What Causes Persistent Pain While On Dilaudid?
several points.
Detailed Answer:
First it might be nice to look for some treatment other than narcotics:
1) a treatmetn for the underlying disorder (unlikely in most disk disese) or
2) nerve dampening medicines such as lidocaine, capcaicin, anti-epileptics and amitryptilin.
second, narcotics work to change the perception of pain by methods that are by their nature not separate from ones own internal wiring. Several points on this: most important is that relief of pain narcotics are quite good at but removal of it is not something these drugs can ever do and thinking that a bit more will change this is sadly deluded. Furthermore, they do not work differently than other non-narcotic modalities such as physical exercise and conditioning.
Then, "fly under the radar" is making it the doctor's preference rather than either legal entities such as medical boards or plain good sense that at some level narcotics are dangerous and should not be increased beyond a certain dose. Certainly with a fatal cancer this does not apply. Otherwise continuing to escalate dilaudid is likely to eventually be a fatal disorder. At some point it is just a bad idea to increase the narcotics.