Dilaudid — also known as — hydromorphone, is a powerful and fast-acting opioid medication. Much more potent than morphine, Dilaudid is prescribed for acute and severe pain due to illness or surgery and is usually given when other pain relievers are less effective.

Like other opioids, Dilaudid poses a high risk of abuse. Its potency and rapid effects can make it an addictive substance, especially if a person is using it for both physical and emotional reasons. However, there is hope for those who become addicted to Dilaudid. Numerous treatment options are available which allow individuals to restore their health and lead new lives free from addiction.

Before going into the treatment methods that are available for Dilaudid addiction, this article will provide an outline of what Dilaudid is and what the long-term effects are.

What is Dilaudid?

Hydromorphone letters on table

Dilaudid is an opioid medication that is used for acute and severe chronic pain caused by medical procedures and conditions such as cancer. It can also be used for cough suppression. Generically known as hydromorphone, Dilaudid is 5 to 10 times more potent than morphine.

Due to its potency and high risk of abuse, Dilaudid is considered a Schedule II Controlled substance by the Food and Drug Administration (FDA), and it is usually only prescribed for short-term use when other treatments have failed. For example, a patient who hasn’t had any pain relief with an over-the-counter medication may then be prescribed an opioid such as codeine. If this also has no effect, a stronger medication like Dilaudid is then prescribed.

On the street, Dilaudid is known as:

  • Footballs
  • Dust
  • Smack
  • Dillies
  • Juice
  • D

How Does Dilaudid Work?

Dilaudid is a full opioid agonist, which means that it completely fills the body’s opioid receptors. This leads to an over-abundance of other pleasure chemicals in the brain, such as dopamine and endorphins, causing a euphoric rush. Dilaudid can also take effect within 10 to 15 minutes of ingestion, meaning its effects are stronger and more potent than some other opioids.

As an analgesic, Dilaudid’s action on the body’s opiate receptors results in a reduction in pain, and it also changes the way the body and brain respond to pain. Dilaudid also slows down the functions in the nervous system, such as blood pressure, heart rate, and respiration, creating a sense of relaxation.

Is Dilaudid Addictive?

All opioids have a high risk of addiction; however, Dilaudid can be particularly habit-forming due to its fast-acting and potent effects. Dilaudid is also known for its potential for tolerance, where a person needs to take higher and higher dosages to experience the same effects. This rise in tolerance can then lead to physical dependence and withdrawal symptoms if the person stops taking it.

Aside from tolerance, Dilaudid is also addictive if a person uses the drug to feel relaxed or to numb uncomfortable feelings. Some individuals who become addicted to opioids have underlying psychological or mental health issues such as anxiety or depression, which are alleviated by substances like Dilaudid. These drugs then become psychologically and emotionally addictive, and it can be difficult to feel normal without them.

The other downside to this process is that Dilaudid withdrawal can also cause anxiety and depression, which can make symptoms worse if these are also underlying conditions. The result is that people can become dependent on Dilaudid’s euphoric and relaxing effects, even if they no longer need it for pain relief.

Dilaudid Addiction vs. Dependence

When it comes to drug abuse, it’s also worth noting that there is a slight difference between dependence and addiction. Dependence, for example, is a state of adaptation in the body that develops after repeated use of the drug. In this state, a person isn’t mentally obsessed or attached to the drug. However, if the drug is discontinued abruptly, withdrawal symptoms can occur and may require medical assistance to taper off.

Addiction, on the other hand, is considered a chronic, primary disease that is marked by compulsive use, cravings, and continued use despite any negative consequences. Therefore, if a person is addicted to Dilaudid, they will be obsessed with taking it and will usually take more of it than prescribed. People who have an addiction feel unable to function normally without the drug and will go to any lengths to keep taking it.

Statistical Overview of Prevalence of Abuse

  • In 2010, the U.S. consumed 65% of the world’s Dilaudid prescriptions.
  • In 2014, it was estimated that 4.3 million people were using narcotic pain relievers such as Dilaudid without a prescription.
  • In 2017, Dilaudid was the 205th most prescribed medication in the U.S., with over 2 million prescriptions.
  • Emergency room visits related to non-medical use of Dilaudid increased by approximately 6,000 between 2008 and 2012.
  • According to the World Health Organization (WHO), approximately 115,000 people died of an opioid overdose in 2017.
  • The number of people in the U.S. dying from an opioid overdose increased by 120% between 2010 and 2018.
  • According to the Centers for Disease Control (CDC), roughly 21% to 29% of patients misuse prescription opioids.
  • It is estimated that between 8% and 12% of people who use an opioid for chronic pain end up developing an opioid use disorder.

The History of Dilaudid

Dilaudid, in its generic form as hydromorphone, was first produced in Germany in the 1920s during a time when the country was extensively researching pain management therapies. Hydromorphone was produced as an alternative to other pain relievers, and it was thought at the time that it carried fewer health risks and negative side effects.

The drug was eventually branded “Dilaudid” and introduced to the mass market in 1926. Its name is derived from its similarities to morphine (by way of laudanum).

Dosage and Methods of Use

Dilaudid can be taken orally, intravenously, or as a suppository. In pill form, Dilaudid tablets are small, round, and colored. In its liquid form, Dilaudid is colorless and slightly viscous with a clear or pale-yellow appearance. The Dilaudid suppositories are usually whitish and oblong in shape.

In terms of dosage, this varies depending on the age and route of administration. However, general dosages can consist of the following:

  • Liquid Solution: Between 2.5 mL and two teaspoons every 3 to 6 hours as needed.
  • Pill or tablet: Between 2 mg and 4 mg every 4 to 6 hours as needed.
  • Suppository: One suppository via the rectum as recommended by a doctor.

Physical and Neurological Effects of Dilaudid

Like other opioids, Dilaudid affects brain chemicals and receptors that are responsible for pain, mood, and appetite. Some of the initial effects that a person may experience include:

  • Euphoria
  • Apathy
  • Drowsiness
  • Relaxation

Potential Side Effects

Dilaudid can also cause uncomfortable side effects, especially if it’s abused or used in excess. These include:

  • Dry mouth
  • Constipation
  • Sweating
  • Stroke
  • Coma
  • Ringing in the ears
  • Depression
  • Anxiety
  • Restlessness
  • Nausea and vomiting
  • Hoarse voice
  • Itchiness
  • Collapsed veins
  • Stomach pain
  • Convulsions
  • Heart attack
  • Trouble breathing
  • Death

Common Dilaudid Combinations

Mixture of pills and substances

While Dilaudid is primarily used for pain relief, some people abuse the drug to get high. It is also combined with other substances to maximize the effects. Some of the most frequent combinations are below.


Alcohol is commonly combined with drugs like Dilaudid. While alcohol is known to increase the feelings of euphoria, this mixture can be dangerous because both drugs are nervous system depressants. Therefore, taking alcohol and Dilaudid together can lead to more pronounced effects such as heightened sedation and shallow breathing. This can result in a lack of oxygen intake leading to the possibility of overdoses, coma, and seizures.

Some of the negative effects that can occur by combining alcohol and Dilaudid include:

  • Slowed heartbeat
  • Dizziness
  • Mood changes
  • Severe drowsiness
  • Weak, shallow breathing
  • Fainting
  • Confusion
  • Agitation
  • Loose, floppy muscles
  • Loss of consciousness


Because itching can be a side effect of Dilaudid, doctors sometimes prescribe an antihistamine such as Benadryl to help. However, combining these medications without medical supervision can be risky as they can produce negative interactions. Some of the potential side effects of combining Benadryl and Dilaudid include:

  • Dizziness
  • Drowsiness
  • Confusion
  • Loss of motor coordination
  • Impaired judgment

Anti-Anxiety Medications

Anti-anxiety medications such as Xanax, Valium, or Ativan can produce dangerous effects when combined with a strong opiate such as Dilaudid. These medications (known as benzodiazepines) also produce a narcotic effect on the body, which means that mixing them with an opioid can result in over-sedation and slowed or shallow breathing.

Individuals who are on anti-anxiety medications prior to taking Dilaudid should inform their doctor. Also, people who abuse these two drugs for recreational effects should be aware that the combination can put them at risk for:

  • Cardiac arrest
  • Respiratory failure
  • Coma
  • Seizure
  • Overdose
  • Death

Over-the-Counter Pain Medications

In cases where a person requires multiple pain relievers, over-the-counter medications such as Aleve (naproxen) can sometimes be taken. However, this drug carries its own side effects, such as drowsiness, itching, dizziness, and stomach upset. As Dilaudid also has similar side effects, these two drugs together can intensify uncomfortable symptoms. Some people have also reported anxiety, constipation, excessive sweating, and nosebleeds when mixing these two drugs. Therefore, it is best to take these medications under medical supervision.


Stimulants such as cocaine, methamphetamine, and prescription Adderall can also produce dangerous outcomes. Because these drugs have opposing effects on the nervous system, the drugs can cancel each other out, causing a person to think they are less intoxicated than they are.

Negative Health Consequences

Using opioids like Dilaudid for an extended period can lead to damaging effects on a person’s health. Below are some of the potential consequences:

  • Difficulty breathing
  • Confusion
  • Seizures or stroke
  • Headache
  • Heart attack
  • Liver problems
  • Coma
  • Constipation


People who abuse opioids are also at a high risk of overdose. Some of the key signs and symptoms to watch out for include:

  • Pinpoint pupils
  • Weak pulse
  • Shallow breathing
  • Unconsciousness
  • Bluish-colored lips
  • Vomiting
  • Disorientation
  • Fatigue
  • Nodding off and not waking up
  • Dizziness
  • Lightheadedness
  • Fainting
  • Cool or clammy skin
  • Hypotension
  • Stomach spasms
  • Muscle twitching

Signs & Symptoms of Dilaudid Addiction

Dilaudid can be physically and psychologically addicting, especially if it is used for sustained periods. The signs and symptoms of addiction do vary from person to person, depending on how much they take and how long they’ve used it. However, there are key signs as outlined below.

Physical Signs of Addiction

Individuals who regularly take Dilaudid for long periods can exhibit physical signs of addiction, such as:

  • Loss of alertness
  • Constricted pupils
  • Slowed breathing
  • Drowsiness
  • Mood swings
  • Poor coordination
  • Chronic nodding off

Behavioral Signs

Sudden changes in behavior can be clear indicators of a problem. Some of the signs of Dilaudid addiction also apply to other drug dependencies and include:

  • Appearing dopey or in a daze.
  • Frequently running out of prescriptions early.
  • Forging prescriptions or faking symptoms to get a prescription.
  • Faking symptoms to get Dilaudid
  • Taking other people’s prescriptions or asking for them.
  • Stashing Dilaudid around the home, workplace, or car.
  • Hiding or lying about Dilaudid
  • Continuing to use Dilaudid despite its negative side effects.
  • Isolation from work, family, and social life.
  • Loss of interest in activities or hobbies.
  • Insomnia or over-sleeping.
  • Worsened performance at school or work.
  • Suspicious behavior such as sneaking around.
  • Frequent or unusual changes in behavior.
  • Abusing other substances (poly-substance use).

Other Abuse Signs

Aside from the signs above, there are other identifying behaviors to watch out for if you suspect someone has a Dilaudid addiction.

“Doctor Shopping”

Doctor shopping is a common behavior exhibited by people who abuse prescription drugs. Because doctors only prescribe a limited amount of Dilaudid, a person who is addicted will try to visit multiple doctors and gain several prescriptions at once. Doctor shopping is often a more extreme sign of prescription drug addiction as the person is going to great lengths to acquire the substance. Individuals also tend to travel great distances to new pharmacies so that they remain undetected.

Mood Swings

Another common symptom of people who are addicted to drugs is mood swings. While different drugs produce different effects when they’re abused, people who are struggling with opioid addiction can often suffer from mood swings. This can be due to the way that the drugs affect the neurotransmitters responsible for mood, and it can also be due to a person’s feelings of guilt and shame about their drug use. If you or someone you know is having mood swings (which are not normally part of their personality), then it may be a sign of ongoing addiction.

Financial Problems

Financial problems are another hallmark trait of people who are suffering from addiction. While some drugs are cheaper than others, Dilaudid is only available by prescription, which means the cost can add up. Individuals may exhibit signs such as not being able to buy food, frequently running out of money, and being unable to afford their rent and bills. Also, long-term drug use can lead to job losses or an inability to acquire a new one, which can create a downward spiral of substance abuse, debts, and financial problems.


If you or a loved one are struggling with Dilaudid abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Clin Calc. (n.d.). Hydromorphone Hydrochloride: Drug Usage Statistics, United States, 2008 – 2018. Clincalc.com. https://clincalc.com/DrugStats/Drugs/HydromorphoneHydrochloride.

National Institute on Drug Abuse (NIDA). (2021). Opioid Overdose Crisis. Drugabuse.gov. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis.

WebMD. (n.d.). Dilaudid. webMD.com. https://www.webmd.com/drugs/2/drug-9130/dilaudid-oral/details.

World Health Organization (WHO). (2020). Opioid Overdose. Who.int. https://www.who.int/news-room/fact-sheets/detail/opioid-overdose.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on RehabAid.com.