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The Dilaudid Dilemma

Every day, physicians across the nation prescribe painkillers to help patients cope with pain. The types of painkillers prescribed are as varied as the type and intensity of pain levels; however, more potent painkillers – like opioidsare typically used to treat moderate to severe pain that may not respond to other pain medications.

While opioid painkillers are meant to be prescribed for short-term treatment of pain, their use continues to rise. In fact, sales almost quadrupled from 1999 to 2014, yet there hasn’t been a marked increase of pain being reported by Americans.

Dilaudid (hydromorphone) is an opioid available in a variety of forms (liquid, tablet, suppository, or injectable.) It’s a synthetic narcotic pain reliever that is considerably stronger than morphine, from which it is derived.

While highly effective, Dilaudid’s potency and lasting “high” – similar to that of heroin – carries a great risk of physical and psychological dependence. In this piece, we’ll show the effects Dilaudid has on the mind and body, risk factors, and the dangers of misuse.

What is Dilaudid?


While Dilaudid is available in a variety of forms, it’s most commonly prescribed as a tablet. These pills go from a starting dosage of 2 milligrams to 8 milligrams for the treatment of severe, acute, or chronic pain. Because of its potency, the drug is a Schedule II controlled substance. Drugs in this classification come with a high risk of chemical dependency and abuse.

This high risk for abuse stems from Dilaudid’s side effects: euphoria, sedation, reduced anxiety, and extended feelings of relaxation. While this is similar to other narcotics, its synthetic design is far more potent, resulting in a greater potential for harm.

In medical environments, the distribution of Dilaudid is typically closely monitored and exact; however, there have been reported cases of accidental overdoses in medical environments. A study by the National Institutes of Health found a patient was mistakenly given 10 milligrams of Dilaudid before being discharged from the ER. This is equivalent to 60 to 70 milligrams of morphine. Unfortunately, the patient went into cardiac arrest shortly after and died at a nearby emergency department.

Outside of a healthcare setting, Dilaudid is often obtained illegally through forged prescriptions, pharmacy thefts, doctor-shopping, and friends or acquaintances. Despite the risk and high likelihood of dependency, Dilaudid continues to be sold illegally under a variety of street names like D, Dust, Juice, and Smack.

Dangers of Extended Use and Misuse

Like any prescription drug, Dilaudid is beneficial when used as instructed by a medical professional. When misused, the risk of danger can increase exponentially. Potential side effects of Dilaudid include:

  • Sensitivity to pain, which can include headaches, migraines, and muscle aches
  • Gastrointestinal upset, such as constipation, cramps, trouble with digestion, loss of appetite, nausea, and vomiting
  • Dizziness
  • Drowsiness
  • Anxiety
  • Slowed breathing
  • Seizures
  • Erectile dysfunction

The severity of these side effects depends on the individual and his or her specific dosing. With frequent misuse, the body develops a tolerance to Dilaudid, which forces individuals to increase their dosage to reach the same euphoric “high” feeling. As dosage increases, so too can the intensity of side effects – ultimately leading to potential permanent injury, coma, respiratory failure, and even death.

To counter developing tolerances and reach a “high” state faster, some individuals bypass taking the medication orally and instead crush pills. The powder is mixed in a solution and injected into the body. This approach can reduce the time it takes to reach peak effect. However, this comes with its own risks, which include infection at the injection site, tissue damage from poor needle placement, or communicable diseases (like hepatitis and HIV) from sharing needles.

There are also risks associated with the use of other substances while under the influence of opioid painkillers. Because Dilaudid is a sedative that slows heart rate and reduces lung function, mixing it with other central nervous system depressants (such as alcohol, Valium, and Xanax) could increase the potential for respiratory and cardiac arrest.

Dilaudid Use and Misuse

An estimated 1 out of 5 patients with pain not related to cancer or pain-related diagnoses are prescribed opioids in a clinical setting. Data from the National Survey on Drug Use and Health show that while Dilaudid is rarely used or misused within the general population, it’s one of the most commonly abused opioid drugs taken by chronic opioid users.

Anyone can succumb to the addictive nature of opioids like Dilaudid (Hydromorphone). In fact, regular use of opioids, as prescribed by a doctor, can lead to misuse. While Hydromorphone use among the general population is low (.09%) compared to other opioids, the percentage of misuse is high. In the chart above, we see that among all opioid users, 10.5% report intentionally misusing Hydromorphone.

Use and misuse of opioids overall have increased dramatically in recent years, mainly due to the environmental availability of drugs. Not only has it become more socially acceptable to treat various ailments with medication, but aggressive pharmaceutical marketing – as well as more prescriptions being written than ever before – has made opioids readily available for those seeking to treat pain or other ailments.

Overdose and hospital visits related to the nonmedical use of opioids have also continued to climb – with opioids accounting for the greatest proportion of prescription drug abuse.

Unfortunately, as many as 1 in 4 people who receive prescription opioids for noncancer pain in a primary care setting struggle with addiction. In 2014, nearly 2 million Americans either misused or were dependent on prescription opioids

Dispensed Dilaudid Prescriptions

From 2009 to 2014, prescriptions and sales of Dilaudid were significantly less than many other opioids, but there was still a marked increase. Dilaudid prescriptions rose 44.9 percent over a six-year period.

The CDC documents multiple concerns with the rise in opioid prescriptions. First, physicians may not receive sufficient training in pain management with prescription opioids, leaving them unable to provide the necessary monitoring to chronic pain patients. As a result, some doctors may rely primarily on long-term opioid prescriptions, regardless of the risk of addiction this presents. Second, there’s not enough scientific evidence that opioids like Dilaudid improve chronic pain, despite relief of some types of acute pain. Lastly, healthcare providers can’t agree on appropriate dosage levels of opioids or when they should be prescribed.

With a lack of consistent education and no clearly established widespread standards for proper prescribing or helping patients stop using opioid painkillers, it’s easy for patients to fall into an extended cycle of prescription painkiller intake. According to the CDC, this long-term use “can be associated with abuse and overdose, particularly at higher dosages.”

Opioid-Related Deaths

Overall, overdose deaths involving prescription opioids have quadrupled since 1999, rising alongside the rapid growth of prescription drug sales. In the U.S., more than 165,000 people have died because of opioid-related overdoses from 1999 to 2014.

In 2014, over 14,000 people died from prescription opioid overdoses – roughly 38 people each day. Today, approximately 50 percent of opioid overdose deaths involve a prescription opioid, with more than 1,000 people treated in emergency rooms for misuse every day.

Of the different types of opioids (heroin, methadone, synthetics, natural opioids, and semisynthetic substances), natural and semisynthetic opioids make up the largest share of overdose deaths. This includes Dilaudid, which is a semisynthetic derivative of morphine.


Data show us that opioids, especially Dilaudid, can cause severe addiction for those struggling with pain. These medications are not intended to be a curative or long-term treatment, but a way to temporarily manage pain and discomfort. When physicians are untrained in the appropriate use of these opioids in pain management, their patients can receive too much medication for longer than necessary, putting them at an elevated risk of becoming addicted. For a person to avoid dependence, they must have a medical plan in place that outlines the gradual reduction of prescription opioid use; the plan should leverage alternative treatments for acute and chronic pain as well.

If you or someone you love has developed a dependence for opioids like dilaudid, relief is available. Visit or call to find details on opioid addiction and the specialized treatment options available.


We visualized data and information from various authoritative sources (e.g., CDC, DEA, etc.) on opioids. We specifically examined insights on hydromorphone and Dilaudid; Dilaudid is a brand name form of hydromorphone. The number of dispensed hydromorphone prescriptions and trends in opioid use and misuse reflect figures for all hydromorphone substances, including Dilaudid.

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