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Hi. Dr. Ashori here.
Even once a week use of dilaudid will cause tolerance.
Maybe if used every 2-3 months, even then with dilaudid the risk of tolerance is higher.
With dilaudid even 2mg can cause major risk of sleep or respiratory depression though much less likely if someone has taken this for some time.
The use of benzo and cocaine together would not offset the effects, they would augment the catecholamine effects and increase risk of sudden death and cardiac risks.
This is hard to explain on this platform but it has to do with the bezos actually causing a short time of low catecholamines but in reality heightening the overall release of catacholamines.
That's correct, dilaudid is very concentrated so much higher chance of tolerance.
Some patients try propranolol which is a beta blocker, that might work for you.
Hope my answers were helpful.
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M. Ashori MD