When I broke my humerus on 2/11, I got morphine and dilaudid IV. It barely touched the pain. Frankly, the only thing that'd make that pain go away was being completely under. For about a week.
How awful. The trouble with some of the most effective pain killers is that they're highly addictive, and in the long run may be worse than some excruciating pain. I've got an elderly relative who's permanently strung out on Oxycontin for hip and back pain, and there's no chance of ever getting her off it. But she's in her 80s and way past trying to do anything productive. In Jackson's case, I wouldn't be surprised if he's been using that kind of stuff for a long time. It would go a long way in explaining his frail-looking condition, while only in his 40s and with no specific medical problems reported other than vitiligo.
Dilaudid didn't touch it? OMG, that's synthetic heroin!