Hydromorphone is a pain-relieving medication that should only be used for short periods of time.
Individuals who abuse hydromorphone can develop multiple physical, psychological, and social issues associated with their use of the drug. Addiction can form quickly.
Hydromorphone is an opioid medication that is primarily prescribed as a pain reliever. Its primary use is to control pain and discomfort in individuals who have recently undergone surgery, although it can be used in other instances to relieve chronic pain.
Extended or long-term use of hydromorphone or other any opioid as a pain reliever should be monitored very closely by prescribing physicians due to abuse potential.
Hydromorphone products are available by prescription only. The products can be obtained in a tablet immediate-release form, a tablet extended-release form, and a liquid.
Some of the more common brand names of hydromorphone products in the United States include Dilaudid, Exalgo (an extended-release form), and Palladone (which has been removed from the market).
Products containing hydrocodone are controlled substances that are listed by the U.S. Drug Enforcement Administration (DEA) in the Schedule II category. All the medications in this category have an extremely high potential to be abused and to produce physical dependence in people who take them for extended periods, even though they do have important medical uses.
Products containing hydrocodone are available only under a restricted distribution program (the Opioid Analgesic Risk Evaluation and Mitigation Strategy Program). This essentially means that the prescription of hydromorphone products is closely monitored. Refills cannot be automatically obtained, as they require a new prescription from a physician.
Hydromorphone products are primarily used to relieve pain while someone is under the supervision of a physician. This medication is not designed to address the aches and pains that occur in everyday circumstances. Instead, this medication is used to address severe pain associated with surgery, a serious injury, or a very severe chronic disorder that produces intense pain.
The immediate-release tablets address postsurgical pain quickly. The extended-release capsules address pain in people who may have developed a tolerance to opioids or who need around-the-clock pain relief.
Hydromorphone is a strong medication estimated to be between two to eight times more potent than morphine, making it an effective pain reliever for people who have tolerance to other opioids. Its potency also results in a higher potential for abuse.
Whenever any prescription medication is considered for any patient, the physician and patient must weigh the costs and benefits of using the medication. There are many considerations when it comes to hydromorphone.
The medication should only be used for its prescribed purposes, such as for severe postsurgical pain, for individuals who have developed some tolerance to other opioids, and sparingly in individuals with chronic pain.
All medications carry a side effect profile that can complicate their medical use. The following are some of the side effects associated with the use of hydromorphone products:
Side effects are relatively rare in individuals who use the medication as prescribed. If they do occur, they will typically resolve over time, or they can be addressed by the physician who prescribed the medication.
Those who abuse opioids like hydromorphone tend to experience more intense and more varied side effects along with a significant increase in tolerance and the potential to severe develop a physical dependence on the drug. Thus, one of the potential signs that someone is abusing hydrocodone is that they experience significant and lingering side effects that are associated with the drug, high tolerance to it, and significant withdrawal symptoms when they do not use the drug.
Hydromorphone products are extremely potent drugs that are primarily designed for use in a hospital or clinic, for individuals who have significant postsurgical pain (for short periods of time), or for individuals who have developed tolerance to other opioids. Long-term use of hydromorphone is never recommended.
According to the National Institute on Drug Abuse (NIDA), abuse of prescription medications is a significant problem in the U.S. Opioid abuse has become so prevalent that it has been labeled an epidemic.
In the early 2000s, prescriptions to hydromorphone began to increase at an alarming rate. Due to recent controls on prescribing opioids, the number of individuals reporting using and misusing hydromorphone products is declining.
SAMHSA and NIDA report that use and abuse of prescription medications are highest among individuals between the ages of 18 and 35, but it occurs across all age groups.
Other individuals at risk for abusing hydrocodone include those with previous histories of substance abuse problems, those who have some other form of mental illness, and those who have a family history of substance abuse or mental illness.
Those who abuse prescription opioids may take the pills orally, but they are also likely to grind up the pills and snort them or mix them with a liquid and inject the solution.
Physical dependence on opioids is typically not a concern for individuals who use them under the supervision of their physician and according to their intended purpose. However, physical dependence is a significant problem for those who abuse opioids. It complicates a person’s cycle of drug abuse since they are compelled to keep taking the drug.
Using hydromorphone for reasons other than its intended purpose is a sign of misuse. Those who use the drug to experience euphoria or relieve stress are abusing the drug.
There are other signs of hydromorphone abuse.
People using hydromorphone products under the supervision of a physician will generally not have issues discontinuing use of the drug when it is time to do so. It’s still a good idea to talk to the prescribing physician about the best way to stop use.
Those who have been abusing hydromorphone need medical detox to stop safely. The withdrawal process from opioids can be incredibly uncomfortable, and relapse is likely without professional help.
Detox should be followed by therapy to address issues related to substance abuse. Usually, a comprehensive addiction treatment program is the best approach to recovery.
While hydromorphone is a potent drug that can lead to serious issues with addiction, recovery is possible.
DEA: (N.D.) Drug Scheduling. U.S. Drug Enforcement Administration. Retrieved January 2019 from https://www.dea.gov/drug-scheduling
(February 2019). Hydromorphone (RX). MedlinePlus. Retrieved February 2019 from https://reference.medscape.com/drug/dilaudid-hydromorphone-343313
(2017). Complete Guide to Prescription and Nonprescription Drugs 2018-2019. Penguin Press. from https://books.google.com/books?id=nBYcDgAAQBAJ&printsec=frontcover&dq=Complete+Guide+to+Prescription+%26+Nonprescription+Drugs,+2018-2019&hl=en&sa=X&ved=0ahUKEwjm0sWOre7YAhUSgK0KHUz9Bx4Q6AEIKTAA#v=onepage&q=Complete%20Guide%20to%20Prescription%20%26%20Nonp&f=false
(December 2018). Misuse of Prescription Drugs. National Institute on Drug Abuse. Retrieved February 2019 from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse
(October 2018). National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration. Retrieved January 2019 from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
(July 2016). Treatment of Opioid-Use Disorders. New England Journal of Medicine. Retrieved February 2019 from http://unmhospitalist.pbworks.com/w/file/fetch/115878559/treatment%20of%20opioid%20use%20disorders%20NEJM.pdf