Do I have a drug problem?

I am not familiar with some of the shorthand that you used for medications, but it sounds to me like you do have a problem. If you aren't taking them as prescribed, it is technically considered abusing them. But mostly, the description of being awake at 3:30a with the terror of them wearing off sounds like how I feel when I am having withdrawals after being in the hospital with IV dilaudid. Plus, with fibromyalgia, opioids will cause the fibro pain to be worse, so that might be some of it. I am not in your shoes and can't tell the pain you're in, but your descriptions sound more like withdrawal symptoms than the pain itself. Not sure if that makes sense or not. You have been through a lot, and I am not trying to make light of your pain, believe me. But I do think that you are abusing your meds by not taking them as prescribed. The biggest thing with pain medication addiction is that you feel like you are fully in control, and you really aren't. The ONLY way to avoid the addiction is to follow the counsel of your doctors and loved ones more than what you think in your own head.

This is the catch-22 with opiate pain medications - At first they feel like a godsend because you can finally get a little relief but tolerance and physical dependency make it so that you need more and more to get that relief and you go into withdrawal when you don't continue to take the medicine. I would have to guess that at least some of the pain you are feeling is from withdrawal. You are at a pretty high dosage of pain medication, but given your tolerance you may still be under-medicated. Doctors are very reluctant to go past a certain dosage of opiates due to the side effects and fall out from the "war on drugs" (which is a huge failure and really just makes it harder for legitimate patients to get the meds they need . . . In my opinion :) ).

That being said, you need to be careful that you are taking your medication exactly as prescribed and that you are communicating to you doctor is what he/she is prescribing is not enough. Taking it more than prescribed is abusing the medication, whether you need it or not. Research has suggested that you can reach a threshold with narcotic pain medications, where going above a certain dosage no longer helps more with pain relief and just further sedates and intoxicates patients. You need to be really honest with yourself about what you need for legitimate pain relief (and this does not necessarily mean you will be pain free, just functional).

You obviously have legitimate medical conditions that warrant the use of these powerful drugs, just be careful, because they are powerful and can take over your life if you're not careful. And if you do find that you have been abusing your medication and need help to get things under control, don't be ashamed to ask you doctors for help. This happens more than you may think with people with chronic illness, and it doesn't necessarily mean you are an addict or "drug abuser".