The Silent Suffering behind Hydromorphone Addiction

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Prescription opioid drug abuse is a serious and widespread problem, with approximately 15 million people suffering from opioid addiction around the world [1]. In the United States, the Centers for Disease Control and Prevention (CDC) reports that every single day, 44 people die from a prescription opioid painkiller overdose [2]. One commonly abused prescription opioid drug is hydromorphone.

Though hydromorphone use often begins with a legitimate medical prescription, it can sometimes lead to a serious, life-threatening addiction. If you suspect you or a loved one may be suffering from hydromorphone addiction, here are some of the signs and symptoms to look out for, plus a look at the dangers and side effects associated with hydromorphone addiction.

What is Hydromorphone?

Hydromorphone (also sold under the brand names Exalgo and Dilaudid) is an opioid narcotic medication used to treat severe and chronic pain or prescribed for those who are tolerant to other opioid drugs. Five to ten times more potent than morphine, hydromorphone works by altering the way the brain and body respond to pain. The Drug Enforcement Administration (DEA) classifies hydromorphone as a Schedule II controlled substance, meaning although it has accepted medicinal purposes, it also has a significantly high potential for abuse and addiction [3].

Since hydromorphone is much more potent than other opioids, it is a popular drug among recreational users. Similar to other opioid drugs, hydromorphone interacts with opioid receptors in the brain and central nervous system, disrupting the body’s natural messengers and receptors, thereby reducing pain, anxiety, and stress and enhancing feelings of pleasure, relaxation, and calm. When abused, it can produce an intense euphoric “high” within 10-15 minutes of use.

Hydromorphone Addiction

According to the DEA, hydromorphone addiction is an ongoing problem in the United States, with a 2011 report stating that approximately 1 million people aged 12 and older used hydromorphone recreationally or for nonmedical purposes at least once in their lives [4].

Though hydromorphone may be abused by individuals with a history of substance abuse or recreational drug use, this is not the only population to be affected by hydromorphone addiction. Oftentimes, abuse starts out with a legitimate and legal prescription for pain relief. Unfortunately, when taken regularly over an extended period of time, an individual may develop tolerance to the drug and subsequently need higher and higher doses for it to be effective. Over time, these higher levels of use can lead to a physical dependence on the drug.

When a person is physically dependent on hydromorphone, they will begin to experience symptoms of withdrawal when the drug leaves their bloodstream. These symptoms can surface within several hours of the last dose.

Withdrawal symptoms include:

  • Anxiety
  • Restlessness
  • Irritability
  • Chills
  • Yawning
  • Insomnia
  • Hypertension
  • Depression
  • Nausea
  • Back and joint pain
  • Increased heart rate
  • Diarrhea
  • Sweating
  • Runny nose
  • Increased respiratory rate
  • Weakness

African American woman fighting Hydromorphone addictionThese symptoms of withdrawal may push some people to continue taking the drug even when they run out of their prescription or when they no longer have a medical need for pain relief. Additionally, since hydromorphone alters the brain and central nervous system’s receptors and messengers, some people who started out using the drug for a legitimate medical reason may keep taking it in order to experience the enhanced feelings that often accompany chronic hydromorphone use.

Signs of Abuse

In 2014, the National Survey on Drug Use and Health (NSDHU) reported that the highest percentage of people abusing prescription opioids (such as hydromorphone) were between 18 and 25 years of age [5]. Additionally, the DEA reveals that hydromorphone abuse occurs much more frequently among rural and suburban populations [6]. Individuals suffering from hydromorphone addiction most often acquire the drug by going to multiple doctors for prescriptions through forged prescriptions, pharmacy robberies, armed robberies, and thefts of nursing homes.

If you suspect a loved one may be suffering from hydromorphone addiction, here are some of the subtle signs and symptoms to look out for:

  • Erratic and unpredictable behaviors
  • Mood swings
  • Withdrawal from social settings
  • Secretive behavior
  • No longer participating in things they used to enjoy
  • Problems at work
  • Irregular sleep schedule
  • Irregular eating habits
  • Weight fluctuations
  • Sudden money problems
  • Legal troubles
  • Criminal activity

Dangers of Addiction

Individuals suffering from hydromorphone addiction are at serious risk of experiencing both short-term and long-term physical side effects. In fact, according to a report by the Drug Abuse Warning Network (DAWN), the nonmedical use of hydromorphone was responsible for approximately 20,000 emergency department visits in 2011 [7].

Side effects of abuse include:

  • Mood swings
  • Difficulty thinking clearly
  • Nervousness
  • Restlessness
  • Increased fatigue and drowsiness
  • Loss of coordination
  • Nausea
  • Vomiting
  • Rash
  • Changes in blood pressure
  • Rapid or slow heart rate
  • Respiratory depression
  • Impaired behavior regulation
  • Inability to handle stress
  • Brain damage

Additionally, if too much hydromorphone is introduced into the bloodstream at once, an overdose will occur. Hydromorphone overdose can lead to loss of consciousness, cardiac arrest, apnea, a collapse of the circulatory system, or even death.

Help for Hydromorphone Addiction

If you suspect you or a loved one may be suffering from hydromorphone addiction, seek help right away. Since hydromorphone dependence can lead to serious detox and withdrawal symptoms, it is not advisable to attempt detox without professional help.

Thankfully, there are numerous treatment programs available that can help individuals suffering from hydromorphone addiction find hope and healing. Start by calling the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 to talk to someone about getting help and to find treatment options in your area.


[1] World Health Organization. Opioid overdose. World Health Organization.
[2] Centers for Disease Control and Prevention. (2020, March 19). Understanding the Epidemic. Centers for Disease Control and Prevention.
[3] Edited by Editorial StaffLast Updated: February 3, 2020. (2020, February 3). Understanding Dilaudid Abuse, Withdrawal, Overdose & Treatment. American Addiction Centers.
[4] HYDROMORPHONE. Drug Enforcement Administration. (2019, September).
[5] Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. (2014).
[6] HYDROMORPHONE. Drug Enforcement Administration. (2019, September).
[7] Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. Substance Abuse and Mental Health Services Administration. (2013, May).

About the Author:

Sarah Musick PhotoSarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.

Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on March 22, 2021, on
Reviewed & Approved on March 22, 2021, by Jacquelyn Ekern, MS, LPC

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.