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Can You Snort or Smoke Dilaudid? Is it Dangerous?

Dilaudid is the brand name for a potent opioid medication called hydromorphone. This drug is prescribed for people who need consistent pain relief but have built up a tolerance to other opioid medications like hydrocodone, oxycodone, or morphine. The opioid painkiller comes in extended-release tablets, oral liquid solutions, or either immediate-release or extended-release liquid injections. The tablets and oral solutions may be prescribed for home use while the injections are used in clinical settings.


Drugs that are consumed orally, and move through the digestive system, are released more slowly into the blood than any other method of drug consumption. Some of the substance may be absorbed through the esophagus and stomach lining, but most of a substance that is eaten or drunk is digested by the intestine, liver, and kidneys. By entering the bloodstream this way, the drug will be bioavailable for longer, but it will take longer to reach the brain.

People who struggle with addiction to opioids such as Dilaudid may abuse this substance by eating pills or drinking the oral solution at first; however, as their body becomes more tolerant to the medication, they may increase how much they take, or they may find a way to get around the slow digestive system and get high faster. Two of the most common and harmful ways to do this are smoking the drug and snorting it.

The speed at which a drug enters the bloodstream and binds to receptors in the brain can predict how addictive the substance will be. Getting high quickly means that, in turn, the high will feel more intense, but it will wear off faster. This may lead to compulsive behaviors to take more of the drug.

Smoking: The fastest way to get high on a substance is to smoke it. When a substance is inhaled, it enters the lungs where the alveoli allow it to be quickly absorbed into blood vessels and sent to the brain. The alveoli evolved to send oxygen to the brain and the rest of the body very quickly. Drugs consumed in this manner will move through the body very fast, causing a high within a few minutes.

Snorting: This is a more common method of abuse for opioids, especially prescriptions. Tablets may be crushed and then snorted, which does not require much paraphernalia and can, in many instances, bypass the time-release mechanisms in extended-release drugs like Dilaudid tablets. When these are bypassed, the individual rapidly consumes all of the opioid in a short period. This greatly increases the risk of overdose. The chemical is absorbed through the mucous membranes in the nostrils, the back of the throat, and the upper respiratory system. Intoxication occurs more slowly compared to smoking, but it is still a fast method of abusing drugs, leading to a high in 20 minutes or less. 

There are no consistent reports of people smoking Dilaudid, but enough dangerous abuse of Dilaudid has occurred by crushing and snorting the tablets that the U.S. Food and Drug Administration (FDA) has issued a warning not to consume hydromorphone in this manner. Abusing hydromorphone greatly increases the risk of overdose and death.

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Several health risks are associated with abusing drugs through any method, but there are unique health consequences of snorting or smoking drugs, including opioids like Dilaudid. For example, smoking drugs can lead to:

  •  Lung infections
  •  Emphysema
  •  Chronic bronchitis, pneumonia, or tuberculosis
  •  Lung cancer
  •  Chronic obstructive pulmonary disease (COPD)
  •  Heart disease, including stroke, pulmonary embolism, and heart attack
  •  Impaired immune system function
  •  Chronic coughing

Snorting drugs increases the risk of lung infections too. Tissue damage in the upper lungs can lead to chronic upper respiratory infections, bronchitis, pneumonia, or tuberculosis.

Snorting also damages the fragile mucous membranes in the nose, which leads to septal perforation, or a hole in the cartilage between the nostrils. If untreated, tissue damage can spread to the upper palate and also lead to palatal perforation.

Abusing opioids like Dilaudid is extremely risky. Overdose on such a potent opioid can lead to respiratory depression, which can cause death from oxygen deprivation. Abusing Dilaudid, fentanyl, heroin, or other strong narcotics in a way that causes rapid intoxication means that overdose and death may occur faster as well. Get help from evidence-based treatment detox and rehabilitation programs to end opioid addiction before overdose occurs. 


According to the U.S. Drug Enforcement Administration (DEA), hydromorphone is a Schedule II opioid medication, so its prescription and dispensation are tightly controlled, but it is important for the substance to be available as an analgesic in specific scenarios. Although opioid addiction is an epidemic in the United States, Dilaudid is not one of the most abused opioid drugs. The U.S. Centers for Disease Control and Prevention (CDC) reports that hydrocodone, oxycodone, and methadone are the most abused prescription opioids, while heroin and fentanyl are the most abused illicit narcotics.

The DEA reports that Dilaudid is diverted or stolen from hospitals, pharmacies, or personal prescriptions. Unlike other narcotics, especially fentanyl, it has not yet been associated with clandestine laboratories and illicit sale.

Some people may worry that Dilaudid could become the next fentanyl — a very potent opioid drug created in illicit labs and sold on the black market. Fentanyl and several of its analogs have prescription drug versions, and like Dilaudid, they are important in treating severe pain in people who either have intense pain problems, such as from cancer, or who are tolerant to high doses of other opioids.

Dilaudid has not yet become such a problem, but knowing the drug’s risks can help to prevent the spread of this opioid’s abuse.

Stressed woman with her hand on her forehead

A sign of abuse of opioid narcotics like Dilaudid is when someone with a legitimate prescription runs out of the drug consistently before they are supposed to. This could indicate they are misusing their own prescription by taking too much of it or that someone is stealing the medication from them.

You may also find powdered residue, smell smoke, or find paraphernalia like rolled-up papers, lighters, or a pipe. These indicate that the individual is not just abusing Dilaudid orally, but aiming for greater intoxication by abusing the drug in a way that will cause a much faster high. Taking too much of any opioid orally is risky enough, but misusing opioids, especially strong ones like Dilaudid, by crushing and snorting or smoking them is very dangerous.


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Dilaudid Oral Liquid and Dilaudid Tablets (Hydromorphone Hydrochloride). U.S. Food and Drug Administration (FDA). Retrieved from

(January 2018). What are the Physical Health Consequences of Tobacco Use? National Institute on Drug Abuse (NIDA). Retrieved December 2018 from

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