<s>[INST] hi, my name is justin and i suffer from chronic pain for several different reasons and i take creams, do physical therapy, exercise, and take medications. my question is what i can take that is equal to or similar to dilaudid 8 mg tab? I take methadone primarily but sometimes (mostly at night) I have to take another medication for breakthrough pain and i am prescribed dilaudid 8mg tablets and they don t seem to work very well. [/INST] Hi, Okay, the methadone does not appear to be prescribed. Taking opiates that are not prescribed is dangerous, illegal and signals more of an issue than just pain. The other key point is that the system gets used to opiates and more and more is needed for the same effect. The fatal dose does not increase to the same degree and this, of course, leads to a dangerous situation. Addiction treatment with methadone is usually helpful with pain. Hope I have answered your question. Let me know if I can assist you further.  </s>