I agree it's easier to give the pain meds when they are due or needed. I also agree with the op. The system is broken. There is a huge heroin addiction problem in the United States in areas of the Country that are considered middle class and not the typical " drug addict" stereotype. Many of these people were once prescribed pain meds from their doctors and then because prescription pain medication has become an issue they are being more controlled to prescribe in many states. These people are turning to heroin, because the dr is no longer prescribing. Dilaudid should not be the go to medication for pain... It is very addicting. I have had PTs and many of you have that not only want their dilaudid but want a cocktail of dilaudid, benedryl, phenergan, all pushed in a certain order etc. I have seen patients flat out lie to the doctors saying they can't hold any food down cause of abdominal pain but have friends and family bring them McDonald's. And the doctor is aware. Dilaudid shouldn't be the one pain med we seem to give. It's very potent and I even had a patient admit to me that they can't live without it IV because it feels so good. And they get sent home after months yes months of refusing to be discharged or having new symptoms when she knows she is being discharged and then they finally discharge her and they are right back in the ER in a few days... I hope she doesn't eventually turn to heroin or something that isn't monitored in a hospital setting, but I do know that I spoke with the dr and he says she is having abdominal pain... That's that. We all know what's right, unfortunately there is nothing we as bedside nurses can do in three shifts per week.