High opioid tolerance and metabolism. Wrenched my lower back in motorcycle accident five years ago. At this juncture Nucynta ER at 500mg 3X daily along with 6mg Dilaudid as needed provides about as much relief as taking sugar cubes. Does this kissing cousin to Ulram, tightly regulated opioid (intended by its manufacturer to be schedule 111) do anything related towards providing strong analgesia - or is it just an overpriced placebo for dupes who are tired of being duped by DEA scheme to rid Amerika of the Opioid menace to doctors and patients?