Dilaudid (Hydromorphone) Abuse and Addiction: Under the Radar and Incredibly Dangerous

While heroin, codeine, fentanyl, and oxycodone are some of the most well-known and commonly abused opioids available today, Dilaudid is actually one of the more powerful substances in this particular class of drugs.

And given the exceptional potency of this `opioid, Dilaudid (hydromorphone) abuse and addiction can be especially dangerous for nearly anyone who succumbs to it.

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Hydromorphone: What Is It Exactly?

Sold under the brand name Dilaudid, hydromorphone is a prescription only medication used to mainly treat severe pain. It comes in a number of different forms, from regular and extended release tablets and injections to suppositories and oral liquids.

While it isn’t a full synthetic opioid, it is semi-synthetic in that it is made directly from morphine and is more technically categorized as a hydrogenated ketone of morphine.

As an opioid, hydromorphone may be used properly according to a doctor’s prescription or it can (and regularly is) used as a substance of abuse.

This has led to these types of substances being categorized as Schedule II narcotics which the DEA defines as having a “high potential for abuse which may lead to severe psychological or physical dependence.”

Other Schedule II drugs include morphine, opium, codeine, hydrocodone and other painkillers used to treat chronic pain.

Dilaudid has a number of street names used today including:

  • Dust
  • Smack
  • D
  • Footballs
  • Juice
  • Drug Store Heroin
  • Lords
  • Little D
  • Dillies
  • Delats
  • Big D
  • Delaud
  • Delantz
  • Delida

Like most other opioids, hydromorphone affects the brain and body by directly interacting with specialized structures called opiate receptors, more specifically the mu-opioid receptor. These receptors match up with certain chemical structures, similar to how a specific key fits into a lock.

When the chemical with the matching structure fits into its corresponding receptor, it activates the nerve cell it’s attached to and can set off a variety of bodily functions.

According to the National Institute on Drug Abuse (NIDA), these receptors are located throughout the body and play a significant role in producing pleasure and providing pain relief as well.

Normally, these receptors are activated by natural bodily chemicals known as endorphins to produce these effects at much lower levels. However, opioids like Dilaudid are far more powerful than these natural chemicals and thus produce a much more intense effect.

Dopamine, a neurotransmitter similar to endorphins, is largely responsible for pleasure and reward responses. When we feel good after accomplishing something, exercising, reading a rewarding book, or having sex, dopamine is usually the cause.

It turns out that opioids also directly affect dopamine production in the brain as well. Over enough time, the behaviors that cause such an intense burst of dopamine become reinforced and eventually, a physical dependence develops.

Dilaudid comes in four forms that patients can administer themselves. It is also used as an injection but these shots are usually provided by a medical professional, not by the patient.

The Mayo Clinic provides the dosage guidelines below:

  • Oral Dosage Form (Tablets) – adults take 2 to 4 milligrams every 4 to 6 hours with adjustments made by your doctor as needed. Children’s dosage will be determined by the doctor.
  • Oral Dosage Form (Liquid) – adults take 2.5 to 10 milliliters or a half to two teaspoons every 3 to 6 hours.
  • Extended-Release Capsules – adults and children should take one capsule per day with the dose provided by your physician.
  • Extended-Release Tablets – adults switching from other narcotics or regular hydromorphone forms will take one table per day with the dosage determined by your doctor.

In the world of opioid abuse, some of the prescription medicines you most commonly hear about being abused are OxyContin and codeine.

However, the patterns of prolific abuse are so common in part because they are so widely available, not because they are necessarily stronger than hydromorphone.

For example, Medscape shows that the potency of 180-200 mg of codeine is actually equivalent to just 7.5 mg of Dilaudid. What’s more, 20 mg of OxyContin is also equivalent to this same amount of hydromorphone.

Even morphine, one of the most notoriously abused opioids known today, pales in comparison to the potency of Dilaudid with 10 mg of the infamous opioid (via injection) being equivalent to just 1.5 mg of hydromorphone.

So, while Dilaudid may be a little less well-known among abused opioids, it actually tends to be stronger than most, making it all the more dangerous when it comes to addiction.


How Serious Is the Opioid Epidemic?

Recent substance abuse trends have revealed that our country is in the middle of what agencies like the World Health Organization and the Centers for Disease Control and Prevention are calling an opioid epidemic.

Recent stats put out by the CDC show that the number of opioid overdose deaths has quadrupled since 1999. Today, an average of 91 Americans die every single day just from opioid overdoses alone.

To put that into perspective, opioids now kill more people than car crashes or guns. In fact, opioids are now the leading cause of death for Americans under the age of 50.

Even more terrifying is the fact that these numbers may actually be an underestimate of the true scope of the problem.

And while there are numerous legislative plans in place to try and combat this growing and deadly trend, the absolute best way of overcoming your hydromorphone addiction is by recognizing the signs of addiction in the first place.

Dilaudid Abuse Facts and Statistics

Many of the statistics surrounding the use of Dilaudid are quite surprising. For instance:

  • Dilaudid is ten times stronger than morphine and it is as much as five times stronger than heroin.
  • According to the DEA, there were 1,688 pounds of this drug that were manufactured in 1998.
  • By 2006, that amount had grown to 7,275 pounds.
  • This drug is typically best used through injections. It is available in tablet form, but it is not as bioavailable.
  • This drug passes through the blood-brain barrier much faster than other opioids. Its elimination period is also much faster.
  • The combination of these two facts makes this drug one of the most addictive opioids on the market.
  • In the 1970s and 80s, the DEA listed Dilaudid as being a leading opioid drug for abuse and addiction.
  • This drug has been approved to use in federal executions since 2009. It has only been used one time.
  • Hydromorphone prescriptions increased 200% between 1998 and 2006.
  • There were about 470,000 prescriptions written for Dilaudid in 1998.
  • By 2006, that number had gone up to closer to 2 million.
  • 6,700 people visited the ER in 2006 because of issues related to Dilaudid abuse.
  • Between 2004 and 2008, the number of ER visits because of this drug increased more than 250%.

The first step in conquering a hydromorphone addiction is actually acknowledging the symptoms of a Dilaudid use disorder in the first place. While it can be a bit tough to spot the signs of addiction in others, it may be even harder to admit that you actually have a problem.

One of the best ways to overcome this first hurdle is to take an objective look at some of the most noticeable effects of addiction. Doing so doesn’t have to take more than just a few minutes either. A quick online addiction quiz, for example, can give you a solid indication if you’re struggling with hydromorphone abuse without having to consult a physician.

For a more in-depth look, you can even consult the Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM-V. This guide contains 11 detailed scenarios that, if they sound especially familiar, probably indicate a hydromorphone addiction. Plus, it’s the criteria actually used by physicians and psychiatrists as well.

As with any other problem, the very first step in treating a Dilaudid addiction is recognizing that it’s a problem at all. And if you can take that first step, you’re well on your way to a sober, hydromorphone-free life.

When a person takes a drug like Dilaudid for the first time, they experience an intense euphoria that is unlike anything else. That euphoria is the result of the increase of dopamine in their brain.

Dopamine is a chemical that naturally occurs in the brain, and it is released all day long. People experience it whenever something good happens to them, like having a good meal. They feel happy and content. Taking opioid drugs like Dilaudid causes even more of it to be released, and that new sensation becomes the individual’s perception of feeling normal.

When the opioid drug is stopped, people typically start feeling bad. Their brains are no longer able to make dopamine on their own after some time has gone by. As a result, they start to feel abnormal and like they need to dose again. This is how addiction takes place.

But the reality is that people turn to drugs like Dilaudid for a number of different reasons. They may choose them because they are going through a difficult time and they want the drug to help them cope. Some people suffer with mental health issues, or co-occurring disorders, which we will discuss in just a moment.

One of the cornerstones of being addicted to Dilaudid and other opioids is the development of physical dependence.

After enough continuous use of these substances, your body begins to adapt to their overwhelming presence in your brain by (as NIDA puts it) “desensitize[ing] the brain’s own natural opioid system, making it less responsive over time.”

As a result, it takes abusing more hydromorphone to get the same effect as before, i.e. tolerance.

When the habitual use of Dilaudid is taken away, however, the adaptations the body has made to your system don’t work as well without consistent hydromorphone abuse. Consequently, the maladapted system produces a number of uncomfortable and even painful side effects. This is called withdrawal.

Symptoms of opioid withdrawal have been described as unbearable, excruciating, and hellish. In fact, these symptoms alone are often enough to make opioid addicts start using again, just for relief from the pain.

The symptoms include:

  • Anxiety
  • Increased tearing
  • Runny nose
  • Yawning
  • Diarrhea
  • Goose bumps
  • Vomiting
  • Nausea
  • Dilated pupils
  • Abdominal cramping
  • Sweating
  • Insomnia
  • Muscle aches
  • Agitation 

What’s more, the hydromorphone detoxification process can also be especially protracted, making it even more difficult to abstain from further Dilaudid abuse.

As a result, the best way to detox from Dilaudid is by seeking out the help of a knowledgeable and experienced addiction professional. They have access to a number of drugs and techniques to help make hydromorphone detoxification much more bearable and as well as more successful.

As with many other substances, abusing hydromorphone can lead to a long list of undesirable side effects.

Some of the most notable ones, provided by the Mayo Clinic, are:

  • Difficulty moving
  • Muscle pain or stiffness
  • Sour stomach
  • Belching
  • Diarrhea
  • Feeling sad or empty
  • Indigestion
  • Loss of pleasure or interest
  • Pain in the extremities
  • Tingling of the hands or feet
  • Unusual weight gain or loss
  • Trouble concentrating
  • Stomach discomfort
  • Muscle spasms
  • Irritability
  • Heartburn
  • Discouragement
  • Bloating or swelling
  • Back pain
  • Nausea
  • Joint pain
  • Difficulty with bowel movements

It’s also worth noting that these side effects will usually increase in severity based upon the amount and duration of Dilaudid abuse. 

Hydromorphone and Serotonin Syndrome

In addition to the effects that opioids like Dilaudid have on the neurotransmitter dopamine in the brain, recent research has also shown that these drugs may also affect serotonin production as well.

Serotonin is another neurotransmitter used in the brain to help regulate anxiety, reduce depression, and control mood, sleep, and even bone health. It is an extremely versatile chemical, as you can see. It even has been shown to have a significant role in addiction and withdrawal.

In addition to the long list of other side effects associated with opioid abuse, another less well-known risk is that of serotonin syndrome. This condition is characterized by a significant buildup of serotonin in the body to the point of causing acute toxicity.

Some of the symptoms of serotonin syndrome are:

  • Hallucinations
  • Fever
  • Shivering or shaking
  • Impaired coordination
  • Diarrhea
  • Nausea
  • Vomiting
  • Muscle stiffness or twitching
  • Excessive sweating
  • Rapid heart rate
  • Agitation

If you experience any of these symptoms seek medical help immediately as this condition may be fatal if left untreated.

One cause of such a buildup can be mixing serotonin production stimulators like opioids with other medicines that boost levels of serotonin, also called serotonergic medicines. A few of the most popular serotonergic medicines are Paxil, Prozac, Zoloft, Cymbalta, Imitrex, and Mucinex DM.

Another way of bringing on this syndrome is using opioids like hydromorphone in excess levels that cross the line into abuse.

Long-Term Effects of Being Addicted to Hydromorphone

While the science is still out on the long-term effects of Dilaudid abuse, there are a few risks associated with the drug. First off, intravenous drug use in general carries with it a host of long-term physical risks by itself.

In addition to that, continued abuse also drastically increases the odds of becoming physically dependent and ultimately addicted to hydromorphone.

According to NIDA, researchers are also currently studying other long-term effects of opioid addiction with a focus on this disorder’s impact on the brain itself.

One theory is that the depressed respiration that can result from continued opioid abuse may cause less oxygen to reach the brain. This condition is called hypoxia and it can have a number of devastating effects like coma and permanent brain damage.

What’s more, continued abuse of opioids like heroin may also reduce the amount of white matter in the brain which could significantly impair decision-making abilities, behavior regulation, and the ability to cope with stressful situations.

The Dangers of Dilaudid IV Addiction

Like many other opioids, hydromorphone is regularly abused via injection. Dilaudid in particular has an extremely low bioavailability, meaning less of the drug actually enters the blood stream when taken orally or intranasally. In fact, it’s bioavailability has been cited as low as 10% in some studies.

As a result, many hydromorphone abusers decide instead to administer the drug through intravenous injection for a stronger high that uses up less of the drug.

Abusers may crush up Dilaudid pills into a powder, dissolve that powder in a liquid, and use a hypodermic needle to inject the solution directly into the bloodstream.

There are a number of specific dangers associated with intravenous drug use though, and abusing hydromorphone this way is no exception. For instance, continuous use of intravenous Dilaudid use can lead to higher risks of contracting viral infections like HIV and hepatitis.

What’s more, repetitive abuse can also directly damage the physical health of the skin causing track marks, abscesses, collapsed veins, and serious bacterial infections that may result in endocarditis along with other cardiovascular problems.

Mixing Dilaudid With Other Drugs

Once someone is addicted to Dilaudid, they can quickly form a tolerance to the drug. That means that it takes more of it for them to feel the effects. Rather than increase how much they are taking, one of the most common ways to keep abusing it is to mix it with another substance.

There are certain drugs that people might commonly mix with Dilaudid. It is important to understand what can happen when they do.

Alcohol is typically the go-to drug that people first combine with Dilaudid. It is easy to obtain, legal, and they know it will make them feel good. According to the National Institute on Alcohol Abuse and Alcoholism, mixing the two is extremely dangerous for many reasons.

Dilaudid functions as a central nervous system depressant in the body. It has relaxing qualities, which is why people gravitate toward it. Likewise, alcohol also has these qualities, which can mean big problems when a person uses both at the same time.

Alcohol tends to enhance the effects of Dilaudid on the central nervous system. People are likely to experience extreme drowsiness and sedation. Their motor skills are decreased, which makes operating a motor vehicle even more dangerous than using either drug alone.

For people who abuse opioids, mixing them with each other can become something of an adventure. The high they typically experience is quite intense, and it can quickly become very addictive.

On the website, Erowid, one user explains his experience with combining Dilaudid with Lortab and Oxycontin. He states, “I began to shiver, and a smile spread across my face. My girlfriend asked if I was alright and I responded, ‘Yes, I’m almost in heaven…” The rush was absolutely amazing. I wanted nothing but to sit and stare at the wall. I was completely comfortable. It felt really good to rub my feet and hands together, and it reminded me somewhat of ecstasy but without the extra energy.”

He goes on to state that he, “…just became at peace with the world around me and accepted things for what they are as I float along in oblivion.”

The combination of Dilaudid and other opioids can be extremely dangerous. It can lead to significant breathing problems because they are all central nervous system depressants. Even the heart can be affected.

Cannabis products are believed to be relatively safe, and they are increasingly being legalized. For both these reasons, people often do not think twice about combining them with opioids like Dilaudid. Research has shown a direct connection between the body’s natural opioid system and the body’s natural cannabinoid system. When they are taken together, their pain relieving qualities are both heightened substantially. This may be one of the main reasons people often combine these drugs. But the other reason is that it just makes them feel good.

There are still studies being done to take a look at the effectiveness of combining opioids with marijuana for pain relief. Many experts are saying that smaller doses of drugs like Dilaudid may be necessary when someone is using cannabis. But the final results are still pending.

There can be dangerous interactions between the two when they are used in higher doses. It is best to consult a doctor before using them together.

Getting Off Dilaudid Successfully

Most people who are addicted to Dilaudid never meant for that to happen. They may have even assumed that they did not have to worry about addiction because their medication was prescribed. This could not be further from the truth.

Once a person has formed an addiction, they often want to stop as soon as possible. There are many methods they may use to accomplish this.

Cold turkey is a quitting method that is typically associated with stopping the use of cigarettes or marijuana. But people utilize it for other types of drugs too, including opioids.

Quitting Dilaudid cold turkey is never a good idea because it will very quickly throw the individual into withdrawal. The symptoms they experience could be too much for them to bear, which will only drive them back to using. Depending on how their tolerance levels have changed while they were off the drug, it could put them at risk for an overdose.

People are often eager to try to detox from drugs at home using natural methods. These might include increasing their fluid intake to flush the drugs out of their body, using supplements and other products.

At first, this method can seem to be worth trying. After all, natural means safe, and if it works, then the person will successfully quit using. But more often than not, natural drug detox is not worth the attempt, and it could actually put people in danger.

This is the best way to stop using Dilaudid. A professional drug treatment program will address both the physical and mental parts of the addiction to help people have a better chance of success.

Professional Drug Detoxification Programs

With a drug like Dilaudid, the best course of action is to begin with drug detox. This is the process of removing toxins from the body that are related to the drug use. It does take time, but with the most modern treatment methods, it can be very effective.

Medication Assisted Treatment and Medical Detox

Medical detox is so important for someone who is addicted to Dilaudid. It allows people to begin opioid replacement therapy, or ORT, to help manage their withdrawal symptoms. This type of treatment refers to medications that block the uncomfortable symptoms they experience during recovery.

Medication assisted treatment includes drugs like Suboxone, which have been shown to help people recover. A new drug called Vivitrol has shown to be even more effective, and it is not an addictive opioid.

Holistic Detox and Treatment Methods

In additional to MAT, patients are also often referred for holistic detox. This involves making significant changes in their diets and including an exercise regimen into their routine. Both of these treatment methods improve the person’s overall health and help the body detox faster.

The Importance of Aftercare

Sometimes people falsely believe that once they get through treatment, their addictions will be cured. If only that were the case. Recovering from a substance abuse problem requires ongoing treatment, and it is not accomplished in a few weeks’ time.

It is so important for people to continue to follow up with an aftercare plan. That might mean a few different things, such as:

  • Beginning an IOP after inpatient treatment
  • Transitioning to outpatient rehab
  • Attending Narcotics Anonymous meetings
  • Meeting regularly with a therapist
  • Attending any number of support groups on a regular basis

Most often, people suffer from relapses because they failed to follow through with their aftercare plans. Those who are successful are typically the people who place recovering high on their list of priorities.

Learn More About Dilaudid Addiction and Treatment Today

At The Evergreen at Northpoint, we understand how hard it is to recover from a Dilaudid addiction. This drug is extremely potent, and getting off it can be a challenge. But it is much easier with the right type of professional support.

Do you have questions about Dilaudid or how to get treatment to stop using it? Please contact us to get the help you need.

All of the information presented on this website is for informational purposes only. It is not intended to take the place of medical advice from a doctor, and it should be substituted for medical advice, a diagnosis or treatment. Relying upon anything discussed here is done at your own risk. Do not disregard medical advice you have received or put off getting help because of something you have read on this website. Please call 911 in the event of a medical emergency right away.

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