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Dilaudid is a powerful drug. It can relieve pain when other opioids aren’t effective, and it can cause an intense high when misused. Misusing Dilaudid is risky. Repeated use causes profound changes to the brain.

Fast Facts: Dilaudid

Abuse Potential
Scientific Name
Drug Class
Street Names
Dust, Juice, Smack, D, Footballs
Side Effects
Rapid Heartbeat, Slowed Breathing, Cold Skin, Coma
How It's Used
Swallowed, Injected
Legal Status
Schedule II

If you’re addicted to Dilaudid or other drugs containing hydromorphone, quitting can seem like an impossible task. Despite your best efforts, you may feel like you have no control of your drug use. You may believe you have no hope.

But there is hope.

Rehab will help you overcome withdrawal symptoms and develop healthy strategies for avoiding relapse. Recovery from Dilaudid addiction is possible. Delaying opioid addiction treatment increases your risk of experiencing serious side effects, including overdose.

What Is Dilaudid (Hydromorphone)?

Dilaudid was the brand name of the first drug containing hydromorphone. It was introduced in 1926 and remained the only brand name drug that contained hydromorphone for more than 50 years. Today, people commonly refer to generic versions of hydromorphone as Dilaudid. These medications come in pill, injection and liquid forms.

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 alternative to morphine for the treatment of pain.

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 Palladone was withdrawn from the market in 2005 because it caused potentially fatal side effects when mixed with alcohol.

Forms of Hydromorphone:

  • Exalgo: Extended-Release Pill
  • Dilaudid: Immediate-Release Pill, Injection, Liquid
  • Dilaudid HP: Injection
  • Generic: Extended-Release Pill, Immediate-Release Pill, Injection, Liquid
  • Palladone: Extended-Release Pill (Discontinued)

Source: Food and Drug Administration

Dilaudid is sold in immediate-release tablets, oral solutions and intravenous injections. The Drug Enforcement Administration lists hydromorphone as a Schedule II controlled substance, meaning it has a high potential for abuse and a high chance of causing dependency.

Dilaudid High

Like other opioids, hydromorphone works by interacting with parts of the brain in charge of pain. Opioids also affect parts of the brain responsible for motivation and happiness. Some people misuse Dilaudid to get high because large doses of the drug overwhelm the brain’s pleasure center.

When you take Dilaudid as prescribed by a doctor, you typically feel pain relief, drowsiness and a mild sense of happiness. If you take hydromorphone when you aren’t in pain or if you use the drug in risky ways, you’ll feel euphoric, care-free and sleepy. You’ll also increase your risk of overdose.

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.

People who are addicted to hydromorphone tend to inject the drug or administer it rectally to increase its bioavailability, or the amount of the drug that enters the blood stream. That means a smaller dose of Dilaudid is necessary to feel its effects when it’s administered in those ways.

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Dilaudid Side Effects

People who take Dilaudid as prescribed by their doctor for short-term treatment of pain rarely experience severe side effects. But they may experience mild or moderate opioid side effects.

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 your chances of overdose.

Severe side effects and symptoms of Dilaudid overdose include:

  • Cold and clammy skin
  • Constricted pupils
  • Impaired coordination
  • Changes in blood pressure
  • Rapid heartbeat
  • Severely slowed breathing
  • Coma
  • Death

Dilaudid is stronger than many prescription opioids. Side effects of long-term Dilaudid use, such as tolerance and dependence, can develop quickly.

When you develop tolerance to hydromorphone, you require higher doses of the drug to feel the same effects. When you’re dependent on the drug, you experience withdrawal if you suddenly stop taking it.

Tolerance and dependency are common side effects of prescription drug use, but they can also be precursors of prescription drug addiction.

Dilaudid Addiction

When used as prescribed, hydromorphone is unlikely to cause opioid addiction. Addiction is defined as the compulsive pursuit of a drug despite negative consequences.

You’re more likely to become addicted if you keep taking Dilaudid after your prescription runs out or if you take it when you aren’t in pain. Misusing Dilaudid by snorting it or injecting it increases your chance of developing an addiction.

Dilaudid addiction is difficult to overcome because opioid withdrawal is unpleasant. Many people become addicted because they take hydromorphone to avoid withdrawal.

Symptoms of Dilaudid withdrawal include:

  • Restlessness
  • Sweating
  • Muscle or joint pain
  • Anxiety
  • Insomnia
  • Nausea and vomiting
  • Rapid breathing
  • Rapid heartbeat

If you become dependent on Dilaudid, a doctor can help you slowly reduce your dosage to avoid serious withdrawal symptoms. If you’re addicted to the drug, more intensive treatment may be required to help you stop taking Dilaudid and avoid relapse.

Dilaudid Addiction Treatment

It’s easy to become discouraged or fearful if you’re unable to quit taking Dilaudid. But remember, few people recover from addiction on their own. Treatment is as necessary for recovery from addiction as it is for recovery from other diseases.

Rehab facilities help you endure withdrawal. They may prescribe medications such as methadone or buprenorphine to ease withdrawal symptoms. Or they may prescribe naltrexone to decrease the risk of relapse.

All facilities provide counseling and therapy to treat underlying causes of addiction. These treatments help you understand why you use drugs and how you can stop. During rehab, you’ll develop a plan for transitioning back to everyday life and living without hydromorphone.

A key component of lasting recovery is finding purpose for your life. Support groups, such as Narcotics Anonymous or SMART Recovery, offer a community where you can thrive after treatment. Support from family and friends is also vital to long-term sobriety.

People can avoid addiction by using Dilaudid only when it’s prescribed by a 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. But people with a history of substance misuse should talk to their doctor about other methods of pain relief.

Medical Disclaimer: aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Chris Elkins, MA
Senior Content Writer,
Chris Elkins worked as a journalist for three years and was published by multiple newspapers and online publications. Since 2015, he’s written about health-related topics, interviewed addiction experts and authored stories of recovery. Chris has a master’s degree in strategic communication and a graduate certificate in health communication.
Kim Borwick, MA

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