Dilaudid (Hydromorphone) Abuse and Addiction: Under the Radar & 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.
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:
- Drug Store Heroin
- Little D
- Big D
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 Addiction Symptoms
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.
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:
- Increased tearing
- Runny nose
- Goose bumps
- Dilated pupils
- Abdominal cramping
- Muscle aches
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
- Feeling sad or empty
- 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
- Bloating or swelling
- Back pain
- 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:
- Shivering or shaking
- Impaired coordination
- Muscle stiffness or twitching
- Excessive sweating
- Rapid heart rate
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.
How to Wean Off Dilaudid
As you can see, coming clean off of opioids like hydromorphone can be an incredibly challenging process. Not only are the symptoms particularly painful and difficult to withstand, they can also end up lasting for several weeks at a time, making it all the more likely that you’ll want to return to abusing the drug.
And given the current opioid epidemic that the country is facing today, it’s no wonder addiction professionals and scientists are continually working to find better treatment alternatives to simply going cold turkey.
For example, opioid replacement therapies (ORTs) are a type of medication-assisted treatment (MAT) that use milder and less dangerous opioids to manage and sometimes block the uncomfortable symptoms of opioid withdrawal.
Medications like Suboxone, for instance, contain buprenorphine which is just such an opioid. It can help prevent the painful withdrawal symptoms without providing the same euphoria that ends up turning opioids into a substance of abuse for many addicts.
As a result, users who may not have been able to withstand the excruciating symptoms of opioid withdrawals can now have a fighting chance against this crippling substance use disorder and make detoxing from Dilaudid and other opiates much more bearable.
Hydromorphone: Under the Radar Yet Exceptionally Powerful
While other opioids like heroin and oxycodone may be the most recognizable causes of opioid dependency, the truth is there are a number of other drugs on the market today that are actually much more potent.
Dilaudid is just one of those substances.
And if you suspect you may be developing a hydromorphone addiction, the absolute best thing you can do is get in contact with an experienced and dedicated drug rehab center today.
Do you have questions about Dilaudid addiction or rehab? Please contact us to get the help you need.
Talk to a Rehab Specialist
Our admissions coordinators are here to help you get started with treatment the right way. They'll verify your health insurance, help set up travel arrangements, and make sure your transition into treatment is smooth and hassle-free.(425) 629-0433 Contact Us