring this up simply because as pain patients we go through hell every day. It's bad enough being in pain but for a doctor cannot believe you and for for the insurance companies are now decide if you're in pain or not because of the all mighty dollar is insane. You could be sure that if the CEO of Aetna wife had chronic pain this would never happen. I am so afraid that within the next few months make those is going to be cut and it will be completely out of my doctors hands because the state and the insurance companies are running the show.

Finally as pain patients everything is out of our control except the horrible pain that will rain every day. Are use tens unit, lidocaine patches, physical therapy, heating pad, you name it I've tried it and as a result my life is so miserable that I wish I could just die.

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I take 4mg 4 times a day and am also on a fentyal patch. They labeled my daiudid wrong once when I was on a dose of 3mg 4 times a day as need for pain to rake once every 3 hours. I was told if I had not listened to the doctor and followed what was written that I would have more than likely died the first night as that would have been way to much. So 7mg every hour seems wrong and fatal.

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My husband suffered from stage IV colon cancer with mets to liver and lungs. Morphine constipated him so severely that he spent hours everyday screaming in pain and discomfort, and the primary pain wasn't even alleviated. Dilaudid was the ONLY thing that worked. He took reasonable doses over the course of about a year, but by the time he was in the active dying process, he needed 16 mg/hr in order to maintain a MODERATE level of comfort. The doctor was in awe when lower doses didn't do the job, and even tried Morphine again, which just did not work for him. THANK GOD that this doctor was open-minded enough and had the compassion necessary to do WHATEVER it took to make my husband's passing a little less traumatic.

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JACK reply to post 35

Thank you for that post. I'm sorry you have such unrelenting pain.I too suffer from a similar condition and manage with about the same dosage as you. I'm a few years younger so my over riding concern is future pain relief without complete tolerance.Rarely do I hear the adminition to control the use of such potent narcotic containing pain meds so as to have some upward titration available in the days to come. Very well stated. Regards,

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Jo John
Yes that's fairly common once you become opiate tolerant the lethal dosage level is so tremendously high as to one cannot procure the amounts needed for this purpose. It's so sad chronic intractable pain patients almost always require some form of physiological support as a compendium therapy. So often professionals are oblivious to this fact.Many times secondary issues of substance abusers magnify this condition.I speak from painful experience . For those of you out there suffering help is available do not fear reaching out for assistance people truly do care.Just ask for help if they fail to hear you SCREAM OUT LOUD.Shame prevents so many of us from receiving the care that's currently available.Wishing you all the very best for a pain managed day...

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I've been on Dilaudid for a few years. Dilaudid only comes in 2mg, 4mg and 8mg. To do 7mg per hour she would have to do 3 pills of the 2mg then a half of a 2mg pill. Seems like a lot of work for her to take 7 mg per hour, why not just do the 8mg pill. I'm not sure what a lethal does would consist of, everyone is different. About 5 years ago I tried to take my life so I took 28 4mg dilaudid pills and around 60 50mg tramadol pills. Yes, I kind of passed out/fell asleep, woke up 6 hours later and I felt like a train hit me but I didn't die so I don't know what a lethal dose would be.

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7 mg an hour is too high of does you won't be able to comprehend anything I mean if your in hospice then ya by all means that's a good dose. But to get 3mg every two HR is more appropriate I've had alot of surgery on my stomach and waking up with big scars and staples I only received 2mg Q 4hrs it's a very strong opioate and I believe the strongest so the come off of it is hard as well as getting used to it will happen all in all just be careful

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My mother was a dialysis patient she hit her head after a fall and was given tramadol then dilaudid 5min in she coded coma and die. What went wrong.

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Dear Freiend- I have been on and off narcotic pain meds since I was hit head on in a high speed accident. My legs shattered and a foot reattached - plus multiple trauma injuries. Dosage should be considered when a patient has been on me medication for a long time- body weight and what other medications are on board. Kaduna is expensive- far too much for me- so EXALGO- E R dialysis has helped adequately. 16 mg every 12 hours and 4 mg dilaudid every 4 hours is what I take. This is not enough. I know you have built an immunity to narcotics- and I understand doo toes are not covering chronic pain adequately- I know. I live with it every day. You need to talk to your doctor- one suggestion: Switching opioids Helos. The body isn't familiar with the new drug and the neurotransmitters in the brain are not absorbing the drug so quickly- So try switching to a different drug and Tell your doctor that you cannot stand the Jain!!! I understand it- I wish you the best outcome for a horrific problem!

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Coping with pain,
It's a struggle ever day to deal with pain that's in the range of 5 to 10 on a daily basis. If it were not for dilaudid, I don't know how I could deal with the severe pain from 15 levels in my spine fused. Now, C2 and C3 are causing real vertigo problems that I just have to be very careful and deal with it whenever I lay down and get up. I worry that one day I will just fall over and severely injure myself in the fall since my neck is fused with metal rods from C3 to T3. My only remaining movement is in C1 to C2 and C2 to C3, so any fall could be fatal. As they say, life goes on and you deal with whatever comes your way. The bottom line is I am still alive, happy in life and feel that I can continue to deal with the pain as best I can. Because I in my mind 60's, I try to keep the dilaudid dose at as low a level as possible to leave myself some room for adjusting the dose as my condition gets worse. I take 6mg every 6 hours an this seem to just take the edge off and keep my pain level at about 5, which is just about the best I ever see. Mornings are the best time for me until about 2:00pm, then even with the dilaudid, I am still in severe pain about 50% of the time. But that's were I am staying so I have room to adjust the dilaudid as I get older, God Willing. Anyways, for you people out there who are coping with severe back pain, please use as low a dose as possible to cope soj your body doesn't start to lose its response to the pain medication, so please DON'T OVER MEDICATE!!!

Jack

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i believe the spouse gave up befor the sick spouse. maybe he wanted to end the pain. but who is to decide. not him the spouse but god himself had to the right to decide. the healthy spouse was money hungry and though of financeses before his wifes life

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I have 15 levels of my spine fused and am now faced with C1and C2 compression after having c3 to T3 fused 2010. Problem is my arms and legs have severe nerve damage and my pain level is in the range of 4 to 10 throughout the day. If not for dialysis, I don't know how I could cope. I have limited myself to 6mg every 8 hours to minimize my dependency on the drug and fight myself to keep a the lowest dose possible and still function since 2010. I don't want a high, only to minimize my pain. It's to easy to just keep upping the dose, you need some will power and must face the fact that you are going to be in pain. To cope, keep your mind as active as possible and it takes your mind off the pain for awhile.

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Lorcets metabolize in your urine as hydrocodone, dalaudids metabolize as hydromorphone. Chances are ya took a Dalaudid, maybe w/o knowing.

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What you described happened to a friend of mine. He told me all opiates will cause edema in high doses and said he was diagnosed with stage 3 kidney failure. Lower your dose and your kidneys will wake up from their slumber and do their job to put that fluid where it belongs: Into your bladder and out of your body naturally. Do it before its too late and let your body heal and straighten itself out.

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I hope you're in a peaceful place whether here of heaven. Thank you for posting such a detailed description of your experience. Im not physically ill. I came on to find out how much di lauded to take to end my life. I've suffered depression my whole life, and have reached the point of giving up. Reading this makes me sad. Here I'm thinking to end my life, and people are suffering greatly, and bravely walking through hell barefoot. I want to live too but I don't want to hurt anymore.

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I too suffer with very bad fibromyalgia which among other issues comes with non stop pain for me. I've tried all the norm meds for fibro with no success. I also found out during a surgery that I have a high tolerance and process pain meds and others faster than norm.? Normal. It takes me 8 mg every 6hrs to just be able to move and do best with pain still around a5-6 on 1-10 scale of pain. I'm so......very tired of living in pain always and loss of who I was to this is killing me. I live alone had to move away from any family or friends just to be off streets . I had to live homeless without any income for 2yrs in pain trying to just get hr to hr. It really sucked. I'm blessed now with my ssdi now and can pay for a place to live but not where I had my doctors or friends / family. Unfortunately I have tried with no success (yet) 3x suicide attempts cause pain and depression from all has gotten to much to handle alone and now not much help. Life is only good if u can live it. But when the gov gets involved and ur forced to move outa area and try to get help. well haha, I found out the answer isn't good. The only thing I have right now is having to drive or get driving 600mi+ to my home town to get refill on my meds. Which without I'm bed ridden without help. I'm trying everything I can to get help and to lower or get off the pills . but cause of all the trauma from move etc. All I got was ptsd now? Now i m just waiting day to day to hopefully die off sooner so the pain and other health issues I've got too take me away. April or mays edition of neurology now has a very good article on chronic pain people like us. It says that if we get the proper medical care for pain we live and without we don't do good. But now with gov taking meds away or restrictions scaring doctors I may lose now even the few I need now. Also I'm not a druggie like some say cause I have to take meds now to function all prescribed correctly . I just don't get enough to kill all the pain off. Only now about 60-70%. Myself I just hold on barely and pray more. If gov would just let doctors do they're jobs I wouldn't be suffering hrly. Unfortunately suicide is now back on the table thanks to the government playing doctors now. Best of luck to all.

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Dilaudid will come up just like Lortabs in your U/A.

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Clarification: tramadol IS a narcotic pain reliever. It is not scheduled by FDA like say morphine et al but chemically and medically, it is a narcotic (opiod) related pain reliever.

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Thanks for all the input. I have chronic pain and was considering cutting my dose of 20mg a day and stocking perhaps 5 mg a day for 6 months to yield about a gram (900 mg). To provide an exit strategy. In light of this forum, it appears too many factors to ensure success. Let alone if this is a sufficient dose. I dont understand why suicide is so taboo....We treat our pets with greater compassion than ourselves. The truth is dead patients don't generate costs. So let the suffering continue...."AT ALL COSTS".

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