A 32-year-old man presents to the emergency department(ED) with generalized joint pain of several days'duration, which he believes is a sickle cell crisis similarto others he has had. He says that 4 to 6 mg of oralhydromorphone usually relieves the pain of these crises,but he recently ran out of his medication and is unableto contact his primary care physician because she ison vacation. He frequently interrupts to ask for a 6-mghydromorphone injection.
