Hydromorphone (Dilaudid) and the Potential for Addiction

A person’s use of hydromorphone or Dilaudid may begin safely, after developing a pain condition or using the medication for pain relief after surgery. Because of this medication’s classification as an opioid, it can become addictive, however, if it is not used with caution.

What Is Hydromorphone?

Hydromorphone is an analgesic opioid drug with notable sedation properties and a short course of action in the body. Because of this short action within the body, the person taking it will have to take it more frequently than a medication that has a longer course of action. Hydromorphone’s analgesic action is more potent than morphine, making it an effective painkiller, according to Suffolk University.

This medication can be obtained by prescription, though it is also sometimes sold illegally on the street. In the US, it’s considered a Schedule II drug under the Controlled Substances Act. If someone begins struggling with misuse of this medication, they may become both physically and psychologically dependent on it.

Intended Use

Hydromorphone was developed to help people who suffer with moderate to severe pain. This medication works by acting on chemical interactions inside the brain.

Even with legitimate use via a prescription, side effects may occur while taking hydromorphone. Potential side effects include:

• Constipation
• Nausea and vomiting
• Dizziness
• Lightheadedness
• Drowsiness
• Skin flushing
• Sweating
• Dry mouth

According to RxList, once the person has been taking this medication for a while, these side effects may lessen or cease altogether. However, if you experience any of these side effects, talk to the prescribing physician promptly.

Who Is a Target for Abuse?

Those who start out with a legitimate prescription for Dilaudid may begin to abuse the drug in time. It is easy for the person to develop a tolerance to the effects of this medication, according to Illinois Eastern Community Colleges. This means that it takes higher dosages of the drug to feel its effects. This may lead the person to increase their dosage so they can continue experiencing the same effects of the medication. Once a person begins increasing their dosage or taking the drug more often than prescribed, they are abusing the drug.

In an effort to feel the effects of the drug more intensely, people may alter the way hydromorphone is taken. They may chew pills rather than swallowing them whole. They may crush the pills and then snort the powder. They may crush the pills, mix the powder with water, and then inject the resulting mixture. Altering the medication in any way can increase the development of an addiction.

Other people may use hydromorphone recreationally. They don’t have a prescription for the drug but they may get it from friends or family members. They aren’t taking the medication in an effort to reduce legitimate pain; rather, they are taking it to experience euphoric effects. Oftentimes, those who use the drug recreationally mix it with other substances, such as alcohol. Mixing Dilaudid with other substances increases the negative effects associated with use, including the risk for overdose.

How Addiction Develops

When a person has been taking Dilaudid regularly, the body can become physically dependent on it, according to Consumer Reports Health. This means that, once the person stops taking the medication, the body will have to adjust physically to the absence of the medication. They may feel shaky, sweaty and restless. They may suffer from involuntary muscle movements, cold flashes, irritability, and insomnia.

A person can become physically dependent on opiates like hydromorphone without being addicted. In fact, those who use the drug as prescribed can become physically dependent on it. When the person becomes psychologically dependent on the medication, feeling as if they need it to get through the day, or abusing it in any way, it is a clear sign of addiction.

If a person has a family member who has suffered from addiction, they are at a higher risk of becoming addicted to hydromorphone. Also, if a person has a history of addiction to any substance, they are at a higher risk for Dilaudid addiction. If any history of addiction is present, personally or in a family member, it’s important to inform the prescribing doctor.

Overdose

As with all opiates, overdose is always a risk if a person abuses hydromorphone. Overdose can be a life-threatening experience, and it requires emergency medical care. Symptoms of a hydromorphone overdose include:

• Pinpoint pupils
• Extreme drowsiness
• Cold, clammy skin
• Weak pulse
• Slowed heart rate
• Shallow breathing
• Fainting
• Shallow or slow breathing
• Bluish tint to the extremities or lips

If an overdose is suspected, call 911 immediately. Prompt medical care can often reverse the effects of overdose and ultimately save the person’s life.

Symptoms of Addiction

After addiction develops, a person is psychologically dependent on the drug. Obtaining Dilaudid becomes the primary goal of the person’s life, and all other areas of life suffer as a result. As a result, the person may begin to experience difficulties at work, in school, with relationships, and with their health.

Health issues related to opiate addiction include:

• Problems with body temperature regulation
• Digestive issues
• Problems with motor coordination and muscular movement
• Cognitive decline
• Issues with emotional processing in the brain
• Respiratory issues
• Heart function problems
• Memory issues

The person may experience run-ins with the law, including arrest related to Dilaudid abuse. They may become emotionally unstable, and lose all interest in recreational pursuits they had previously enjoyed. Addiction can reach into every aspect of a person’s life so prompt treatment is needed to prevent substantial damage.

Is Medical Detox Necessary?

Before addiction treatment begins, those struggling with opiate addiction will go through medical detox. This withdrawal process is medically controlled and supervised, according to Harvard Medical School’s Harvard Health Publications.

Medications that are given during the detox process help to manage withdrawal symptoms, such as anxiety, agitation, achy muscles, runny nose, and sweating. In addition, medications may be given to manage nausea and vomiting, according to the University of Maryland Medical Center.

In some instances, replacement medications, such as methadone or buprenorphine, are used during the medical detox process from opiates. The person is then gradually weaned off the replacement medication over a period of months, or even years. In other instances, minimal medications are used during the medical detox process, but the 24-hour support and medical supervision provided help to address specific withdrawal symptoms and prevent relapse.

Medical detox is always recommended in cases of opiate addiction.

The withdrawal process will differ somewhat from person to person, and its timeline will be influenced by a variety of factors, such as a person’s physical makeup, the abuse of other substances in addition to hydromorphone, and co-occurring medical or mental health issues.
Early symptoms of withdrawal include:

• Anxiety and agitation
• Increased tearing of the eyes
• Muscle aches
• Insomnia
• Sweating
• Runny nose
• Yawning

Later withdrawal symptoms may include:

• Abdominal cramping
• Nausea
• Vomiting
• Diarrhea
• Goosebumps
• Dilated pupils

Addiction Treatment

While detox is generally the first step in opiate addiction treatment, it does not constitute treatment on its own. It must be followed by therapy. Therapy addresses the initial reasons that led to the substance abuse in the first place. Throughout treatment, the person will identify triggers that may prompt them to abuse Dilaudid again and devise ways to deal with those triggers to avoid relapse.

Comprehensive opioid addiction treatment should always include a robust aftercare plan. There is no magic bullet to treat addiction. Since recovery is a lifelong process, an ongoing aftercare plan to support sobriety is needed. With time, aftercare can become less intense; however, ongoing support is generally needed for life.