The length of time that hydromorphone products can be detected in the body depends on the amount of the drug taken, the mode of administration used, and other factors.
Hydromorphone is a prescription pain medication that is most often prescribed to treat post-surgical pain.
It is an opiate analgesic, which alters the subjective experience of pain by attaching to selective receptors in the brain (mu-opiate receptors) that are specialized for endogenous neurotransmitters that have similar effects to opioids.
Continued use of the drug can lead to serious physical consequences, including the development of physical dependence and an opiate use disorder.
Hydromorphone is most commonly recognized by the trade name Dilaudid. It is also available in other forms, including a generic form.
It is a controlled substance in the Schedule II category with significantly greater potency than morphine — anywhere between two and eight times higher than morphine. This means that a far lower amount of hydromorphone can lead to significant effects compared to morphine.
Onset of Effects
The effects of hydromorphone are dependent on the route of administration. It can be taken orally in pill form, orally as a liquid, injected (most often intravenously or intramuscularly) or inserted rectally.
According to the books Workplace Drug Testing, Pharmacogenomics of Alcohol and Drugs of Abuse, and Accurate Results in the Clinical Laboratory: A Guide to Error Detection and Correction, the amount of time hydromorphone remains in the body is variable.
When taken orally, either in pill or liquid form, hydromorphone products typically begin to work within 15 minutes and reach their peak effects in 30 minutes to an hour after administration.
The half-life for oral hydromorphone is about four hours. This means the drug is reduced by half of its original concentration within about four hours after taking it if no more is ingested during this time.
The drug should be expected to remain in the body for between two and three days following administration
Intravenous injections of hydromorphone products will typically result in a person feeling the effects within five minutes of the injection. An intravenous injection injects the medication directly into a vein, one of the preferred methods of drug abusers.
The half-life for intravenous injections of hydromorphone is between two and three hours, most often closer to two hours, but it can still remain in the body for up to three days.
Injecting hydromorphone into the muscle tissue will often result in the onset of the effects occurring within about 15 minutes.
The half-life for intramuscular injections is about three hours. Hydromorphone may remain in the body for several days following intramuscular injections.
When patients have severe nausea or cannot tolerate an injection, they may be given hydromorphone rectally. This may occur with cancer patients.
The effects should occur within about 30 minutes, and the half-life is a bit longer between four and five hours. Rectal administrations of hydromorphone may result in the drug remaining in the body for up to several days.
Length of Time Hydromorphone Stays in the Body
For individuals taking medicinal doses of hydromorphone, the following guidelines apply:
- Hydromorphone is typically detectable in blood tests for about 24 hours.
- It is typically detectable in urine tests for up to three days, with the two to three-day window being an appropriate estimate in most cases.
- Saliva testing should reveal the presence of hydromorphone for about two to three days after taking the drug.
- Hair follicle tests, which can detect drugs for longer periods of time, may be able to detect hydrocodone for up to six months after using it.
The extended-release version of hydromorphone (Exalgo) allows people to take one dose instead of multiple doses during the day.
Depending on the dose of the drug used, the extended-release versions may result in the detectability of hydromorphone being extended. These formulas will typically have an onset of action within six hours of administration, the effects will peak within nine hours, and the effects will last about 13 hours.
The half-life ranges between eight and 15 hours, but it is often reported to be 11 hours. This means that the drug could be detectable, depending on the dosage taken, up to four to five times longer than the immediate-release versions.
Special Note on Tolerance and Abuse
The above data regarding testing for hydromorphone is based on the average dose for oral treatment with hydromorphone, which is about 2 to 4 mg for most people. Users of opiate drugs develop a tolerance for these drugs very rapidly. They will typically use higher amounts of the drug and often take it multiple times.
Developing tolerance to a drug like hydromorphone does not necessarily mean that the liver can metabolize it significantly quicker.
Those with tolerance to the drug may take many times the recommended amount, and they may take it more than once or combine it with other drugs. Any of these practices can seriously affect normal elimination of the drug and extend the timeframe for detection.
There can be quite a bit of individual variation in metabolism based on a person’s genetics, weight, and other differences.
Chronic abusers of hydromorphone products may find that the drug remains in their system longer than the timeframes quoted here. In some cases, the drug may be detectable for many days or even longer.