What Is Hydromorphone (Dilaudid)?
Dilaudid is one brand name for hydromorphone, an opioid painkiller made from morphine. Other brand names include, Exalgo and Palladone. Some street names for hydromorphone include: Dillies, Big D, M-80s, and Peaches.
Hydromorphone is usually prescribed in 2mg or 4mg doses, to manage chronic pain or pain resulting from emergency situations. Dilaudid is also available in an oral liquid, but it is mainly used for emergencies in a hospital setting, due to its fast-acting properties.
Dilaudid takes effect about 15 minutes after consumption, and can last up to six hours or more in some individuals. The medication acts on the central nervous system (CNS) and modifies the way the body perceives sensations of pain and pleasure.
Previous studies have indicated that hydromorphone is six to nine times more potent than morphine. However, a more recent study reports that this may be an overestimation, and hydromorphone may only be two to three times stronger than morphine.
As morphine is considered to be one of the strongest opioids, hydromorphone is extremely potent. Due to its potency, Dilaudid may be considered more addictive than other opioids.
Hydromorphone Abuse Vs. Addiction: What’s The Difference?
Drug abuse happens when a person uses illegally or legally obtained drugs in an inappropriate manner. This includes repeated drug use in an attempt to avoid or alter one’s reality, according to the National Institute on Drug Abuse (NIDA).
Addiction, as defined by the NIDA, only occurs when a person cannot control the psychological urge to use drugs, even when there is a high possibility of self-harm or death.
When someone starts abusing drugs like hydromorphone, this abusive behavior can develop into an addiction. Opioids like Dilaudid temporarily change brain chemistry. With frequent abuse, these chemical changes can cause permanent, structural changes to the brain, which are thought to influence addictive behaviors.
Signs And Symptoms Of Hydromorphone Abuse
Signs and symptoms of hydromorphone abuse can vary from person to person. Hydromorphone is a fast-acting narcotic, and chronic abuse can quickly lead to drug tolerance. Tolerance to hydromorphone can develop within two to three weeks of misusing the drug.
When someone abuses hydromorphone, it is possible for them to experience side effects of the drug.
Side effects of Dilaudid abuse may include:
- trouble falling or staying asleep
- dry mouth
- muscle spasms
- slowed breathing
- mood swings
- stomach pain
- flushing or itching
While under the influence of large doses of hydromorphone, it is common for people to appear drunk. They will lack coordination, slur their words, and may fall asleep in the middle of sentences.
Once a tolerance is established, more frequent and larger doses of hydromorphone will be required to produce the same effect a smaller dose once had. People taking hydromorphone as a prescription may find that they are finishing their prescription ahead of time.
Individuals who developed a tolerance to Dilaudid will also experience withdrawal symptoms as the drug wears off. Experiencing withdrawal symptoms is the key sign that an addiction has developed. Anyone who wishes to stop taking Dilaudid but is not able to may be suffering from addiction.
As abuse crosses over into addiction, certain behavioral changes may occur. These lifestyle or personality changes can include:
- forging prescriptions for hydromorphone
- doctor shopping (visiting several, different doctors to obtain multiple prescriptions)
- spending large amounts of money to obtain hydromorphone illicitly
- isolating themselves from family and friends
- lying to family and friends about their drug use
How Is Hydromorphone Abused?
It is common for people abusing Dilaudid to inject the drug by crushing it and mixing it with water. Others abuse Dilaudid by crushing the pills into a fine powder and snorting them. Similar to other opioids, abusing hydromorphone causes an intense sense of relaxation, which is thought to play a role in addiction.
However, even if someone is abusing hydromorphone, the abusive behavior will not necessarily turn into an addiction. Addiction becomes likely when abuse is left unchecked and untreated.
Dangers Of Hydromorphone Abuse
Some of the dangers of hydromorphone abuse include overdose and potentially death. Taking larger than normal doses of Dilaudid may lead to fatal breathing or heart problems.
Mixing hydromorphone with other CNS depressants like alcohol or other drugs increases the likelihood of overdose and death.
Some complications of hydromorphone overdose can include:
- nausea and vomiting
- collapsed veins
- stomach pain
- cold, clammy skin
- heart attack
- trouble breathing
People who abuse Dilaudid by injection are also at an increased risk for contracting or transmitting HIV/AIDS and hepatitis.
Drug abuse and addiction can impact other parts of someone’s life, and lead to problems such as:
- financial burden from purchasing high-priced hydromorphone illicitly
- family issues from prioritizing drug use over social obligations
- incarceration due to theft or forging prescriptions
- increased likelihood of becoming addicted to stronger and cheaper opioids, like heroin
Hydromorphone is particularly dangerous due to its potency, which causes tolerance to develop more quickly. Prescription opioid pain medications, like Dilaudid, caused 19,000 deaths in the U.S. during 2014.
Teenagers are more likely to abuse hydromorphone.
The likelihood of teenagers abusing hydromorphone is higher than with other age groups. Teens are more likely to abuse Dilaudid because it is more easily accessible to them through friends and family who have prescriptions.
Hydromorphone withdrawal occurs when someone has developed a physical dependence on the drug. After using the drug for an extended period of time, the body becomes used to operating with that level of Dilaudid in its system.
However, when suddenly stopping use of the drug, the level of hydromorphone in the body drops drastically and this causes the body to respond with uncomfortable withdrawal symptoms.
Withdrawal symptoms from hydromorphone include:
- muscle and bone pain
- drug cravings
- body cramping
- cold sweats
- nausea and vomiting
- dysphoria (feeling uneasy, depressed, and anxious)
- suicidal thoughts and behaviors
It is never recommended to withdraw from powerful opioids like hydromorphone without help. Due to the intense cravings reported by those who have detoxed from the drug, it is a much safer option to undergo detox in a medically-supervised environment.
Medically-supervised Hydromorphone Detoxification
Medically-supervised hydromorphone detoxification may involve tapering off the dose of hydromorphone currently tolerated by the person misusing the drug. Or, it may involve replacing hydromorphone with methadone or buprenorphine. In some cases both options will be used to ensure that unpleasant withdrawal symptoms will not lead to relapse.
Generally, it takes about a week to detox from hydromorphone. After the initial detox, some people will choose to enroll in an inpatient program to continue with supervised treatment. These programs usually involve different types of therapy as part of the treatment that help individuals change their habits and behaviors so they can continue to live opioid-free.
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Treatment For Hydromorphone Abuse And Addiction
Successful treatment for hydromorphone abuse and addiction involves a comprehensive look at individual circumstances and a robust aftercare plan. Detox is only the first step towards recovery.
Recovering from drug addiction is a long-term process, and an aftercare plan can help individuals stay on track with the use of 12-step programs or other support groups. With time, aftercare becomes less intense, but ongoing support is usually needed to ensure a drug-free life.
To find out more about hydromorphone abuse, addiction, and treatment, contact us today.
The National Center for Biotechnology Information—The Relative Abuse Liability of Oral Oxycodone, Hydrocodone and Hydromorphone Assessed in Prescription Opioid Abusers
U.S. National Library of Medicine, MedlinePlus—Hydromorphone