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Hydromorphone or dihydromorphinone belongs to a family of a potent semi-synthetic opioid analgesic. Derived from morphine, the hydromorphone belongs under opiate analgesics (narcotic). It greatly affects the central nervous system in which control the brain’s perception of pain and how to respond to it.  Doctors prescribed the drug to relieve the patient from severe pain that other prescription drug cannot control.


The drug is called as dihydromorphinone and marketed under the brand name Dilaudid and Exalgo. Pharmaceutical companies developed a generic form of hydromorphone. The generic brand of the drug usually cost less but not necessarily as effective as the branded ones. The drug comes in the forms of oral tablet, oral liquid solution, extended-release oral tablet and intravenous solution. Only a licensed medical practitioner can administer its injectable solution. Patients who need constant pain management treatment use the extended-release tablet form.


History of hydromorphone

First developed in Germany in 1924, Knoll first mass produced hydromorphone in 1926 under the brand name of Dilaudid. The name indicates that the origin of the drug is similar that of morphine.


Why was the drug made?

Hydromorphone is a medication to treat patients suffering from pain. Particularly for patients who need long-term medication around the clock. These cases usually apply to people who developed tolerance on other opioid drugs. Correspondingly, the drug is not designed to treat short term, mild or moderate pain.


Why is hydromorphone abused?

These medications hardly cause any abnormal addiction to the user. However, the chance of addiction increases when a person suffered from substance abuse. Since hydromorphone is an opiate, it becomes a very popular drug choice for users. And when it comes to opiates, a drug user will always go for what is available.


Dilaudid, the branded name of hydromorphone will show up in health care facilities lists as one reason people go into rehab.


What causes Hydromorphone addiction?

Several interrelated factors can lead to hydromorphone addiction. These may include the biological, mental and environmental issues.


  • Biological factor


Genetics plays an important part of hydromorphone addiction since genes can be passed on from one family member to another.  A family history of substance abuse increases the chance to for a person to develop an addiction. However, it does not guarantee an addiction.


  • Mental health


Mental health problems related to addiction includes feelings of anxiety, depression, and traumas. The users turn to substance abuse as a way to escape reality.



  • Environmental factors


Similar cases of substance abused within the family can lead to a higher chance of hydromorphone addiction. Poverty acts as another reason for hydromorphone addiction. Because of the availability and acceptability of hydromorphone makes it easier for the user to get the drug. The drug rarely contains addictive properties.  A hydromorphone user may have other drug abuse problems. They may suffer from other types of addictions.


What are the signs and symptoms of hydromorphone addiction?


The most common sign of hydromorphone addiction includes sleepiness and drowsiness. Users usually nod off as soon as they take the drug.  There are other evident signs and symptoms of hydromorphone addiction. Although not all user shows the same symptoms.  One determines a user based on some of the clear signs listed below:


  • Restlessness
  • erratic sleeping pattern
  • Isolation from other activities
  • “Phantom pains” when not taking hydromorphone
  • Hiding hydromorphone, or avoiding discussion about the drug
  • Unnecessary need for hydromorphone


What are the side effects of Hydromorphone?

Hydromorphone addiction can produce short and long term side effects. Addiction hampers all facets of life.


Prolonged exposure to hydromorphone results to adverse side effects to the physical, mental and social well-being of a person. As a lethal opioid analgesic like morphine and heroin, the drug can cause respiratory and circulatory problems.


Furthermore, using hydromorphone with other drugs is fatal.  Drugs such as tranquilizers, muscle relaxants, sedative and other anesthetics can result to respiratory problems, coma even death. Some of the effects from hydromorphone abuse include:


Physical Effects


The abuse of the drug hydromorphone can physically alter the regular behaviors of the body by disturbing various mechanisms. Here are some negative physical consequences resulting from using the drug hydromorphone:


  • Respiratory Problems


Hydromorphone greatly affect the respiratory system. One indication of hydromorphone abuse shows slowed or labored breathing. Overdose deaths commonly occurred because the heart stops beating. Another deadly factor of hydromorphone overdose occurs when a user mixes the drug with alcohol or other opiates. The combination can suppress breathing which can immediately lead to death, even in small dosage.



  • Digestive Issues


Opioid medication like hydromorphone can hit the digestive system and may result in the loss of appetite, dry mouth, and liver damage. Aside from abdominal pain, the user may experience:


  • vomiting
  • constipation
  • nausea
  • death because of a drug overdose


  • Nervous System and muscle problems

This potent drug can cause problems with the nervous system and muscles of the user. It includes:

  • dizziness
  • headaches and migraines
  • involuntary shaking
  • unusual eye movement
  • goosebumps

Psychological Effects

Substance abuse such as hydromorphone addiction can harm damage the mental health of the user. Some of the damaging mental and psychological effect of hydromorphone includes:


  • mood swings
  • depression
  • anxiety
  •  changes in personality
  • paranoia
  • a distorted picture of reality
  • low self-esteem
  • uncontrolled anger
  • agitation


  • Social Effects


Some of the hydrocodone effect on the social life of the user includes:


  •  isolation or withdrawal from family and friends
  • decreased interest in previous activities
  • broken relationship with family members or close friends
  • Separation from loved ones


Other side effects


More of side effects of hydromorphone include:


  • flushing (reddening or warming of the skin)
  • euphoria
  • hives
  • itching
  • erratic heartbeat
  • chest pain
  • change in vision (trouble seeing or blurry vision)
  • dilated pupil


What are the treatments available for Hydromorphone addiction?

Fortunately, several options are available for hydromorphone addiction. Treatment for full recovery needs a long term plan and lots of support from loved ones. Addiction treatment involves:


  • stopping drug intake
  • maintaining a drug-free life
  • having a productive life at work, school and family


However, a user cannot simply stop taking hydromorphone, as this drug can cause moderate to severe withdrawal reactions. Medically assisted therapy program serves as an important factor to a successful treatment.

Detoxification or Detox


Detoxification or detox is the first step to sobriety. It involves removing all traces of the drug from the body. Hydromorphone user can become dependent on the drug within two or three weeks. Removing the drug from the body can lead to uncomfortable withdrawal symptoms because the user can no longer function without hydromorphone.


Also, hydromorphone withdrawal symptoms can gradually lead to serious complications. It is always advisable to have an inpatient treatment program for this type of drug. Some of the withdrawal symptoms include:


  • Muscle and joint pain
  • Diarrhea
  • Restlessness
  • Shaking
  • Intense drug cravings
  • Body cramps
  • Vomiting
  • Anxiety
  • Agitation
  • Low blood pressure


How long is the duration of the withdrawal?


There are several factors comes into consideration for the length of time in the detox process. It usually depends on how long the user abused the drug and the dosage intake of it.  Withdrawal can start within an hour to several days from the last intake of the drug.  Users who took a larger dosage of the drug need longer time recovering.


Hydromorphone withdrawal timeline


First Hour

Within the first hour from the last drug intake, hydromorphone users will experience the initial withdrawal symptoms. These include anxiety and restlessness.


1 to 2 days

Symptoms increased after 14 hours from quitting the drug. Users may experience nausea, shaking, muscles aches, sweating, and chills.


3 to 4 days

The withdrawal symptoms usually disappear after the third or fourth day from the last drug consumption. The user may experience mild symptoms of aching muscles and dizziness.


5 to 14 days

Within this week, users can still feel depressed, anxious, irritability and insomnia.




Depending on the user’s history of hydromorphone abuse, they can still choose to have the detox treatment in an outpatient setting. However, medical monitoring still needs to supervise a safe and effective treatment. In an outpatient setting, the user can still go about their normal activities while undergoing the treatment program.


Therapists can assist the user with the relapse and help them in maintaining a drug-free life. They can also determine the root cause of the addiction. It is crucial to address the physical, mental and psychological state of the user to stop the addiction. Users may take part in the different therapy session to cope up with their daily stressors.


Cognitive behavioral therapy


In this therapy, the user can recognize the source of the addiction, and in a way avoid and cope with the situation.


Multidimensional family therapy


It addresses the series of drug influences on the substance abuse patterns. This therapy is designed to improve the general family function of the user.


Motivational interviewing


This therapy renders the user to change their behavior and start a treatment program. The therapy consists of incentives to inspire the user to stop the addiction. It may also involve positive reinforcement from loved ones.



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