Hydromorphone is an analgesic drug that is in the opioid class of medications. It is derived from morphine and is somewhat similar in effect to hydrocodone, though hydrocodone contains codeine and is not a morphine derivative. Hydromorphone is used to treat moderate to severe pain.

One of the pharmaceutical brand names for hydromorphone is Dilaudid or Dilaudid-5. Hydromorphone is a Schedule 2 controlled substance, as categorized by the DEA. Schedule 2 drugs include opioid narcotics and have a potential for abuse, though this class of drugs has an accepted medical use. Other drugs in Class 2 include hydrocodone and oxycodone, and these drugs can become very addictive when used for long periods or at higher dosages than prescribed. Hydromorphone is medically prescribed for pain and most commonly comes in oral liquid and 8 mg tablet forms. The oral liquid is sweet and the tablets are white and triangular-shaped with a #8 on one side, indicating the dosage of 8 mg.

Hydromorphone is a powerful narcotic that can give the user feelings of extreme euphoria and delightful apathy. This drug is known by other names, especially when it is abused and purchased on the black market illegally. Some of the street names used for hydromorphone include:

  • Dillies
  • Hydro
  • M2s
  • Hospital Heroin
  • Dust
  • Juice
  • Smack
  • D
  • Footballs
  • Big D
  • Super 8
  • M-80s
  • Moose
  • White Triangles

History and Trends of Hydromorphone

In 1924, chemists working at the German pharmaceutical company, Knoll, synthesized hydromorphone and brought it to market two years later under the brand name Dilaudid. This name indicated its similarity to and derivation from morphine (laudanum). That brand name is now well known as its generic name, hydromorphone, causing Dilaudid to be used interchangeably with any form of hydromorphone. This drug is highly popular as a street drug for addicts, as its effects can become apparent within 15 minutes and remain effective for up to 5 hours. It is eight times more potent (per milligram) than morphine alone. Dilaudid is taken by different methods. It can be sold as ampules in a sterile solution, injected intravenously, swallowed as an oral liquid, ingested as a tablet or used in the rectum as suppositories.

When taken for recreational reasons, hydromorphone can achieve desirable effects such as:

  • Feelings of euphoria
  • Blissful apathy
  • Relaxation
  • Release of stressful or anxious feelings

Hydromorphone will help greatly with pain relief, to suppress coughing and even in some cases, to control diarrhea. It may cause side effects that can become dangerous. Some of the side effects of hydromorphone include:

  • Nausea
  • Vomiting
  • Dizziness
  • Sleepiness
  • Anorexia
  • Constipation
  • Hallucinations
  • Itching
  • Rash
  • Sweating
  • Irritability

Taking an overdose of hydromorphone can result in the following:

  • Depressed breathing and respiratory distress
  • Stupor
  • Coma
  • Skeletal muscle relaxation
  • Clammy, cold skin
  • Heightened blood pressure
  • Circulatory collapse
  • Heart attack

Trends in substance abuse of opiates show addicts switching from one opiate to another, depending upon what is available to them. So those using hydromorphone are just as likely to abuse oxycodone, morphine, hydrocodone, or even heroin, to achieve the effects they seek. Dilaudid is shown to have a lower possibility for abuse or addiction than the other opiates, but when this drug is changed into liquid form and injected, it gives the user the same euphoric rush as heroin and other narcotics can.

Abuse and Addiction

Often, addiction to hydromorphone begins when someone needs a strong drug to control their pain or severe coughing. They may then become dependent upon the drug and, when they are unable to get subsequent prescriptions from their own doctor, they go “doctor shopping” for more hydromorphone. An addict may go to a variety of different doctors in order to procure more prescriptions for the drug, filling them at different pharmacies. An addict may also resort to stealing prescription pads or money or drugs to support their dependence on hydromorphone.

Use of hydromorphone is a serious abuse risk with extended use of more than 3 weeks’ time. If a person is increasing their dosage of Dilaudid, they may feel restless at first, even nauseous, which can then progress to a loss of consciousness with labored breathing. Another risk for those addicted to hydromorphone is the withdrawal symptoms upon stopping the drug. These symptoms can last for months at a time.

The withdrawal symptoms associated with stopping hydromorphone include:

  • Increased nausea and vomiting
  • Diarrhea
  • Arm and leg restlessness
  • Profuse sweating
  • Loss of appetite
  • Emotional instability
  • Thoughts that are irrational
  • Sleeplessness
  • Mood swings
  • Concentration difficulties
  • Loss of interest in sexual relations
  • Cold skin
  • Muscle aches
  • Flu-like symptoms
  • Suicidal thoughts
  • Seizures


Someone who becomes addicted to hydromorphone or Dilaudid, needing stronger and stronger doses to achieve the same effects, should seek treatment. This is because, as this tolerance for the drug sets in, it is practically impossible to stop using hydromorphone without feeling withdrawal symptoms.

Residential treatment centers are highly effective for hydromorphone addiction, where a quiet environment can allow the user to focus on recovering. The drug being abused is regulated for detox purposes and psychological therapy is integrated in the treatment plan, which is usually a personalized one. Inpatient treatment can last anywhere from 30 to 90 days, with 90 days being the most optimal for staying sober.