Hydromorphone (Dilaudid) Addiction & Withdrawal

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What is Hydromorphone (Dilaudid)?

Hydromorphone is the chemical in the prescription drug more commonly known as Dilaudid. This substance is derived from morphine and as such is a powerful opioid drug, according to the National Library of Medicine.

Per the Journal of Opioid Management, hydromorphone is a pain reliever typically used to treat pain that results from injuries or surgeries. While the medication is effective for pain relief, it can also be dangerous, leading to abuse and serious complications.

Some people may have a legitimate need for Dilaudid and benefit from this medication without any adverse effects, but others may misuse the drug and experience negative consequences. In some cases, people may need treatment for Dilaudid abuse and addiction.

How is Dilaudid Classified?

As noted previously, Dilaudid belongs to a class of drugs called opioids, which are used primarily to treat pain. Some people may refer to this class as narcotics.

In the legal arena, Dilaudid is classified as a Schedule II Controlled Substance, according to the U.S. Drug Enforcement Administration (DEA). This places Dilaudid alongside other prescription opiates such as oxycodone, fentanyl, hydrocodone, and methadone, as well as ADHD medications, including Adderall and Ritalin. Cocaine and methamphetamine also fall into this category.

Dilaudid Side Effects

Dilaudid may be a prescription medication, but that does not mean it is without adverse effects. The Food and Drug Administration (FDA) has reported the following side effects associated with Dilaudid:

  • Lightheadedness/Dizziness
  • Sedative Effects
  • Nausea and Vomiting
  • Sweating
  • Euphoria
  • Flushing
  • Dry Mouth
  • Itching
  • A Sense of Dissatisfaction 

While the above are the most common Dliaudid side effects, not everyone will experience negative reactions to this drug. On the other hand, in rare cases, people may suffer more severe side effects, such as diarrhea, heart palpitations, blurred vision, weakness, tremor, agitation, anxiety, sleep problems, rashes, high or low blood pressure, or difficulty urinating.

Dilaudid Addiction

Dilaudid is a prescription medication, but that doesn’t mean it cannot be abused. Some people may misuse this drug, which can involve taking larger doses than a doctor prescribes, taking a prescription that belongs to someone else, or purchasing the drug illegally from a drug dealer. People may abuse Dilaudid because they enjoy the pain-relieving effects, or they may take it because it creates euphoria, which can cause a person to feel “high.”

Is Dilaudid Addictive?

When people misuse Dilaudid, they may develop a tolerance to the drug, meaning they need more and more of it to achieve the same desirable effects. Over time, this can lead them to take very large doses of the drug, until they become dependent, which means the body cannot function optimally without it.

As the National Institute on Drug Abuse has explained, dependence is not the same as addiction, but dependence and addiction typically occur together. While dependence means that a person cannot function without a drug and will experience withdrawal in its absence, addiction involves compulsive drug use that continues even as a person experiences negative consequences.

The FDA has warned that Dilaudid can be additive, cautioning that it poses a risk for misuse, abuse, and addiction, even among people who have legitimate prescriptions and take the recommended doses of the drug. For this reason, the FDA advises that doctors should prescribe the lowest possible dose to achieve the desired pain-relieving effects, and prescribe Dilaudid over the short-term. In addition to this warning from the FDA, it is important to remember that Dilaudid is a Schedule II Controlled Substance, which, according to the DEA, means it has a high potential for abuse and can lead to severe dependence.

Signs of Dilaudid Addiction

If a person becomes addicted to Dilaudid and seeks treatment, an addiction professional will diagnose an opioid use disorder, which is the clinical term for addiction to drugs like Dilaudid. There are specific diagnostic symptoms of an opioid use disorder. These include the following:

  • Using larger doses of Dilaudid than intended
  • Being unable to stop or decrease Dilaudid use
  • Giving up important activities, such as socializing or recreation, to use Dilaudid
  • Failing to meet obligations at work or home because of Dilaudid use
  • Spending large amounts of time using or obtaining Dilaudid
  • Experiencing intense Dilaudid cravings
  • Continuing to use Dilaudid despite relationship difficulties
  • Using Dilaudid even when it results in danger
  • Continued Dilaudid use even when it is associated with physical or mental health problems

Given these diagnostic criteria, some behaviors that might indicate Dilaudid addiction include failing to fulfill parenting duties because of drug use, giving up friendships in favor of Dilaudid, or missing work due to being under the influence. Some other behavioral signals could include going to multiple doctors to try to obtain more Dilaudid pills, driving while under the influence of the drug, or using it even if it is causing health issues, such as gastrointestinal problems or worsened anxiety.

Dilaudid Abuse Statistics

To further demonstrate the extent of Dilaudid abuse and addiction, it is helpful to review Dilaudid statistics. The DEA has reported that as of 2016, 2.1 million people in the United States used Dilaudid. By 2018, this figure had dropped to 1.8 million people. Furthermore, 239,000 people had misused Dilaudid as of 2016, compared to 229,000 in 2018.

It appears that here has been a slight decline in rates of Dilaudid use and abuse over the last several years, but that does not mean that there are not risks associated with the drug. Given the potential for Dilaudid to be dangerous, it is still important to take seriously the potential consequences of this drug.

Dilaudid Overdose

In addition to side effects, which range from mild to severe, Dilaudid use and abuse can cause overdose. Large doses of Dilaudid can cause a person to experience an overdose, and a person is especially at risk when beginning to use Dilaudid. Mixing this medication with benzodiazepines like Xanax, as well as alcohol, muscle relaxers, other pain medications, sleeping pills, or sedatives can also elevate the risk of an overdose. According to the U.S. National Library of Medicine, some Dilaudid overdose symptoms include the following.

Dilaudid Overdose Symptoms

  • Cold and clammy skin
  • Sleepiness
  • Weak muscles
  • Dizziness and fainting
  • Slow heart rate
  • Loss of consciousness
  • Slowed or completely stopped breathing

It is important that a person receive emergency medical care in the case of a Dilaudid overdose. Medical staff can administer a medication called naloxone, which can block the effects of high levels of opioids and reverse a Dilaudid overdose.

Hydromorphone (Dilaudid) Withdrawal

The research shows that Dilaudid addiction is a possibility, and those who do become addicted are likely to experience some withdrawal symptoms if they try to stop using the drug. As mentioned, addiction tends to go hand-in-hand with dependence. This means that a person is unable to function properly without a drug and will experience unpleasant symptoms if he or she stops using.

With Dilaudid addiction, a person is likely to experience some of the following opioid withdrawal symptoms, according to the National Institute on Drug Abuse.

Dilaudid Withdrawal Symptoms

  • Restless Behavior
  • Pain in the Muscles or Bones
  • Sleep Problems
  • Nausea and Vomiting
  • Cold Flashes
  • Goose Bumps
  • Uncontrollable Leg Movements

The above symptoms can be extremely uncomfortable and make it difficult for a person to stop using Dilaudid.

Treatment Options

While a detox program can help people to get through Dilaudid withdrawal symptoms, withdrawing is only the first step in the treatment process. To fully recover from Dilaudid addiction and abuse, it is important to receive ongoing substance abuse treatment to address the underlying psychological issues that contributed to the addiction. Ongoing treatment can occur either in an inpatient facility or in an outpatient clinic. Treatment typically involves a combination of individual and group therapy.

The specific type of therapy can vary based upon personal choice and each individual’s unique needs. One form of therapy that can be useful for treating addiction is cognitive-behavioral therapy (CBT). With CBT, people can replace unhealthy thoughts about drug use with rational, helpful ways of thinking. For example, a person who thinks that life is meaningless without Dilaudid can use skills learned in CBT to identify areas of life that are fulfilling but do not involve drug abuse.

Relapse prevention programs are also an important part of Dilaudid addiction treatment. In these programs, people can learn to identify triggers for Dilaudid abuse and learn ways to cope with triggers so they do not threaten sobriety.

In addition to behavioral treatment, it is common for people to continue to take medications like buprenorphine or methadone while in ongoing addiction treatment. According to a research review in Neuropsychiatric Disease and Treatment, buprenorphine seems to be the preferred medication for treating addiction to prescription opiates like Dilaudid. Studies show that buprenorphine is both safe and effective, and people are less likely to abuse it when compared to methadone. When combined with behavioral therapy, medications like buprenorphine can help people to be successful in treatment for Dilaudid abuse and addiction.

Getting Help for Dilaudid Withdrawal

Dilaudid withdrawal can cause unwanted side effects, so it is often necessary for a person to receive help when withdrawing. Detox programs can help people to undergo Dilaudid withdrawal and remain as comfortable and safe as possible.

When receiving help for Dilaudid withdrawal, a person in detox will have access to 24-hour medical care and supervision. According to the World Health Organization, when a person experiences a mild case of withdrawal from an opiate like Dilaudid, staff in a detox program will typically administer treatment to address symptoms as they arise, while ensuring that patients drink enough fluids to replace those lost to nausea and vomiting.

For moderate to severe opiate withdrawal, it is not unusual for patients to be prescribed buprenorphine or methadone to make them more comfortable. Both of these drugs can reduce cravings for Dilaudid and ease withdrawal symptoms. A newer drug called lofexidine is also available to treat opioid withdrawal symptoms and may be an option for those in detox from Dilaudid.

Dilaudid Withdrawal FAQs

Beyond the detailed information provided herein, it can be helpful to quickly refer to some frequently-asked questions about Dilaudid:

What does Dilaudid look like?

According to the DEA, Dilaudid is available as a tablet that is taken by mouth or in a liquid solution that is swallowed. Furthermore, it is sometimes in the form of a liquid solution that is administered under the skin. Dilaudid tablets are available in 2 milligram, 4 milligram, and 8 milligram doses. The 2-milligram pills are round and light orange in color, whereas a 4-milligram tablet is round but light yellow. The 8-milligram tablets appear as white triangles.

Do people use street names for Dilaudid?

Since Dilaudid has a potential for abuse, people may try to hide their use of the drug by referring to it with street names. These include terms such as Dillies, Dust, Smack, Juice, Footballs, and D. A person who uses these terms may be trying to keep his or her drug use secretive.

How much Dilaudid does it take to become addicted?

Whether a person becomes addicted to Dilaudid depends upon the dose he or she is taking, as well as unique factors like a person’s genetics, history of addiction, and general health. The U.S. National Library of Medicine reports that addiction is more common with long-term use. Those who take large doses of Dilaudid over the long-term or who abuse the drug are likely at the greatest risk of addiction, so it is important to take the drug exactly as a doctor prescribes and to avoid large doses or long-term use if possible.

How long does Dilaudid withdrawal last?

According to the World Health Organization, withdrawal from short-acting opioid drugs like Dilaudid tends to begin eight to 24 hours after a person stops using, and symptoms can last for four to 10 days. On the other hand, there is an extended release form of hydromorphone called Exalgo. If a person has been using hydromorphone in this form, withdrawal symptoms may take longer to appear but last for up to 20 days.

Can a person die from taking Dilaudid?

While Dilaudid can be safe for those who take it as prescribed while under the care of a doctor, abusing the drug can lead to a fatal overdose. Someone who takes too high of a dose can suffer from the effects of opiate overdose, which include breathing problems that can cause death if left untreated. This is why a person should never take Dilaudid that is not prescribed or use larger doses than a doctor recommends. Without proper medical advice, a person can take too high of a dose and die from overdose.

What is the difference between hydromorphone vs. hydrocodone?

While the two drugs have similar names, hydromorphone and hydrocodone are different substances. Both drugs are opioids with pain-relieving effects, but hydromorphone is typically available under the name Dilaudid, whereas hydrocodone is commonly prescribed as Vicodin. Despite having similar effects, Dilaudid may be stronger than Vicodin. A study in Drug and Alcohol Dependence found that hydromorphone was modestly stronger than hydrocodone, but the two drugs carry a similar potential for abuse.

While the two drugs have similar names, hydromorphone and hydrocodone are different substances. Both drugs are opioids with pain-relieving effects, but hydromorphone is typically available under the name Dilaudid, whereas hydrocodone is commonly prescribed as Vicodin. Despite having similar effects, Dilaudid may be stronger than Vicodin. A study in Drug and Alcohol Dependence found that hydromorphone was modestly stronger than hydrocodone, but the two drugs carry a similar potential for abuse.

It is never safe to take Dilaudid that belongs to someone else, to take extra doses, or to buy this drug illegally from a drug dealer. Dilaudid abuse can lead to addiction and have serious consequences. Those who are misusing Dilaudid or having difficulty giving up this drug should seek treatment to avoid devastating outcomes like a fatal Dilaudid overdose.

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