It has definitely crossed my mind that some of the alternate pain relief therapies have gone out the window such as meditation, massage etc. but really, who has time for that? Push the drug and let's go. Now, if I had patients like you and me and didn't want to be all screwed up on dilaudid then I would find the time... Also, you have to maintain your boundaries. If they understand the consequences and choose to continue down that path, you just have to protect your own sanity and go along with it with a smile on your face. You can really drive yourself crazy trying to save those that don't want saving.