A Guide to Hydromorphone (Dilaudid)

By The Fix staff 08/02/14

Hydromorphone is a semi-synthetic opioid analgesic (a painkiller) that is thought to be six to eight times stronger than morphine. It is derived from morphine and is known under the brand names: Palladone, Hydromorph Contin, Hydrostat, Exalgo, Dilaudid-HP and Dilaudid. Dilaudid's generic brand name is hydromorphone, though it is more commonly referred to as Dilaudid and rarely by its generic name.

By any name the substance is most available in the form of either instant-release or time-released capsules. Street names include: Dillies, Hydro, Hydromorph and D's. It can also be taken rectally or intravenously. In any form, it is highly addictive.  

How it affects the brain

Hydromorphone affects the brain much like the drug morphine does in that it produces morphine-like actions at the kappa receptors but differs in that it does not produce the same effects at the mu and delta receptors. In effect, hydromorphone has a shorter duration compared to other opioids but like them, by activating certain nervous system receptors, it limits the perception of pain and increases pain tolerance while creating euphoric effects. It starts to affect the body within 30 minutes of taking it orally and within 5 minutes of injecting it. .

Medical Uses

Hydromorphone is used to treat moderate to severe pain and it is rarely used as a cough suppressant. It should not be taken by anyone who has recently taken antidepressant MAO inhibitors.

Addictive Properties

Hydromorphone provides the same euphoric rush that is felt from IV heroin. Addiction to hydromorphone was thought to be prevented through the creation of time-released capsules but users found that by crushing the capsules and altering the recommended methods of dosage, they could achieve a euphoric high, especially when mixing with alcohol (which leads to something called dose dumping). Studies have shown that the abuse liability does not differ between that of hydromorphone, hydrocodone or oxycodone.

Long term effects

Hydromorphone is habit forming and can cause mental or physical dependence. Other long term effects include rashes, difficulty urinating, fainting and difficulty breathing. It aggravates the conditions for people with kidney. gallbladder, liver, thyroid, pancreas or prostate ailments or blocked intestines or breathing difficulties of any kind. It also may cause stomach damage or bring on seizures, especially for those people who have had them in the past or who have had any serious head injuries or brain tumors.  


Symptoms of overdose include pinpoint pupils, slowed or stopped heartbeat, dizziness, fainting, cold or clammy skin, sleepiness, and coma. Similar to oxycodone, hydromorphone can cause heart attacks and fatal loss of breathing capacity. 

Legal Status

Hydromorphone is a Schedule II drug in the United States.










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