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Dilaudid, the brand name for hydromorphone, is a drug used to treat moderate to severe pain. It belongs to the drug class opioid analgesics. Dilaudid is typically used only when other alternative pain medications have failed, such as non-opioid pain relievers and opioid combination drugs.
Dilaudid (hydromorphone) is available as a liquid oral solution or as a tablet. The drug concentration of the liquid solution is 5 milligrams/milliliter (mg/ml). The tablet is available in 2, 4, or 8 mg doses. It should always be stored at room temperature. Dilaudid is also available for injection if a person is unable to take it orally.
Use Dilaudid only as prescribed by a health care professional. Dosing for each form is as follows:
- Oral Liquid solution — for adults, usual dosing is 2.5 mL to 10 mL every three to six hours. This amount is equivalent to 2.5 mg to 10 mg of the drug
- Tablet — for adults, usual dosing is between 2 and 4 mg, and must be taken every four to six hours
As an opioid, Dilaudid works by blocking pain signals going to the brain. This decreases pain intensity and improves a patient's emotional response to pain.
Here is a list of the most common types of pain that can benefit from Dilaudid use:
- Back pain: Doctors prescribe Dilaudid to manage chronic back pain, especially severe cases. However, they will usually start with less intense opioid medications. If the pain persists or worsens, doctors will then use Dilaudid.
- Cancer pain: Cancer patients experience varying degrees of pain during treatment. Dilaudid provides immense relief in patients with continuous and severe cancer-related pain.
- Chest pain: Doctors sometimes prescribe Dilaudid for chest pain. This depends on the source of the chest pain.
- Neuropathic pain: Also known as nerve pain, neuropathic pain is one that radiates from nerves that have been damaged due to different causes. Some doctors use Dilaudid to treat this kind of pain. However, further studies are needed to determine the efficacy of Dilaudid in neuropathic pain treatment.
- Stomach pain: Some doctors prescribe Dilaudid for stomach pain, while others don't. This is because one of Dilaudid's side effects is also stomach pain.
Side Effects of Dilaudid
The most commonly reported adverse side effects of Dilaudid include:
- Pain relief
- Nausea and vomiting
- Dizziness or lightheadedness
- Dry mouth
- Sedation or sleepiness
- Heavy sweating
- Loss of appetite
Additionally, more serious side effects can include:
- Hearing impairment or permanent loss
- Skin rashes
- Impairment of mental and physical performance
- Anxiety or fear
- Low blood pressure
- Serotonin syndrome
- Mood changes
Dilaudid passes through breast milk. If you are pregnant or plan on becoming pregnant, seek medical advice from your healthcare provider before breastfeeding.
Risks of Dilaudid
Dilaudid is classified as a Schedule II drug by the Drug Enforcement Administration. These are defined as “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”
It is important to pay attention to the dosing of the liquid form of Dilaudid to ensure you are taking the correct amount. Do not confuse mg and mL with each other, resulting in accidental overdose and death. Additionally, make sure to use proper measuring equipment to avoid inaccuracies in dosing.
Furthermore, Dilaudid may cause life-threatening respiratory depression in patients with preexisting pulmonary issues. It is advised NOT to use the drug without proper monitoring if you have acute or severe asthma. Patients with chronic pulmonary disease are at an increased risk of decreased respiratory function and apnea (temporarily stopping breathing).
If you are allergic to sodium metabisulfite, do not take the drug as it may cause a severe allergic reaction. Signs of an allergic reaction include:
- Rash and hives
- Swelling of the lips, face, or throat
- Difficulty breathing or swallowing
If any of these occur, stop using Dilaudid and contact emergency medical services right away.
If you have a head injury, do not take Dilaudid, as it can elevate the pressure of the cerebrospinal fluid. This elevation may become exaggerated with a head injury and can become dangerous.
Dilaudid Drug Interactions
Dilaudid has several adverse drug interactions, including:
- Other opioid analgesics/opioid antagonists
- Benzodiazepines such as clonazepam, lorazepam, and diazepam
- Muscle relaxants
- Sleep drugs/tranquilizers
- Antipsychotics such as phenothiazine
- Sodium oxybate
- MAO inhibitors
Is Dilaudid Addictive?
A study from 2018 found that about 10 million people (12 and older) have misused opioids in the past year. This is nearly 4 percent of the U.S. population.National Survey on Drug Use and Health (NSDUH)
Dilaudid is a powerful synthetic narcotic that belongs to the opioid class of drugs. With continued use, a person can rapidly develop an addiction to the drug. Regular users can build up tolerance. This means that to achieve the desired effects, one has to use larger and more frequent doses.
Tolerance can be developed in as short as two to three weeks. Once this happens, Dilaudid users usually take the drug ahead of time, causing them to run out of their prescription way ahead of schedule. This is because, even if they take the drug as prescribed by their doctor, the regular dose is no longer as effective as before.
Furthermore, Dilaudid has similar properties to other opioid medications, such as oxycodone, fentanyl, and hydrocodone. These drugs are addictive and may eventually lead to Dilaudid addiction, physical and psychological dependence, and abuse.
The active ingredient hydromorphone binds to the opioid receptors in the brain and blocks the sensation of pain. This interaction induces feelings of euphoria (a high) and calm, which can become addictive very quickly. This is what leads to Dilaudid abuse and addiction.
Addiction is characterized by a set of behaviors surrounding drug use. Someone who is addicted to Dilaudid might have cravings when not taking it, may be unable to stop using it, and may continue to do so despite knowing it is harmful.
Signs and symptoms of Dilaudid addiction and abuse include:
- Lack of hygiene
- Changes in sleep patterns
- Frequent flu-like symptoms
- Isolation from family or friends
- Taking their next dose of hydromorphone before the prescribed time
- Changes in exercise habits
- Weight loss
- Decreased libido
- Money problems
- Associating with people who encourage addiction
- Stealing from family, friends, or businesses
Someone who uses Dilaudid for an extended period of time can become physically and psychologically dependent on it. In short, they need to take the drug to feel normal and function daily. If drug use is stopped suddenly during dependence, withdrawal syndrome can occur. Symptoms of Dilaudid withdrawal include:
- Increased pain
- Irritability or agitation
- Anxiety or restlessness
- Difficulty sleeping
- Muscle cramps/aches
- Watery eyes, runny nose
- Chills, sweating or goosebumps
- Stomach cramps
- Changes in blood pressure
- Suicidal thoughts
- Rapid heart rate
Do not attempt to withdraw from Dilaudid on your own, as this can be extremely dangerous.
A sudden change in opioid use can induce seizures, and in some severe cases, death. Talk with your doctor about quitting opioid use and how to do so safely.
One supervised method of stopping Dilaudid use is tapering off the drug. This process reduces the dose of the drug slowly over a period of time to prevent shock to the body’s systems. With this, withdrawal symptoms will be much less severe and can be managed with other medications. To ensure safety, tapering should only be done under the direction of a medical professional.
Overdoses from opioids can happen for many reasons, including:
- Using more of the opioid than is prescribed (intentionally or accidentally)
- Mixing opioids with other CNS depressant medications, alcohol, or illicit drugs
- Taking an opioid with the intention of getting high
- Taking an opioid that was not prescribed for you
Respiratory depression (slow and ineffective breathing) is an extremely dangerous condition that can develop with opioid use. High doses of the drug act on the brain stem, where breathing rate and rhythm are controlled. Using alcohol, benzodiazepines, and other drugs that affect your central nervous system can exacerbate respiratory depression.
Most often, breathing problems are seen in opioid overdose or when too much drug is taken in a single dose. Signs of Dilaudid overdose to look out for include:
- Trouble breathing
- Severe drowsiness
- Inability to speak
- Limp body
- Pale and clammy skin
- Purple/blue lips and fingernails
If any of these symptoms are observed in a person taking Dilaudid, call 911 for medical attention immediately and administer naloxone if available.
How Long Does Dilaudid Stay in your System?
The length of time that Dilaudid stays in a person's system depends on several factors, which include:
- Dosage taken
- Kidney health
- Liver health
- Metabolism rate
- Overall health
- Chemical preparation of the drug
IV Dilaudid has a half-life of two hours, while oral forms (liquid or tablet) of the medication have four hours.
Half-life is the amount of time it takes for a drug's plasma concentration levels to reach half of its original value. The longer the half-life, the longer the drug stays in the body.
Drug testing detects the presence of the substance in several parts of the body long after the last use. Here is a list of the amount of time it takes for Dilaudid to be eliminated from different parts of the body:
- Blood: Less than 24 hours
- Hair: 3-6 months
- Saliva: 2-3 days
- Urine: 2-3 days
Treatment Options for Opioid Abuse & Addiction
There are several options for people suffering from opioid addiction. These include:
- Medication-Assisted Therapy (MAT) — There are three medications approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. Naltrexone is less commonly used, but it blocks your opioid receptors, making it impossible to get high. Medication-assisted therapy is most effective when combined with other forms of treatment.
- Inpatient Programs — Inpatient programs are the most intensive and effective treatment options for opioid addiction. These programs guide you through medically supervised detoxification, then behavioral therapy and other services (possibly including MAT), will be added to your treatment. They typically last 30, 60, or 90 days, however they may be longer if necessary.
- Partial Hospitalization Programs (PHPs) — PHPs are also known as intensive outpatient programs (IOPs). They are the next most intensive type of treatment for opioid addiction. They provide similar services to inpatient programs such as detoxification, behavioral therapy medical services, and custom treatments such as MAT. The difference is that in a PHP, the patient returns home to sleep. Some programs will include transportation and meals, but this varies by program. Partial hospitalization programs are helpful for both new patients and patients who have completed inpatient treatment and still need intensive recovery therapy.
- Outpatient Programs — Outpatient programs work best for people who have a high level of motivation to recover. They create treatment programs that work around your schedule. These programs can either be an effective treatment option for new patients or a part of an aftercare program for people who complete inpatient or partial hospitalization program.
Overcoming addiction to Dilaudid is difficult to do alone. Find medical help today.