Hydromorphone is a powerful opioid painkiller, commonly known by the brand name Dilaudid. Used to treat intense, severe pain, hydromorphone is roughly four to five times more powerful than morphine. However, hydromorphone’s side effects and potential for abuse make it one of the least prescribed pain relief medications in the US.

Every day, more than 115 people in the United States die from overdosing on opioids. The misuse of prescription pain relievers such as Oxycontin and fentanyl has created a serious public health crisis. This crisis is especially problematic for our veteran population, who in the course of their service often develop injuries that are treated with opioid pain medications.

Safely managing pain medication is tricky, especially for those with conditions that cause chronic pain. Changing prescriptions, adjusting dosages, and dealing with the side effects of pain medication can be confusing and difficult to figure out. Knowing more about the adverse effects of hydromorphone and other pain medication can help you manage your pain relief safely.

What Does Hydromorphone Do?

hydromorphone side effects

Dilaudid, or hydromorphone, is a pain reliever prescribed for severe or chronic pain, usually in people who have developed some tolerance to weaker painkillers already. The Drug Enforcement Administration (DEA) classifies Dilaudid as a Schedule II controlled substance, meaning it’s considered a drug with valid medicinal uses but a very high potential for abuse and dependence.


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Dilaudid comes in liquid, pill, and IV forms. Once taken, hydromorphone is processed by the liver into metabolites which then attach to the receptors in the brain that regulate pain. Dilaudid is most often prescribed for pain after a major injury or surgery because of its fast-acting and strong pain relieving effects. However, Dilaudid’s half-life is rather short, with its effects fading within a few hours.

The most notable of hydromorphone’s side effects is the release of excessive amounts of dopamine in the brain, which causes a feeling of euphoria similar to heroin. This activates the reward center of the brain, creating a sense of desire for the same experience. The more this happens, the less the brain will naturally produce dopamine, making hydromorphone seem like the only way to feel happy again.

Hydromorphone Side Effects

Hydromorphone’s adverse effects are largely due to the intense rush of chemicals in the brain that it produces. Hydromorphone side effects can be acute, meaning they only last for a few days, or persistent, meaning they occur often and for long periods of time. These side effects may include:

  • Drowsiness
  • Dizziness
  • Lightheadedness
  • Nausea & vomiting
  • Sweating
  • Flushing
  • Euphoric effects
  • Dry mouth
  • Itching

More severe hydromorphone side effects include heart problems, vision changes, nervous system issues, stomach issues, mood changes, blood pressure changes, and breathing complications. If you experience any of these serious symptoms, contact your doctor as soon as possible.

Hydromorphone Overdose

As a potent opioid, Dilaudid dosages are often limited to eight milligrams every four to six hours as needed. Generic prescriptions for hydromorphone may have dosage as large as 30mg. However, this amount is rare and usually only used for immediate treatment after an injury or surgery. This restriction is in place due to how easy it is to overdose on hydromorphone.

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. But the way that you take hydromorphone plays a part as well. Snorting, smoking, or injecting it causes the body to digest a large dose all at once rather than over time. This significantly raises the risk of overdose and other dangerous hydromorphone side effects.

Even when used properly, using hydromorphone over a long period of time can cause physical dependence. Since your body becomes used to the effects of hydromorphone, suddenly removing it from your system can lead to withdrawal symptoms. The effects of hydromorphone withdrawal usually include the following:

  • Insomnia
  • Anxiety
  • Chills
  • Irritability
  • Depression
  • Nausea and cramps
  • Diarrhea
  • Fever

The discomfort of withdrawal, in addition to hydromorphone’s strong potential for abuse, can cause people to take it after their prescription runs out or when they no longer need its pain relieving effects. After the brain’s motivation system has been desensitized by hydromorphone, it can seem impossible to get through life without it.

Why Are Veterans Prescribed Hydromorphone?

Why Are Veterans Prescribed Hydromorphone?

Chronic pain affects 30% of American adults, but affects 60% of veterans returning from overseas deployments. Overall, it affects more than 50% of older veterans in the VA health care system. This is partially because battlefield injuries can often result in long-term moderate to severe pain. As part of a pain management treatment plan, veterans with service-related injuries are often prescribed painkillers like Dilaudid.

Because of the severity and frequency of pain from service-related injuries, veterans typically get prescribed increasingly strong forms of pain medication as they develop a tolerance to the effects of opiates. Used properly, pain medication can ease suffering and improve quality of life, but there is always a risk of long-term use leading to addiction and reliance. Dilaudid addiction is so common that when considering taking it, you should consider addiction as a potential hydromorphone side effect.

Self-medication for stress is one reason why hydromorphone abuse is so prevalent among veterans. Oftentimes, veterans prescribed drugs like hydromorphone to deal with physical health issues begin abusing medication in order to help deal with the symptoms of PTSD relating to their military experience. The U.S Department of Veterans Affairs estimates that one in three veterans seeking help with substance abuse also has PTSD.

The transition to civilian life often comes as a shock for veterans separating from the military after years of living within the military chain of command. Finding a job, finding housing, getting transportation, family issues, and coping with PTSD are a few things that can trigger overwhelming stress. This causes some veterans to rely on opioids and/or alcohol to deal with their emotional stress without having to open up to others.

Seeking Treatment for Hydromorphone Abuse

Among veterans, addiction is unfortunately a common hydromorphone side effect. And while some veterans have found success in civilian treatment programs, many veterans find that they work best with other military personnel. That’s why at Heroes’ Mile, our veteran staff members use their shared experiences to help treat the health issues that veterans face.

Our addiction treatment programs take place in an environment that’s filled with veterans in treatment and veterans in the care staff. We allow for open, honest discussions of health issues with people who really understand. Whether it’s initially getting off of opioids in our veteran detox program, learning addiction coping skills in our veteran rehabilitation program, or transitioning back to regular life in an outpatient program, we’re here for you every step of the way.

At Heroes’ Mile, we devote ourselves to helping veterans recover from opioid addiction and other substance abuse issues. If you’re ready to talk about your options, call our admissions specialists at 888-838-6692 or ask your questions online with our confidential contact form.


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