Dilaudid is the brand name for a potent synthetic opioid drug called hydromorphone. This medication was developed to treat severe, chronic pain in people whose bodies have become tolerant to other opioids, who need pain relief around the clock, or who cannot be treated with other prescription narcotic painkillers.
Because it is an opioid painkiller, Dilaudid can also be habit-forming. With a doctor’s supervision, it is unlikely that you will misuse the medication for recreational reasons, but people who do not have a legitimate prescription for this drug may steal it to abuse. It could be diverted from medicine cabinets or hospitals for substance abuse. Hydromorphone abuse is rare, compared to other potent opioid drugs like heroin and fentanyl, but it may still happen.
People who take Dilaudid have likely taken other prescription opioids before, but they have developed a high enough physical tolerance to other pain-killing medications that they need more potent opioid drugs. It is not likely that someone who takes Dilaudid will want to quit this medication or switch to another drug; it is more likely that someone who abuses high doses of heroin or fentanyl may instead need Dilaudid in a hospital setting to manage their pain if they have not started the detox process yet. Illicit hydromorphone may be abused, however.
According to the U.S. Drug Enforcement Administration (DEA), the main sources of illicit Dilaudid are “doctor shoppers,” or those who go to multiple doctors for multiple prescriptions; forged prescriptions; and robberies of pharmacies and nursing homes.
The National Forensic Laboratory Information System and System to Retrieve Information from Drug Evidence (STRIDE) reported, in 2011, that there were 3,026 instances of hydromorphone drugs, and in 2012, that rose to 4,242 instances. About 1 million people report abusing Dilaudid for nonmedical reasons at least once in their lifetime.
When hydromorphone drugs are abused, they may be ingested orally as tablets or injected in the liquid injectable form. In addition, the tablets could be crushed and snorted, smoked, or dissolved into a liquid and consumed orally. Some people may inject Dilaudid as a replacement for heroin.
Symptoms of Dilaudid withdrawal are like those of other opioid drugs, although they may be more intense and last longer.
Short-acting opioids and less potent narcotics, like hydrocodone, heroin, and morphine, have a withdrawal period from five to 10 days. The body quickly metabolizes the drug. It is important to work with a medically supervised detox program to manage symptoms from withdrawal if you abuse these drugs, but acute withdrawal symptoms will conclude in a week to 10 days.
With hydromorphone, the flu-like withdrawal symptoms can lead to deadly consequences. Dilaudid is very potent, and it lasts in the body for a long time. People who abuse Dilaudid or who take it with a doctor’s prescription already have a high tolerance to opioids, leading them to consume this much more potent drug. While Dilaudid will be metabolized out of the body at the same rate as other narcotics, there may be a buildup of opioids in the body due to high-dose, long-term abuse of these drugs, which can extend the withdrawal period.
Additionally, withdrawal symptoms associated with potent narcotics like Dilaudid are more intense, especially vomiting and diarrhea. These symptoms of withdrawal can lead to dehydration, which, in turn, leads to hypernatremia or a high level of sodium in the blood, resulting in heart failure. Quitting cold turkey by yourself is risky because nausea, loss of appetite, and physical pain may be so intense that getting up to get water and stay hydrated can be exceptionally difficult, even if you know that the risk of dehydration is high.
Staying safe while withdrawing from Dilaudid addiction requires medical oversight. There is a specific detox treatment plan, which includes medication-assisted treatments (MATs) to ease off physical dependence on this potent drug as safely as possible.
The World Health Organization (WHO) states that withdrawal management (WM) is the medical and psychological care and oversight for people who are experiencing withdrawal as a result of quitting a drug they are addicted to or physically dependent on. WM can involve a doctor working with a patient to slowly reduce the amount of prescription medication, or it can involve specific detox practices to overcome withdrawal symptoms from abusing an intoxicating substance for a long time.
People who quit a potent medication like Dilaudid are likely to need inpatient treatment, which may include having their symptoms monitored three or four times per day. Because hydromorphone is so strong, quitting this drug will likely lead to moderate-to-severe withdrawal symptoms. Your overseeing physician may prescribe buprenorphine or methadone to ease these symptoms and taper your body off dependence on narcotics.
This is currently the preferred MAT approach in the United States, although it was approved by the U.S. Food and Drug Administration (FDA) as recently as 2002. It has been the leading approach to opioid addiction treatment in Europe since the 1980s.
Buprenorphine is a long-lasting partial opioid-agonist, so it binds to the opioid receptor cells in the brain for at least a full day, maybe two, depending on the dose. Since it is a partial agonist, the drug eases withdrawal symptoms and cravings for narcotics, but in people who have any level of tolerance to opioids, it is not likely to cause intoxication. It also has some analgesic effects, so if physical pain were part of acute withdrawal, this symptom would be eased along with the psychological symptoms.
Since buprenorphine is a partial agonist, unlike methadone, medications like Suboxone containing buprenorphine are considered safer and less habit-forming. This means the drug can be safely prescribed through physicians’ offices as long as the physician has specific addiction-focused training. Buprenorphine medications are not restricted to specific clinics, like methadone. This means more people have access to withdrawal management treatments for opioid addiction than ever before.
For people who struggle with Dilaudid abuse, however, buprenorphine may not be strong enough to ease withdrawal. Your doctor at your detox program will know for sure, but people who struggle with addiction to potent, long-lasting drugs like hydromorphone may benefit more from methadone treatment.
This was one of the first approaches to detox for opioid addiction in the U.S., leading to the rise of methadone clinics in the 1970s and 1980s that treated people who struggled with heroin addiction.
Methadone is also a long-acting drug, which can bind to opioid receptors in the brain for a day or two, depending on the size of the dose. Unlike buprenorphine, methadone is a full opioid agonist, so it is possible to become intoxicated when taking this medication. However, people who have abused potent narcotics like heroin or hydromorphone are not likely to feel intoxicated by a physician-supervised dose of methadone.
It is not as easy to access methadone treatment as it is to receive buprenorphine treatment. Methadone can only be administered under specific supervision, although after a period of compliance, you may be able to take methadone home to administer yourself, provided you attend regular checkups.
The tapering process with methadone is much longer than with buprenorphine. While buprenorphine treatment may last a couple of months, some people spend years tapering with methadone. The recommended minimum length of methadone treatment is 12 months (one year). SAMHSA reports federal law requires MAT patients must receive counseling such as different forms of behavioral therapy, medical, vocational, educational, and other assessment and treatment services.
If you struggle with Dilaudid addiction, you need supervision to safely overcome your body’s physical dependence on this potent opioid. Look for a detox program that specializes in opioid narcotics like fentanyl, heroin, and Dilaudid because they will have the resources and understanding to best help you. Access to medication-assisted treatment is a must, so look for physicians who understand buprenorphine and methadone treatment.
Be prepared for a long tapering process and a lengthy focus on rehabilitation afterward. Dilaudid is a powerful narcotic, but there are specialists who can help you overcome addiction to this drug.
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