Hydromorphone addiction occurs when someone wishes to stop using the drug but is physically or mentally unable to do so. When an individual forms an addiction to hydromorphone, they can become obsessed with finding their next dose, continue misusing the drug despite potential risks of self-harm and neglect their family, friends or other social obligations.

Signs and symptoms of hydromorphone abuse can vary from person to person. While under the influence of large doses of hydromorphone, people can appear to be drunk. They may slur their speech, be very uncoordinated and, potentially, fall asleep in the middle of sentences.

Possible signs of hydromorphone abuse include:

  • headache
  • insomnia
  • dry mouth
  • lightheadedness
  • drowsiness
  • muscle, back and joint pain
  • stomach pain
  • flushed or itchy skin
  • depression

cooccurring disorders

It is possible for these symptoms to increase in severity, especially if an individual is allergic to opioid medications. Symptoms of hydromorphone allergy and severe abuse may include:

  • rash and hives
  • swelling of the eyes, face, lips, tongue, mouth, throat, arms, hands, feet, ankles or lower legs
  • trouble swallowing or breathing
  • hoarseness
  • agitation, hallucinations or confusion
  • nausea and vomiting
  • sexual dysfunction in men
  • irregular menstrual cycles in women
  • decreased sex drive
  • seizures
  • chest pain
  • extreme drowsiness or fainting
  • lightheadedness when changing positions, i.e. from laying down to sitting up

Because some of these symptoms can be life-threatening, anyone experiencing them should seek medical attention immediately. As someone transitions from abusing hydromorphone to being addicted to the drug, they can also experience behavioral changes.

Some examples of these lifestyle or personality changes include:

  • forging or stealing prescriptions for hydromorphone
  • doctor shopping (visiting several doctors to obtain multiple prescriptions)
  • spending large amounts of time and money to obtain hydromorphone illicitly
  • isolating themselves from family and friends
  • lying to family and friends about their drug use

People who have developed a physical dependence to hydromorphone will experience withdrawal symptoms as the drug wears off. Experiencing withdrawal is a key sign that addiction is present.

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What Is Hydromorphone?

Hydromorphone is an opioid painkiller made from morphine. Some prescription medications that contain hydromorphone include: Dilaudid, Exalgo and Palladone. Typically, hydromorphone is prescribed to manage chronic pain or pain resulting from emergency situations.

Like other opioids, hydromorphone is a central nervous system (CNS) depressant. In large doses, hydromorphone can cause a euphoric rush and modify the way the body perceives sensations of pain and pleasure.

Effects of hydromorphone can be felt about 15 minutes after administration and can last up to six hours or more, in some individuals. Hydromorphone is a very potent opioid that can temporarily change an individual’s brain chemistry.

With frequent abuse, these chemical changes can cause permanent structural changes to the brain, which are thought to impact addictive behaviors.

How Is Hydromorphone Abused?

When someone abuses opioids like hydromorphone, they crush up the pill and mix it with water to inject it. Others may crush up the pill to snort it. The intense rush the drug produces shortly after it is taken is thought to be a contributing factor in addiction.


Crushing the pills into a powder can be very risky, especially if the medication is an extended-release version. This is because these pills tend to be more potent when released all at once, which increases risk of fatal overdose.

Dangers Of Hydromorphone Abuse

There are many dangers associated with hydromorphone abuse and addiction. Taking doses larger than recommended may lead to fatal breathing and/or heart problems. Overdosing on hydromorphone is also a risk of abusing the drug, especially if abusing the extended-release version of the drug.

Possible symptoms of hydromorphone overdose include:

  • nausea and vomiting
  • collapsed veins
  • stomach pain
  • cold, clammy skin
  • heart attack
  • trouble breathing
  • fainting
  • stroke
  • coma
  • death

Individuals who mix hydromorphone with other substances also increase the risk of negative side effects. When hydromorphone is mixed with another depressant, it can quickly cause the respiratory system to become so suppressed that it becomes impossible for the individual to breathe.

When hydromorphone is used with a stimulant, like cocaine, it can cause strange and unpredictable side effects. When stimulants and depressants are mixed they can have a masking effect, because the effects of each drug oppose the effects of the other.

Individuals who abuse hydromorphone by injection are also at an increased risk for contracting and transmitting HIV, AIDS and hepatitis (liver disease).

Drug abuse and addiction can impact other parts of someone’s life and lead to problems such as:

  • financial burden from purchasing high-priced hydromorphone illicitly
  • family issues from prioritizing drugs over social obligations
  • incarceration due to theft or forging prescriptions
  • increased likelihood of becoming addicted to stronger, cheaper opioids, like heroin

Hydromorphone Withdrawal

Similar withdrawal from other opioids, hydromorphone withdrawal often starts with flu-like symptoms. Individuals going through hydromorphone withdrawal often seem cold, clammy and achy. Hydromorphone withdrawal can be broken into two stages: acute withdrawal and prolonged withdrawal.

Possible acute withdrawal symptoms include:

  • anxiety and agitation
  • restlessness
  • increased tearing
  • muscle aches and pains
  • pain in bones
  • insomnia
  • excessive sweating or cold sweats
  • runny nose
  • yawning

Possible prolonged withdrawal symptoms include:

  • abdominal cramping
  • nausea and vomiting
  • diarrhea
  • goosebumps
  • dilated pupils
  • tremors
  • dysphoria (feeling uneasy, depressed and anxious)
  • suicidal thoughts and behaviors

The length of time someone spends withdrawing from hydromorphone will vary, depending on the severity of their addiction. In most cases, withdrawing from hydromorphone lasts about two weeks. Withdrawal duration depends on how much hydromorphone was abused, frequency of abuse and duration of abuse.

Those who have abused hydromorphone in large amounts for extended periods of time are more likely to have longer withdrawal periods compared to those who abused smaller doses less frequently.

If someone is suffering from a second, co-occurring substance use disorder, withdrawing from hydromorphone may take longer than average, depending on the second substance. It is never recommended to withdraw from powerful opioids like hydromorphone without help.

Medically-Supervised Hydromorphone Detoxification

Withdrawing from hydromorphone has the potential to produce life-threatening withdrawal symptoms and it is never advised to stop taking hydromorphone without medical supervision. Symptoms like difficulty breathing and potential heart problems make medically-supervised hydromorphone detox a safer option.

As each individual will experience withdrawing from hydromorphone differently, medically-supervised detox allows individuals to taper off the drug gradually. Slowly weaning off hydromorphone allows individuals a smoother transition to an opioid-free life.

Within a medical detox program, buprenorphine (Subutex or Suboxone) may be prescribed to help ease cravings for hydromorphone and other uncomfortable withdrawal symptoms. In addition to buprenorphine-assisted treatments, other medications may also be used to help combat psychological withdrawal symptoms, like anxiety and depression.

Treatment Options For Hydromorphone Addiction

There are many different treatment options available to help address hydromorphone addiction. Treating a complex disease such as addiction requires a comprehensive look at the person and their individual needs and circumstances.

Formal addiction treatment, such as an inpatient treatment program, can increase the likelihood of a positive recovery. Inpatient treatment ensures the highest level of care and provides a positive environment where recovery is more likely.

Contact us for more information on hydromorphone addiction and treatment options.