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What is Dilaudid?

Dilaudid is an opioid analgesic pain prescription drug synthesized from morphine to create a potent drug called hydromorphone. We know it by the brand name Dilaudid. It helps people who suffer from severe pain but also puts them at risk for abusing the medication [1].

Dilaudid is sold in immediate-release tablets, oral solutions, and intravenous injections. The Drug Enforcement Administration (DEA) [2] lists hydromorphone as a Schedule II controlled substance, meaning it has a high potential for abuse and a high chance of causing dependency.

Dilaudid addiction means that the person physically and psychologically needs the drug longer than they actually feel the pain from their injury. This dependency affects all aspects of their life, including family, school, work, and community life.

Dilaudid Side Effects
Dilaudid is a very potent narcotic and can certainly cause confusion and altered mental status, usually within 30 to 60 minutes of taking it.

Medical professionals typically prescribe Dilaudid for pain related to cancer and other serious injuries, such as severe burns or multiple fractures. Like other opioids, hydromorphone works by interacting with parts of the brain in charge of pain. Opioids also affect parts of the brain responsible for motivation and happiness. Some people misuse Dilaudid to get high because large doses of the drug overwhelm the brain’s pleasure center.

Dilaudid takes effect within 15 minutes, and its pain-relieving effects last up to six hours. Dilaudid is habit-forming and is commonly abused amongst consumers for its potent euphoric effects, which have been described as being similar to that of Heroin. Dilaudid side effects can range from mild to severe. However, you should never ignore any of them. Recognizing the signs and symptoms puts you on the path to helping your loved one seek addiction treatment.

Is Dilaudid an Opioid?

One of the most common questions about Dilaudid is whether it is an opioid or not. Yes, Dilaudid is an opioid. Hydromorphone is considered a semi-synthetic opioid agonist that was derived from the drug morphine. Like other opioids, hydromorphone works on the central nervous system to relieve pain. If you undergo a drug test, Dilaudid will be positively identified as an opiate.

Compared to other opioids, hydromorphone is very potent. The dangers associated with Dilaudid addiction are real and potentially deadly. Many individuals who get addicted to opioids like Dilaudid begin with a legitimate prescription. As opioids help users deal with pain, it is not unusual for individuals to keep on using the drug even after the prescription period. This can build tolerance for the medication, meaning they will need a higher dose to get the same level of pain relief. This increased tolerance for prescription drugs and chronic use can lead to addiction.

While addictions can develop from legitimate hydromorphone prescriptions, it is also possible to get addicted if the drug is used for recreational purposes. Some individuals abuse leftover Dilaudid in their home’s medicine cabinets or buy the drug from illicit sources. The problem with sourcing the drug outside of a pharmacy is that there is a risk that the drug is not really what you think you’re getting. Many opioids sold in the street are often laced with synthetic opioids like fentanyl. These potent synthetic opioids can quickly cause an overdose and even death when taken or abused.

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Street Names

Street names for Dilaudid usually highlight a particular aspect of the brand involved in terms of its effects, color, or form. People use street names as a way to hide their drug activity from others.

  • Dust-This – refers to Dilaudid tablets that have been crushed
  • Juice-This – Dilaudid in solution form
  • Dillies
  • Hospital heroin
  • Smack
  • M2
  • Big D
  • Hydro
  • M-80

Why is this Medication Prescribed?

Like other opioid medications, Dilaudid is primarily used for pain relief. Opioids work by physically blocking the pain signals that reach the brain by decreasing the intensity of pain and improving the patient’s emotional response to it. Because the source of the pain can vary depending on each patient’s circumstances, Dilaudid may be prescribed to some people and not to others.

The World Health Organization (WHO) recommends that physicians use a three-step ladder for managing pain with opioids like Dilaudid. First, non-opioid, over-the-counter medications like aspirin, ibuprofen, and acetaminophen are used to control the patient’s discomfort. If these drugs prove ineffective, mild opioids like codeine are prescribed. If this still does not do enough to relieve the patient’s pain, potent opioids like oxycodone and Dilaudid are prescribed.

Dilaudid may be prescribed to patients recovering from cancer, major surgeries, or conditions that involve chronic pain. Before taking Dilaudid, it’s important that you talk to your doctor about your medical history to accurately evaluate if Dilaudid is safe for you.

Dilaudid Side Effects

As an opiate painkiller, Dilaudid side effects will likely include drowsiness, nausea, euphoria, constipation, difficulty urinating, vomiting, and suppressed ability to breathe. If an individual continues to abuse this drug, the higher risks they will experience Dilaudid side effects such as addiction, guilt, depression, track marks up and down the arms and legs, intense cravings for the drug, and a dread of the withdrawal sickness that will result from not having the drug to abuse.

Dilaudid Side Effects
 Recovery from Dilaudid side effects and addiction is possible.

Dilaudid is a strong painkiller of the opiate class. Each formulation of drugs in this class—oxycodone, oxymorphone, hydrocodone, methadone, fentanyl, and others—has slight differences from the others. Some are stronger than others, some will last longer and others will take effect more quickly. Dilaudid is a strong painkiller that is often used after surgery. When an individual wants to abuse it, he (or she) will not get the desired high if he ingests or snorts it. Dilaudid only creates the desired euphoric effect if it is injected intravenously. This characteristic means that many abusers inject the drug after crushing and dissolving the pills.

Common Dilaudid Side Effects

  • Itching
  • Mood Changes
  • Low Blood Pressure
  • Dry Mouth
  • Constipation
  • Drowsiness
  • Dizziness
  • Excessive Sweating
  • Temporary Redness Of Face And Neck
  • Decreased Appetite
  • Headache
  • Nausea
  • Vomiting
  • Generalized Weakness
  • Feelings Of Dissatisfaction, Sadness, And Unease

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How does Dilaudid Affect the Body?

Respiratory depression

  • Dilaudid affects the respiratory center in the brain through action on the opioid receptors in the brain.
  • This induces slowing down of respirations and the breathing pattern can become irregular.
  • This can result in reduced gas exchange with elevated carbon dioxide and reduced oxygen levels in the body.
  • Overdose of Dilaudid can also cause respiratory arrest.

The feeling of high and addiction

  • Dilaudid, in the process of altering the perception of pain in the brain, promotes more dopamine in the brain.
  • Increased dopamine in the brain produces a feeling of high, by interacting with the brain’s reward circuit.
  • This feeling of high, experienced by the individuals on Dilaudid use, becomes highly desirable and thus adds the potential for addiction to Dilaudid.
  • This makes Dilaudid one of the most commonly abused drugs.

Tolerance and addiction

  • Individual taking Dilaudid at a recommended dose for prolonged time develop tolerance to the drug and experience blunting of the therapeutic response to Dilaudid at that dose.
  • Diminishing therapeutic response prompts an individual to increase the dose of medication intake, to derive the desired effect.
  • This sets the cycle for addiction and abuse.

Withdrawal syndrome

  • Reducing your dosage gradually over a period is the preferred way to quit Dilaudid.
  • Sudden withdrawal from Dilaudid may induce intense unpleasant sensations, such as, nausea, vomiting, intense muscle aches, sleep disturbances, abdominal cramps, and diarrhea.

How does Dilaudid Affect the Brain?

Hydromorphone, one of the main chemicals found in Dilaudid is a full opioid agonist affecting the mu-opioid receptors. So what happens in the brain when you take Dilaudid?

When you take Dilaudid, the hydromorphone binds to mu receptors, creating analgesia. It also causes pain relief. Although the precise mechanism of the analgesic action is unknown, opioid receptors throughout the brain and spinal cord are thought to play a key role in the analgesic effects of Dilaudid.

Dilaudid is also known to cause respiratory depression by a direct effect on the brain system’s respiratory centers. Respiratory depression is a state of reduced brain responsiveness to both increases in blood gas tension and electrical stimulation. Finally, Dilaudid is known to cause excessive constriction of the pupil of the eye, even in total darkness. Pinpoint pupils are usually the first sign of an opioid overdose.

Why does Dilaudid Cause Itching?

Itching is a possible side effect of Dilaudid for certain users. Dilaudid itching can be severe in some cases, with users reporting severe itching all over their bodies. Those who experience it commonly ask, “Why does Dilaudid make you itch?” but unfortunately, the exact reasons are not clearly defined.

There may be treatment available to alleviate itching discomfort. For example, Phenergan is a commonly prescribed medication for itching. However, taking Dilaudid with Phenergan is not recommended since it can increase Dilaudid side effects like confusion, dizziness, and drowsiness. This combination can also cause several other Dilaudid side effects, with the potential for new Dilaudid side effects to develop over time. These include pneumonia, constipation, dependence, and hepatic necrosis.

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Effects of Dilaudid Addiction

Dilaudid addiction typically starts from using the drug as directed. Sometimes from pain and other times simply for the feeling of euphoria, patients will increase their dose on their own.

Over time, the patient needs more Dilaudid to feel the same effect, as the opioid receptors in the body start to desensitize. This adds to the abuse potential when a patient needs the drug during long-term treatment. 

Administering more Dilaudid than needed at once or continuing the use over a long period of time, mixed with any of the risk factors mentioned above, makes a perfect cocktail for addiction.

Common physical effects of Dilaudid addiction include:

  • Dizziness and lightheadedness
  • Itching
  • Sweating
  • Nausea and vomiting
  • Belly pain
  • Trouble urinating
  • Noticeable marks on hands, arms, legs, and feet from using needles
  • Slowed breathing

More serious adverse reactions of the addiction include:

  • Breathing difficulties
  • Circulatory collapse
  • Seizures
  • Heart attack
  • Stroke

Dilaudid Side Effects and Overdose 

Dilaudid overdose isn’t always fatal. But people can die from an overdose, especially if it isn’t treated properly and urgently. In 2014 alone, more than 14,000 people died from prescription opioid overdoses. Even those who survive a Dilaudid overdose may be left with harmful after-effects.

Other complications of Dilaudid overdose include:

  • Permanent brain damage due to lack of oxygen to the brain.
  • Muscle damage from lying on a hard surface for a significant period of time
  • Pneumonia (often secondary to aspirated gastric contents)

The FDA cites the following as signs of a Dilaudid overdose:

  • Shallow, slow breaths or trouble breathing
  • Drowsiness
  • Possible loss of consciousness or falling into a coma
  • Lack of muscle tone or flaccid skeletal musculature
  • Cold or clammy skin
  • Constricted pupils
  • Low blood pressure
  • Weak pulse or slow heart rate

Anytime too much of the drug is introduced into the bloodstream at once, an overdose is possible. However, the method of taking Dilaudid can impact overdose. Snorting, smoking, or injecting it sends the full dosage of the drug very quickly across the barrier between a person’s blood and brain and can raise the risk for overdose. The FDA warns that injecting Dilaudid may increase the risk of suffering from an overdose by resulting in a collapse of the circulatory system, cardiac arrest, or apnea.

Effects & Symptoms of Withdrawal from Dilaudid

It is a rare person who can abuse an opioid as strong as Dilaudid and not get addicted. For most people, continued use will make it difficult to quit when they want to. Getting clean and sober means they have to get through the typical opiate withdrawal symptoms which can mean some days of pain, sickness, and misery.

Specifically, withdrawal effects from Dilaudid will include:

  • Muscle pain
  • Body cramps
  • Insomnia
  • Vomiting
  • Tremors, shaking and restlessness
  • Severe cold sweats
  • Diarrhea
  • “Dysphoria”—defined as a feeling of depression, anxiety, and unease

The usual list of effects of opiate withdrawal will also include a runny nose, goosebumps, and yawning but these rather harmless symptoms tend to minimize the severe sickness that typically occurs when a person is trying to get off drugs “cold turkey.”

According to the National Institutes of Health, it can be possible to detect withdrawal symptoms after just a week of Dilaudid administration. Physical dependence is likely to be significant after several weeks of administration. Some drug users report that they go through withdrawal from Dilaudid use after just a few days or a week of use at home or in the hospital.

But what also happens is that a person in this situation gets sick with withdrawal symptoms but just thinks they came down with the flu after leaving the hospital. They recover and never realize they went through an opiate withdrawal after their medical care.

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Dilaudid Side Effects and Addiction Treatment 

Dilaudid Detox

It is important to us to be transparent about the topic of detox. It will not be an easy process. A person will likely experience many different Dilaudid side effects from their drug use. These Dilaudid side effects may be emotional, physical, or mental. Someone in withdrawal will likely experience many uncomfortable feelings and negative thoughts about life during the process of detox. Unfortunately for those with dependency, detox is an unavoidable first step to recovery

Please, do not try to detox on your own. The Dilaudid detox process can be painful and difficult without medical assistance. Getting through the detox process is crucial for continued treatment.

Dilaudid Detox Medications


Using it with Naloxone can lower the risk of someone developing a dependence. This happens as Buprenorphine alleviates the pain and discomfort caused by withdrawal. Naloxone blocks the euphoria that Opioids can bring if the patient were to relapse.


Methadone is one of the most common treatment medications for people suffering from opioid withdrawal.


Naltrexone functions in the body as an Opioid-agonist. If you were to use it while Dilaudid was still in their system, you could experience severe symptoms of withdrawal. Naltrexone is only prescribed after the individual has been off Opioids for at least 7 to 10 days.


Clonidine is a non-opioid used to relieve anxiety, agitation, cramping, and tension. It also helps regulate blood pressure and pulse while reducing cravings.

Another detox method some doctors provide involves a rapid anesthesia process. The addicted person is first given medication to relax. Then a doctor puts them under general anesthesia and injects the patient with a drug that blocks the effects of Dilaudid. The providers of this method claim it speeds up the withdrawal process and there are fewer withdrawal symptoms after.

Many rehabilitation programs keep up with the scientific understanding of co-occurring disorders and offer dual-diagnosis treatment for mood disorders alongside therapy for addiction. Treatment plans vary for each individual. For occasional substance misuse, occasional counseling may be enough to help a person recover. For more serious cases, time at a rehabilitation facility may be the best option. The only way to truly determine the correct treatment plan for each person is to see a qualified treatment professional.

If someone is struggling with Dilaudid Addiction because of its intense and often dangerous Dilaudid side effects, that person needs to consider inpatient Dilaudid detox. We Level Up NJ addiction specialists are standing by to help.

Dilaudid side effects
Rehab will help you overcome Dilaudid side effects and withdrawal symptoms and develop healthy strategies for avoiding relapse.

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[1] NIH –

[2] DEA –