Dilaudid is a painkiller containing hydromorphone, a powerful synthetic opioid derived from morphine, which is found in the opium poppy. Hydromorphone acts in the body by attaching to opioid receptors in the nervous system. The opioid system, activated by the body’s naturally occurring endorphins, controls how much pain a person feels. Dilaudid takes the place of these endorphins and stimulates the opioid system far more powerfully, making it effective for treating moderate to severe pain, such as seen in cases of major injury, severe burns, or cancer.
It comes in an injectable form, an oral liquid form, and as both an immediate-release tablet and an extended-release tablet. According to the Drug Enforcement Administration (DEA), the injection is effective within 15 minutes, and the liquid and tablet forms act within 30 minutes, with each lasting over five hours. The extended-release formulation lasts for a day, and it is only for use in patients who have severe, chronic pain that is resistant to less powerful painkillers.
Dilaudid Abuse
The drug is a Schedule II controlled substance, meaning that while it does have medical uses, it also has a high potential for abuse. There are a number of ways that Dilaudid can be abused:
- Taking Dilaudid that you don’t have a prescription for or that was prescribed to someone else
- Taking Dilaudid for reasons other than it was prescribed for, such as to get high
- Taking Dilaudid in higher doses or more often than prescribed
- Crushing Dilaudid tablets into powder to snort or inject
- Breaking or crushing an extended-release tablet can cause the full day’s dose of the drug to enter your bloodstream all at once. This can trigger overdose, which is often fatal.
The Centers for Disease Control and Prevention (CDC) reported that in 2013, 16,235 people died from overdosing on prescription opioids, including Dilaudid.
Dilaudid can be lethal in a variety of ways:
- High doses of hydromorphone can lower the body’s rate of breathing. If lowered sufficiently, the user stops breathing entirely. The skin may take on a bluish tinge from the lack of oxygen. If you suspect that someone has overdosed on Dilaudid, call 911 immediately.
- Hydromorphone can cause nausea and vomiting as well as sleepiness or unconsciousness. If a user falls unconscious and vomits, he may inhale his vomit and suffocate. Rolling the person onto his side can help reduce this risk while waiting for medical personnel to arrive.
- Hydromorphone can cause dizziness, drowsiness, and impaired reflexes. Many people cannot drive safely under the influence of Dilaudid. Attempting to do so can result in a lethal accident.
- Dilaudid interacts with a wide range of other drugs, such as alcohol, sleeping pills, tranquilizers, other painkillers, muscle relaxants, antidepressants, and anti-seizure medications. Combining it with any of these drugs can increase its potency and the risk of lethal side effects.
Overdose isn’t the only risk of Dilaudid use. Other potential complications include:
- Altered mood
- Muscle tremors
- Suppressed cough reflex
- Low blood pressure
- Slowed heart rate
- Delayed and slowed digestion, resulting in constipation
- Fleeting visual disturbances, hallucinations, blurred vision, or disorientation
- Harm to the developing fetus among pregnant women
Dilaudid is also highly habit-forming, with tolerance and dependence arising in as short a time as two to three weeks even if taken as directed by a medical practitioner.
- Tolerance occurs as the body grows accustomed to Dilaudid and begins growing resistant to its effects. Users have to take higher and higher doses of the drug in order to experience the same effects.
- Dependence happens once the body has become so resistant to opioids that its own endorphins alone are no longer enough to allow the user to feel well. If the user tries to quit using Dilaudid, she may experience intense withdrawal symptoms, including:
- Anxiety
- Restlessness
- Irritability
- Insomnia
- Depressed mood
- Yawning
- Sweating
- Goosebumps
- Clammy skin
- Chills
- Runny nose
- Watery eyes
- Loss of appetite
- Nausea
- Vomiting
- Abdominal cramps
- Diarrhea
- Muscle, joint, and bone pain
- Twitching legs
- High blood pressure
- Rapid heartbeat
- Rapid breathing
These symptoms are unpleasant enough that many people will continue using Dilaudid simply to prevent withdrawal. Dilaudid use under a doctor’s supervision is generally safe, and dependence alone doesn’t mean that someone is addicted to the drug. However, it’s easy for safe use patterns to spiral out of control.
The mid-1990s to the current decade saw a huge surge in the use and abuse of opioid painkillers. Between 1996 and 2011, overall opioid use increased 1,448 percent and opioid misuse soared by 4,680 percent, according to research in Pain Physician. For hydromorphone specifically, the study found that between 2004 and 2011, medical use of hydromorphone rose by 140 percent and its misuse rose by 438 percent. Emergency department visits also rose, reports the DEA – hydromorphone caused 12,142 visits in 2008 and 18,224 visits in 2011. As of 2011, the DEA reports, about 1 million people aged 12 and older had used Dilaudid for nonmedical purposes within their lifetimes.
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Signs of Addiction
There are a number of signs that someone may be abusing or addicted to Dilaudid:
Physical signs
- Red or flushed skin
- Red eyes
- Pupils that do not dilate properly in response to light
- Vomiting or loss of appetite
- Constipation
- Unexplained rash
- Needle marks on arms, legs, or feet
- Stumbling, shakiness, clumsiness, or delayed reaction times
- Delaying or refusing to reduce dosage of Dilaudid when directed to do so
- Persisting in seeking a prescription for Dilaudid even after multiple doctors have declined to prescribe it
- Missing work, school, family functions, or other responsibilities in order to use Dilaudid or recover from the effects of having used it
- Giving up friends or previously enjoyed activities in order to spend more time using Dilaudid
- Using Dilaudid even when it is causing serious mental or physical side effects
- Using the drug despite it causing legal consequences or conflict with friends or loved ones
- Using Dilaudid when it might be dangerous, such as while caring for children, operating machinery, or driving a car
- Abrupt or unexplained changes in mood, such as irritability or paranoia
- Secretive behavior or lying about the drug use
- Money or drug supplies going missing
Get Help for Dilaudid Dependence, Abuse, or Addiction
If you, or a loved one, are experiencing Dilaudid dependence or addiction, you can get help. A number of interventions are effective at helping to stop use of the drug:
- Tapering. In order to cease using opioids without experiencing withdrawal, users can gradually reduce their dosage of the drug over the course of weeks under a doctor’s supervision in a process called tapering. This slow process gives the body’s endorphin system time to detoxify and heal from the chemical onslaught so that withdrawal no longer occurs. If the user is dependent upon Dilaudid after having used it medically but has not abused it, his supervising doctor may have the user taper off the Dilaudid itself. If he has struggled with Dilaudid abuse, then the doctor may replace the Dilaudid with a less dangerous drug first.
- Replacement. Dilaudid is a very dangerous drug, and certain other opioid drugs present fewer dangers but still prevent the user from experiencing withdrawal symptoms. In particular, one drug called buprenorphine has a ceiling effect, meaning that increasing the dose of the drug past a certain point will no longer increase its effects (or dangers). This both decreases the likelihood of overdose and reduces the addictive properties of the drug. The user can then taper off the new drug or maintain a low dose to prevent cravings.
- Maintenance. For some people, however, tapering doesn’t solve the problem of cravings, and they find themselves wanting to return to Dilaudid use. Instead, maintaining a low dose of a drug like buprenorphine can prevent cravings that might drive a return to the far-more-dangerous Dilaudid. A study in JAMA Internal Medicine found that maintenance treatment was more effective than tapering at encouraging abstinence from opioid abuse.
- Behavioral therapy. Dilaudid addiction isn’t just a chemical problem to be fixed by drugs – treating it also requires tending to each person’s mind and habits. Psychotherapy can help individuals struggling with addiction to identify the circumstances and stressors that trigger their drug use and develop new strategies for managing them. Many people who are addicted to Dilaudid also have other problems that they are using the drug to self-medicate, such as mental illnesses, past traumas, family conflict, or learning or behavioral disabilities, and psychotherapy can help treat these as well. Dual diagnosis refers to the co-occurrence of addiction and mental illness. It is crucial to treat both conditions at the same time if either is to see lasting improvements.
- Support groups. These groups can offer a circle of peers who understand the unique challenges of facing addiction. Even after formal treatment has ended, continuing to attend a support group regularly can help recovered users resist the urge to relapse.
- Holistic treatment. Drug addiction can have far-reaching consequences throughout a person’s life. Other services, such as legal counseling, relationship or family therapy, parenting classes, job skills training, nutritional counseling, or fitness training, can help them rebuild a new future.
Get Help for Dilaudid Addiction
You’ve already taken the first step towards getting help for yourself or your loved one. At Axis, we offer evidence-based treatments that will guide you along the path back to recovery and health. To learn more, call us today.
