What are the Short and Long-Term Effects of Hydromorphone?

Medically Reviewed

Hydromorphone is one of the most potent opioids that is prescribed for pain relief. It is often prescribed under the brand name Dilaudid.

The drug comes with a range of both short-term and long-term effects.

Potential short-term side effects include excessive sweating, balance issues, and constipation, among others. Long-term issues include tolerance, dependence, and addiction.

Hydromorphone is only prescribed to people who have severe pain that does not respond to less potent opioids.


As a potent opioid, hydromorphone is subject to abuse. It can quickly lead to overdose, particularly for those who do not have a tolerance to opioids.

Overdose can reduce respiratory rates to dangerous degrees and ultimately stop breathing altogether. This can lead to coma and death.

As oxygen levels are lowered, the skin may turn a bluish color, and breathing may become labored. This is a clear sign to call 911.

Other signs of overdose include the following:

  • Confusion
  • Damp skin
  • Exhaustion
  • Pinpoint pupils
  • Vomiting
  • Stomach spasms
  • Difficulty breathing
  • Low blood pressure
  • Slow heartbeat
  • Dizziness
  • Losing consciousness

Hydromorphone overdose is more likely if the medication is combined with other substances of abuse, such as alcohol.

If an overdose is suspected, call 911 immediately. First responders will administer naloxone (brand name Narcan), an opioid reversal drug that can temporarily reverse an overdose. In some instances, more than one dose of naloxone may be needed.

Naloxone is processed out of the body faster than opioid drugs. This means the overdose can return, so further treatment is needed. Even if you have naloxone on hand and can administer it, the person still needs professional medical attention.

Short-Term Effects

While overdose is the most serious short-term effect of hydromorphone use, there are others.

  • Loss of balance
  • Sleepiness
  • Excessive perspiration
  • Skin Irritations
  • Feelings of exhilaration
  • Constipation

Since constipation is a major problem with opioid use, doctors recommend increasing water consumption and eating high-fiber foods. Stool softeners may be recommended as well.

Constipation is particularly common in older patients who are ages 65 and older.

Hydromorphone may also lead to a hypotensive effect. It can cause severe low blood pressure in someone who has reduced blood volume or has simultaneously taken multiple drugs.

The drug also impairs the mental and physical ability to safely operate a vehicle or other machinery, or participate in any other activity that may be deemed hazardous.

Benign symptoms may resolve quickly after initially taking hydromorphone, but if they linger beyond a couple of days, talk to the prescribing doctor.

The doctor may adjust the dosage or prescribe a different medication altogether.

Long-Term Effects

Generally, hydromorphone is only prescribed for a short period of time. Long-term use is usually associated with abuse.

With long-term use, tolerance will form quickly. This means the same dose of hydromorphone no longer produces the same effects. If the medication is prescribed by a doctor, the dosage may be raised.

After tolerance forms, dependence is likely. This means the body has come to depend on the presence of the opioid to function normally.

Physical dependence happens with the legitimate medical use of opioids, and it is not a cause for concern if the person is using the drug under the supervision of a doctor. If a person is abusing the drug, addiction quickly follows physical dependence.

When the drug is processed out of the body, withdrawal symptoms may occur. People continue the cycle of abuse to keep withdrawal symptoms at bay.

There are other problems associated with long-term hydromorphone use.

  • Insomnia and other sleep problems
  • Intestinal issues
  • Extreme fatigue
  • Depression
  • Brain damage
  • Respiratory issues


Once physical dependence is present, a person needs help to stop taking hydromorphone. This is true whether they use the drug for medical reasons or recreationally.

If a person is using it medically, the prescribing doctor will advise on the best way to stop use. Usually, this involves gradually reducing the dose over a period of weeks until the person is no longer taking the drug.

Since hydromorphone is such a strong painkiller, it’s likely that the person will need another form of pain management. The doctor may switch the individual to a less potent opioid and recommend alternative forms of pain management. These may include the following:

Alternative Forms of Pain Management

  • Physical therapy
  • Massage
  • Meditation and yoga
  • Acupuncture
  • Heat therapy

If a person has been abusing hydromorphone, medical detox is needed. If they suddenly stop using the drug, they will be thrown into withdrawal. This will be painful and intense.

In medical detox, medication-assisted treatment (MAT) is usually used for opioid withdrawal. A replacement medication, such as methadone or buprenorphine, is prescribed that mostly takes the place of hydromorphone in the brain. This reduces the presence of withdrawal symptoms and cravings, making the person comfortable and helping them make it through detox so they can focus on therapy.

How Treatment Mitigates the Damage

Abuse of any opioid, especially one as strong as hydromorphone, can result in serious health issues. Changes can be made to brain structure that can alter how a person functions in everyday life.

The best chance of mitigating the damage from hydromorphone abuse is to enroll in a comprehensive addiction treatment program. This treatment includes medical and psychological care which can address damage on all fronts.

Each client will participate in various forms of therapy, helping them to build a new life that is free from all substances of abuse.

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