Does This Sound Like Dilaudid Abuse / Addiction?

My 50-year old brother started taking dilaudid 14 months ago. At this point he takes about 48 mg daily. He originally started on it due to "mild" tennis elbow. I put the "mild" in quotation marks because I accompanied him to the radiologist and that is what they read out from the MRI. He has since claimed that both elbows are affected (very rare) and now he has pain in both hips. He has only had arthroscopic surgery - no major surgery requiring serious pain medication. Yet he continues to take dilaudid and even claims he still has serious, chronic pain. He has not worked in 14 months, he spends most of his time in bed and has stopped doing all he enjoys. When challenged, my brother claims I don't understand what it's like to have chronic pain. Yet I can't help but think this is dilaudid addiction as various doctors find it strange that he has so much pain when nothing serious appears on MRIs, X-rays, etc. What do you think? Is 48 mg daily a lot to be doing over an extended period of time when there hasn't been major surgery? Or am I not being sympathetic to his chronic pain, which as he points out, cannot be measured?

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There are some conditions that could cause these kids of symptoms, such as fibromyalgia, which would not show on various imaging tests, but only a doctor is qualified to make such a diagnosis.

Is his doctor prescribing him that much? That is a very high dose and not commonly given in such amounts.

The FDA warns that this medication carries the risk of being habit forming and may cause side effects, such as nausea, dizziness, headache, dry mouth, and constipation.

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