Hydromorphone (Dilaudid): overview, uses, effects, and signs of abuse

Hydromorphone, also known by the brand name Dilaudid, is an synthetic opioid analgesic that is used for pain relief. This prescription drug is most often used for chronic or severe pain.

The opioid painkiller was first synthesized in 1921 and introduced clinically in 1926.

Hydromorphone has a potential for abuse and dependence similar to other opioids like hydrocodone.

How Hydromorphone Affects The Brain And Body

Hydromorphone affects the brain by interacting with opioid receptors in the central nervous system and interrupting nerves signaling pain.

This interaction releases excess dopamine to the brain, which initiates the good feelings that people associate with an opioid high.

Forms Of Hydromorphone

Hydromorphone is sold as a pill with extended release and immediate release forms.

It can also be taken orally, as a liquid, or administered through an IV or as a suppository.

Hydromorphone Side Effects

Hydromorphone causes various side effects.

Generally, the side effects of prescribed hydromorphone are minimal, but there are rare cases of more life threatening side effects, including trouble breathing.

The side effects of Dilaudid can include:

  • flushing
  • sweating
  • dry mouth
  • nausea
  • mood swings
  • respiratory depression
  • vomiting
  • constipation
  • dizziness
  • headache
  • physical weakness
  • itching
  • drowsiness
  • low blood pressure
  • passing out
  • trouble breathing
  • drug dependence
  • drug withdrawal
  • increased pressure on the brain
  • seizures
  • stopping breathing while sleeping
  • adrenal insufficiency
  • coma
  • increased heart rate

Methods Of Hydromorphone Abuse

There are a few different methods of hydromorphone drug abuse.


Oral hydromorphone abuse involves using pills without a prescription or taking a larger dose than prescribed.


People use snorting as a method of abuse by crushing hydromorphone pills into powder and snorting it for a more immediate, extreme high.


People use injection as a method of abuse by dissolving the powder from hydromorphone pills in water and injecting the liquid into a vein.

Street Names For Hydromorphone

People who buy and sell hydromorphone illicitly use a variety of names to refer to the drug.

The street names for hydromorphone include:

  • d
  • dillies
  • dust
  • footballs
  • juice
  • smack

Signs Of Hydromorphone Addiction

There are numerous signs of drug dependence that could indicate a hydromorphone addiction. If you or a loved one is displaying these signs, you should talk to a licensed medical professional.

Common signs of substance abuse include:

  • cravings
  • small pupils
  • trouble breathing
  • not being responsive
  • drowsiness
  • loss of appetite
  • weight loss
  • weight gain
  • vomiting
  • nausea
  • sweating
  • attitude change
  • avoiding friends and family
  • decreased work or school performance
  • isolation
  • irritability
  • nervousness
  • moodiness
  • theft
  • doctor shopping
  • headache
  • stomach pain
  • depression
  • rash
  • hives
  • facial swelling
  • hallucinations
  • confusion
  • chest pain
  • lightheadedness

Risks Of Hydromorphone Abuse

There are both short-term and long-term risks of Dilaudid abuse.

Short-term risks

The short-term risks of hydromorphone abuse usually occur within hours or days of taking the prescription drug.

The short-term risks of Dilaudid abuse include:

  • physical dependence
  • drowsiness
  • nausea
  • constipation
  • difficulty breathing
  • confusion
  • relaxation
  • euphoria
  • vomiting
  • cold skin
  • faint heartbeat
  • purple lips
  • loss of consciousness

Long-term risks

The long-term risks of hydromorphone abuse often occur over years and are more common in cases of chronic, severe abuse.

The long-term risks of Dilaudid abuse include:

  • reduced fertility
  • cardiac arrest
  • depression
  • fatigue
  • increased blood pressure
  • overdose
  • poisoning
  • serious fractures
  • breathing issues during sleep
  • immunosuppression
  • constipation
  • bowel obstruction
  • tooth decay

Hydromorphone Detection Windows

Drug tests can be used to detect opiates like hydromorphone.

The detection windows for hydromorphone vary based on the type of sample taken, the extent of the individual’s drug use, and various other factors.


A urine drug test can detect hydromorphone for two to three days after use. This is the most common form of drug test.


A drug test based on saliva will detect Dilaudid if the person used it during the past one to four days.


Dilaudid metabolites can be detected in blood up to three days after use.

This kind of drug test is usually performed in a hospital setting by healthcare providers.

Hair Follicle

Signs of Dilaudid use can be found in a hair follicle for up to 90 days after use, but it takes around 30 days from the first use to be detectable in a hair follicle.

Hydromorphone Withdrawal Symptoms

Dilaudid withdrawal can be severe and result in a combination of physical and psychological symptoms.

The symptoms of Dilaudid withdrawal include:

  • cravings
  • watery eyes
  • runny nose
  • sneezing
  • yawning
  • insomnia
  • hot and cold flashes
  • hallucinations
  • sweating
  • anxiety
  • irritability
  • nausea
  • vomiting
  • diarrhea
  • lack of appetite
  • shakes
  • joint pain
  • bone pain
  • muscle pain
  • headaches

No one should go through Dilaudid withdrawal alone, as dangerous symptoms do occur in some cases.

Signs Of A Hydromorphone Overdose

A Dilaudid overdose is an emergency situation that can result in death.

If you or a loved one are experiencing signs of a potential overdose, call 911 immediately and administer Narcan (naloxone), if available.

The signs of Dilaudid overdose include:

  • blue fingernails
  • blue lips
  • breathing problems
  • cold skin
  • low body temperature
  • coma
  • confusion
  • constipation
  • dizziness
  • drowsiness
  • fatigue
  • skin flushing
  • itching
  • lightheadedness
  • muscle spasms
  • nausea
  • vomiting
  • small pupils
  • stomach spasms
  • weakness
  • weak pulse

Hydromorphone Addiction Treatment Options

There are several effective inpatient and outpatient Dilaudid addiction treatment options.


There are several methods used for Dilaudid detox, including:

  • rapid detoxification by stopping the drug immediately without medication
  • detoxing under the supervision of a medical professional who gives medicine to reduce withdrawal symptoms
  • tapering off the use of Dilaudid slowly to prevent severe withdrawal symptoms
  • using medicines such as methadone to prevent withdrawal and minimize the risk of future drug abuse

Behavioral Therapy

Behavioral therapy offered through treatment programs can be a key factor in recovering from Dilaudid addiction.

Behavioral therapy reinforces abstinence from use of drugs in a substance use disorder.

Behavioral therapy is especially useful for opioid addiction when those living with addiction undergo behavioral family counseling versus individual therapy.


Aftercare or continued care is a service provided by a treatment provider that helps those recovering from Dilaudid addiction to adjust to everyday life.

Aftercare is provided in several ways, including:

  • check-ups
  • aftercare orientation
  • individual or group therapy
  • structured aftercare sessions
  • aftercare groups

Get Treatment For Opioid Addiction Today

While it is easy for Dilaudid addiction to take control of your life, you can take that control back with substance abuse and mental health services.

Contact our team at Bedrock Recovery Center today to learn more about how we can help you recover from drug addiction.

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  2. Drug Enforcement Administration (DEA) https://www.dea.gov/sites/default/files/2020-06/Hyrdromorphone-2020_1.pdf
  3. Health Direct https://www.healthdirect.gov.au/hydromorphone#:~:text=in%20managing%20pain.-,How%20does%20hydromorphone%20work%3F,the%20brain%20and%20the%20body
  4. Health Direct https://www.healthdirect.gov.au/opioid-withdrawal-symptoms#most-likely/
  5. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/tapering-off-opioids-when-and-how/art-20386036/
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  19. ThermoFisher Scientific https://assets.thermofisher.com/TFS-Assets/CDD/Application-Notes/AN-10021613-MTL-Hydrocodone-Smart-Note-EN.pdf/

Written by Bedrock Recovery Center Editorial Team

Published on: October 2, 2023

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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