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Dilaudid is a brand name for a drug containing hydromorphone. Hydromorphone is a prescription opioid that’s also found in Exalgo, Palladone and generic pain relievers. The drug has a high potential for abuse and addiction.

  • Drug Name Hydromorphone
  • Addiction Liability High
  • Street Names Dust, Juice, Smack, D, Footballs
  • How It's Used Swallowed, Injected
  • Side Effects Rapid Heartbeat, Slowed Breathing, Cold Skin, Coma
  • Psychological Dependence Very High
  • Physical Dependence Very High

What Is Dilaudid?

Dilaudid was the brand name of the first drug that contained hydromorphone. It was introduced in 1926, and Dilaudid was the only brand name drug that contained hydromorphone for more than 50 years. Today, generic versions of hydromorphone are commonly referred to as Dilaudid.

Hydromorphone is a prescription painkiller that belongs to a class of drugs called opioids. It’s two to eight times stronger than morphine. For decades, Dilaudid was a popular second-line drug to morphine for the treatment of acute and chronic pain.

Other brand names for drugs containing hydromorphone include Exalgo, introduced in 1984, and Palladone, introduced in 2004. Both drugs come in extended-release pill formulations. Palladone was withdrawn from the market in 2005 because it caused potentially fatal side effects when mixed with alcohol.

Dilaudid is sold in immediate-release tablets, oral solutions and intravenous injections. A total of 3.9 million hydromorphone prescriptions were dispensed in the United States in 2012.

The Drug Enforcement Administration lists hydromorphone as a Schedule II controlled substance, meaning it has a high potential for abuse and a very high chance of causing physical and psychological dependency.

How Hydromorphone Works: Dilaudid vs. Other Opioids

Like other opioids, hydromorphone attaches to opioid receptors in the brain to relieve pain, but it also causes side effects such as constipation, nausea and slowed breathing. In therapeutic doses, the side effects are minor.

When Dilaudid and other immediate-release versions of hydromorphone are swallowed, they take about 30 minutes to work, and they last for about four hours. Extended-release versions of the drug last for either 12 or 24 hours.

When Dilaudid is injected intravenously, it takes about five minutes for the initial effects to kick in and 20 minutes to feel the full effect of the drug. The effects are felt more quickly than morphine’s effects but more slowly than those of fentanyl, a more powerful opioid. The bioavailability of Dilaudid is greater when it’s injected, meaning a much smaller dose of Dilaudid is necessary.

People who misuse hydromorphone take the drug without prescriptions, in higher doses than prescribed, in ways other than how it is meant to be taken or in combination with other substances of abuse. The drug has been used as a substitute for heroin, an illicit opioid, because it’s available in intravenous formulations and is stronger than other prescription opioids, such as oxycodone and hydrocodone.

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Avoiding and Overcoming Dilaudid Addiction

When used as prescribed, hydromorphone is unlikely to cause addiction. Opioids should be used to treat short-term pain from injury or surgery. No evidence confirms that opioids, such as Dilaudid, are effective at treating long-term pain.

Dilaudid is stronger than many prescription opioids, so tolerance and dependence develop quickly. When the body gets used to receiving hydromorphone regularly, it stops producing natural opioids called endorphins. If a person stops taking Dilaudid, the brain goes into withdrawal.

Tolerance and dependency are common side effects of prescription drug use, but they can also be precursors of prescription drug addiction. Addiction occurs when a person compulsively seeks the drug despite negative consequences. Misusing Dilaudid drastically increases a person’s chance of developing an addiction.

Dilaudid addiction is difficult to overcome because withdrawal is unpleasant. Symptoms of Dilaudid withdrawal include:

People who take Dilaudid as prescribed by their doctor for short-term treatment of pain rarely experience withdrawal symptoms. But they may experience side effects of taking the drug.

Common side effects of hydromorphone include:

Side effects become more severe when the drug is abused. Consuming high doses of Dilaudid or mixing hydromorphone with other drugs drastically increases a person’s chances of overdose.

Severe side effects and symptoms of Dilaudid overdose include:

If a person becomes dependent on Dilaudid, medications such as methadone or buprenorphine can ease withdrawal symptoms. Top drug rehab facilities provide medication-assisted treatments during detox, and addiction treatment centers treat underlying causes of addiction with counseling and therapy.

Many people in recovery from opioid addiction benefit from support groups, such as Narcotics Anonymous. Support from family and friends is also a key component of long-term sobriety.

Individuals can avoid addiction by using Dilaudid only when it’s prescribed by their doctor. They should notify their physician if they begin to develop symptoms of dependence or withdrawal. When used as prescribed, the drug is safe and effective.

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