Started Dilaudid (hydromorphone) a year ago for pain and I am trying to work out whether what I am feeling now is tolerance or something else.

Pharmacist, not doctor, is where the useful advice has come from every single time.

There is a point in the afternoon where the effect is gone and the restlessness starts, and that point has moved earlier over a year.

My pharmacist was more useful than the appointment, and it was a two minute conversation at the counter.

Sleep is the variable that moves everything else. Bad night, worse day, more constipation.

Posting partly so that the next person searching finds an answer sooner.