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Drugs containing hydromorphone, such as Dilaudid and Exalgo, can effectively treat pain, but they have a high potential for abuse and addiction. Hydromorphone addiction can lead to severe side effects, including overdose. Drug rehabilitation centers help people recover from hydromorphone 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 Hydromorphone?

Hydromorphone is a prescription painkiller belonging to a class of drugs call opioids. Brand name drugs such as Dilaudid and Exalgo contain hydromorphone, which is two to eight times as strong as morphine. Hydromorphone has sedative properties, but the effects of the drug are usually short-lasting.

Hydromorphone comes in tablets, suppositories and liquid solutions that can be taken orally or injected. A total of 3.9 million hydromorphone prescriptions were dispensed in the U.S. in 2012. The U.S. Food and Drug Administration approved an extended-release version of hydromorphone called Palladone in 2004, but the drug’s sponsor removed it from the market the following year after new data showed its combination with alcohol could be fatal.

The U.S. 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.

People who abuse 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 also been used as a substitute for heroin, an illicit opioid. Abusing hydromorphone drastically increases a person’s chance of developing an addiction.

Hydromorphone Addiction

Drugs containing hydromorphone, such as Dilaudid, can lead to physical dependency in a short period of time. The drug works by changing the way the brain and nervous system respond to pain. After a short period of time — sometimes a few weeks — the body gets used to the presence of the drug. The brain eventually requires a larger dose of the drug to feel the same effects, a phenomenon called tolerance.

Tolerance and dependency are common precursors of hydromorphone addiction. Addiction occurs when a person begins to compulsively seek the drug despite negative consequences. People with a dependency or addiction to hydromorphone suffer withdrawal symptoms when they stop taking the drug.

Dilaudid was one of the most common opioids of abuse before the rise in popularity of oxycodone and hydrocodone — newer prescription opioids. Abusing hydromorphone can cause life-threatening side effects, including death by overdose.

Symptoms, Side Effects and Risks of Hydromorphone Abuse

People who take hydromorphone as prescribed by their doctor may experience mild side effects. It can cause minor changes in mood such as nervousness or restlessness. However, side effects of hydromorphone are usually temporary or negligible when used as prescribed.

Common side effects of hydromorphone include:

Side effects become more severe when the drug is abused. Consuming high doses of hydromorphone or consuming the drug in improper ways — such as snorting or injecting it — drastically increases a person’s chance of overdose.

Severe side effects and symptoms of hydromorphone abuse and overdose include:

Drugs have been developed to counteract the effects of opioid overdose. Naloxone can neutralize respiratory depression caused by hydromorphone. People suffering from hydromorphone addiction or dependency should seek treatment to recover.

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Treatment for Hydromorphone Addiction

Opioids such as hydromorphone change brain chemistry. Trying to quit cold turkey can cause serious and dangerous withdrawal symptoms, because the brain gets used to the presence of the drug.

Symptoms of hydromorphone withdrawal include:

Treatment at a drug rehab facility can ease a person’s withdrawal process in a safe environment. Treatment will also help people change behaviors that contribute to their addiction and give them resources for life-long recovery.


Drug rehab facilities begin treatment with supervised detoxification. Depending on the length and severity of hydromorphone addiction, a doctor may recommend slowly decreasing the dose of medication during detox. Detox isn’t easy, but some medications can help with symptoms of withdrawals.

Medications used to treat opioid addiction include:

Because withdrawal is different for everyone, the length of detox and types of medications used will vary.

Common Therapies

Medication can help patients during the detox process, but counseling and therapy assist in preventing relapse in the future. Therapy treats underlying causes of addiction, including co-occurring mental health disorders, problems at home or other stressors in life. Common therapies for hydromorphone addiction include cognitive behavioral therapy, contingency management and motivational incentives therapy.

Continuing Support

Recovery from drug addiction doesn’t end after detox. People recovering from hydromorphone addiction often transition from treatment facilities to sober living homes or other safe living environments. The goal is to avoid people or situations that may cause stress and lead to relapse.

Support groups such as Narcotics Anonymous are popular among people in recovery, and support from family and friends is a key component of long-term sobriety. With hope, dedication and support, people regularly recover from hydromorphone addiction.

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