In this randomized controlled trial, 2 mg intravenous (IV) hydromorphone will be more
efficacious than usual care (usual care is analgesic management according to the judgment of
the attending physician caring for that patient) in emergency department (ED) patients aged
21-64 years. The primary efficacy outcomes are the proportion of patients in each arm who
choose to forgo additional pain medication in 30 minutes of entry into the study and the
change in numerical rating scale (NRS) pain scores from baseline to 30 minutes post baseline.