Hydromorphone is a prescription medication used for the long-term treatment of moderate to severe pain that cannot be managed by other pain medicines or non-pharmacologic options.
Hydromorphone is an opioid pain medication that is available as a(n) 2:
- Oral liquid.
- Immediate-release tablet.
- Extended-release tablet.
- Injectable solution.
Like other opioid pain medications, hydromorphone works to change perceptions of pain in the user. It does not treat the underlying cause of the pain; it only makes the pain more bearable for the user. When the substance is injected or consumed orally, the pain relief will begin between 15 and 30 minutes. The analgesic (painkilling) effects will last for about 5 hours, and the drug has a potency that is several times greater than morphine 2.
While the opioid effects will be similar, substances containing hydromorphone are more potent than many other opioid-based drugs, including 3:
Though an invaluable painkiller in hospital-based and other medical settings, as a potent opioid, hydromorphone is also desirable street drug. Dilaudid, one brand name for the drug, is sought illicitly under the names 2:
Abuse of prescription narcotics like hydromorphone has grown to epidemic proportions in the United States. Consider that 2,4:
- Pain relievers are the most abused drugs after marijuana and hashish.
- In 2014, 4.3 million people in the U.S. admitted using painkillers non-medically.
- In a 2011 survey, 1 million people admitted to abusing hydromorphone in their lifetime.
As prescribed drugs, the opioid painkillers may seem to contribute to the national landscape of drug abuse more inconspicuously than their commonly thought of street drug counterparts like heroin. And though perhaps slightly more insidious than something like heroin, the progression towards addiction is no less assured with these potent opioid drugs—used under a prescription or otherwise. In fact, many people with valid prescriptions may end up abusing the drug at some point.
Hydromorphone abuse happens in a number of ways, including 5:
- Taking the medication in a way other than prescribed (more often, in higher doses, or via other methods of administration like crushing and snorting it).
- Using medication that was not prescribed for you.
- Taking the substance for the purpose of getting high.
People abusing hydromorphone will seek the pleasurable effects produced during a high. The high will soon give way, however, to dangerous and potentially life-threatening effects, especially as a person increases their dose to combat increasing tolerance. Increasing doses is extremely risky, as just one large dose can be fatal 5.
Signs and Symptoms
Despite the dangers, many people abuse hydromorphone for its intoxicating effects, which are similar to those of other opioids, including those that are typically labeled as more serious, such as heroin. These effects include 2:
- Intense pleasure.
- Physical relaxation and decreased tension.
- Decreased anxiety and worry.
- Increased sleepiness.
These results arise via the biomolecular interaction between hydromorphone and specific structures throughout the brain and spinal cord known as opioid receptors 5. Once attached to the receptors, a reduction in pain perception is achieved. Additionally, the activation of the opioid receptors triggers dopamine release, which imparts a rewarding or pleasurable sense to the drug use. Because dopamine is strongly tied to these rewarding feelings, users may continue to seek out hydromorphone in an attempt to recreate these feelings.
Not all signs and symptoms of abuse are pleasurable, however. Side effects may include 1,2:
- Decreased appetite.
- Feeling lightheaded or dizzy.
- Increased sweating.
- Hyperalgesia, or worsening pain.
The following symptoms may be more serious and may require emergent attention 1,2:
- Rash or hives.
- New and unexplained swelling.
- Trouble breathing.
- Difficulty swallowing.
- Chest pain.
- Extreme drowsiness.
While many of the effects listed above may occur with normal hydromorphone use, they may be exaggerated in someone abusing the substance. For example, someone misusing hydromorphone may be too sedated to even have a conversation or so anxious they cannot leave their home.
Effects of Abuse
Some of the most significant effects to be aware of regarding hydromorphone abuse manifest as tolerance, physiological dependence, withdrawal, and addiction 3.
Tolerance is the need to take more of a drug over time as the body begins to adjust to the previously effective dose. Because of this, the individual will no longer get the same sense of pain relief or high as they initially did, so they will require higher doses or increased frequencies to feel the effects 3.
Dependence is another risk of long-term opioid use. As hydromorphone levels increase, the body becomes more accustomed to its availability. The body begins to depend on the drug and require it simply to feel and behave in the expected fashion 3. Without the drug (or with drastically reduced doses), the body goes into withdrawal.
Symptoms of hydromorphone withdrawal include 3:
- Increased sensations of pain.
- Inability to sleep.
- Muscle spasms.
- Cold flashes.
- Increased blood pressure and heart rate.
Addiction is a product of regular abuse of hydromorphone as the individual seeks out the substance compulsively and without regard to what will happen as a result. Someone addicted to hydromorphone may 2,3:
- Lie to and manipulate others for money or the substance.
- Struggle to perform routine activities like going to work or school.
- Have problems paying their bills/fulfilling financial obligations.
- Schedule many doctors’ appointments to receive multiple prescriptions.
- Isolate themselves or spend time with new groups of people.
Lastly, a huge risk of hydromorphone abuse is the potential for life-threatening overdose. Visit our Effects of Hydromorphone Use page to learn the signs.
How Dangerous is Hydromorphone?
Opioids like hydromorphone can wreak havoc on a user. Consider these statistics 5:
- Opioid pain medications caused 19,000 deaths in the U.S. during 2014.
- Among people age 15-24, men account for 75% of deaths from painkiller overdose.
According to the Drug Enforcement Administration, in 2011, hydromorphone was associated with more than 18,000 emergency department visits, a sharp increase from just over 12,000 in 2008 2.
The teenage population is known to use hydromorphone and other opioid painkiller medications nonmedically. These prescription drugs are desirable to teens and young adults because they are often free and readily available from friends and relatives with prescriptions.
If your teen is abusing hydromorphone, you may wish to encourage professional treatment or services. To prevent your teen from abusing painkillers:
- Educate your child about the risks and dangers of substance use and prescription drug misuse.
- Assess and discuss their mental health status and stability to assess for the potential for any “self-medication” behavior.
- Keep accurate count of medications within the home.
- Keep any medications in your home locked away securely.
If hydromorphone has been having a negative impact in your life or the life of a loved one, you may benefit from calling . Here, you can be connected to someone that can recommend helpful treatment options to limit the influence of hydromorphone and begin a path to recovery.