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Dilaudid vs Morphine – What Is The Difference?

Joseph Sitarik, DO

Medically reviewed by

Joseph Sitarik, DO

January 23, 2019

Morphine and Dilaudid are analgesic opioids prescribed for the treatment of intense pain. Morphine is intended for the long-term treatment of chronic pain whereas Dilaudid is meant for treating severe pain quickly on a short-term basis. It is important to understand the differences between these drugs as both are highly addictive and can lead to many health risks if taken improperly.

Almost always prescribed for mild to severe, or otherwise unmanageable pain, both morphine, and Dilaudid are considered analgesic opioids. Analgesic simply means a painkiller or pain reliever, and an opioid is a class of drug that binds to specific opioid receptors in the brain. In many cases, morphine and Dilaudid are a second or third choice for doctors to prescribe, commonly after other methods of pain management have failed.

Both morphine and Dilaudid are only available by prescription in the United States, however, an increasing number of people are becoming dependent on the drug. This phenomenon is contributing to the opioid epidemic that is sweeping the United States. How can something that is prescribed by professional physicians and meant to help people be so dangerous?

How Do Opioid Analgesics Work?

While some people are surprised by the dangers associated with a drug that can help people suffering from immense pain, understanding the biology of opioids can help make sense of the epidemic surrounding the drug. Opioids can be derived from the naturally occurring opium poppy plant, but often undergo additional chemical changes and other additives before becoming a marketable drug such as morphine or Dilaudid.

Opioids work by binding to special receptors in your central nervous system, usually centered around the brain and spinal cord. These receptors, appropriately named opioid receptors, are usually located near the head of nerve cells. These nerve cells, or neurons, bind with the opioid when it is introduced into your system and can block or interrupt the chemical signals that are sent through your central nervous system to tell the brain when to feel pain. This interruption is what can produce the pain killing effects of opioids.

While this pain-killing effect is the outcome most patients are looking for in opioids, it can also affect the rest of your body in negative ways. The liver, kidney, and intestines are common organs that are directly affected by opioids. Your liver and kidneys are essential when it comes to filtering out toxins and infection from your body, and the interruption of chemical signals by opioids can severely reduce the effectiveness of these filters.

Opioids also commonly cause constipation for individuals due to the fact that your intestines depend on the triggering of nerve endings to properly move waste through your digestive system. When opioids block the chemical signals telling the brain that solid waste has left your stomach, then your intestines will not contract and move the waste into the large intestine and upper gut.

Perhaps the most dangerous effect of opioids is its negative impact on your respiratory system. Your respiratory system exists for the sole purpose of allowing you to breathe, or respire. Just as opioids can block the chemical signals needed for proper digestion and filtering of waste, they can also block the chemical signals that are essential for providing proper amounts of oxygen to the brain. If the brain is starved for oxygen, for example when you are in a deeply restful state, then it sends signals to your respiratory system to take a deep breath. If these signals are blocked or dulled, this information may not be properly delivered and translated, resulting in a lack of oxygen in the brain. Unfortunately, this is a common cause of death from opioid overdose.

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What Is The Difference Between Morphine And Dilaudid?

Despite being derived from morphine, Dilaudid is far more potent than morphine is. Because of its potency, a dose of Dilaudid is generally much smaller than a dose of morphine. This certainly does not make the drug any less addictive. Dilaudid can, in fact, be even more addictive than morphine.

Morphine is intended to be used to treat chronic pain. Chronic pain is a type of pain that lasts for many years and never really goes away for any period of time. This type of pain is generally categorized as mild to moderate pain that doesn’t require intense doses of painkillers but does require long-lasting painkillers. Because chronic pain can be treated for years at a time, extended relief painkillers like morphine are usually tame enough that individuals can perform normal day-to-day routines while taking the medication.

Dilaudid, on the other hand, is a potent opioid that is intended to treat moderate to severe pain. Dilaudid can hit the system quickly, and deliver a powerful dose of opioids to your central nervous system. This type of medication is intended to be taken on an as-needed basis, and generally inhibits an individual enough to prevent them from performing routine tasks. Recovering from surgery or major trauma could be events where Dilaudid would be well served.

Dilaudid and morphine can both be taken intravenously (through an IV into the vein), subcutaneously (through a needle, just under the skin), or orally (a pill taken via the mouth). Generally, intravenous and subcutaneous injections of Dilaudid and morphine are administered in a hospital, clinic, or physician’s office setting, while oral prescriptions can be taken at home without medical supervision.

Dilaudid vs Morphine – Side Effects

Because both morphine and Dilaudid are opioids, they interact with your body in very similar ways. Most opioids share common side effects such as constipation, dry mouth, dizziness, drowsiness, nausea, and vomiting, just to name a few. However, as each drug is created using different techniques and chemicals, they will each have a few side effects that are unique only to their specific impact on the body.

Despite Dilaudid’s potency, a common side effect with the drug is muscle or joint pain. The fact that a drug that is designed to relieve pain can actually cause more pain is surprising to many people. However, when you consider the impact it has on the chemical reactions that try to naturally occur in your body, it makes sense that any chemical disruption could cause nerves to under-fire (interrupting pain perception) or over fire (causing phantom pains).

Other side effects that can present themselves with Dilaudid include:

  • Anxiety
  • Depression
  • Insomnia, difficulty staying asleep
  • Flushing of the skin
  • Itchiness
  • Fluctuations in blood pressure
  • Dizziness when standing up

Morphine affects the body in a way that can actually cause your skin to turn blue or purple, instead of the red flushing that Dilaudid may cause. This is known in the medical community as cyanosis and is actually a blueish tint to fingertips, lips, and extremities caused from lack of oxygen. This lack of oxygen is caused by decreased respiratory activity which can rapidly decrease blood flow to the outer parts of your body.

Other side effects that are unique to morphine can include:

  • Confusion
  • Mood changes
  • Agitation
  • Diarrhea
  • Weight loss
  • Difficulty urinating
  • Pain when urinating
  • Small pupils
  • Fever
  • Blood pressure changes
  • Weakness

The Dangers Of Morphine And Dilaudid Dependence

While intravenous and subcutaneous injections of both Dilaudid and morphine are usually more powerful than an oral dose of the drugs, taking any opioid on a regular or semi-regular basis can prepare your body for drug dependence. Drug dependence is a serious chemical dependence that can be very difficult to overcome on your own. Aside from battling behavioral and mental addictions to the state of mind that an opioid high can provide, a chemical dependence on a substance means your body needs a substance so badly that you will begin to physically withdrawal from not having it.

Drug dependence leading to substance abuse causes many deaths in the opioid epidemic. It is not uncommon to hear reports of individuals who have simply stopped breathing in their sleep from an opioid overdose. Often when this happens, it is difficult to detect even if someone is lying next to you. For many overdose victims, their breathing becomes more and more shallow until it stops altogether.

There are many medical uses for both Dilaudid and morphine that can be administered in a safe and responsible way. Opioid addiction, however, does not only affect people who are seeking out a high. It can happen to anyone, regardless of their intentions. Everyone is affected by drugs a little differently, and for some people, it isn’t possible to take opioids without the risk of dependency.

Your state of mind and history of drug abuse or addiction can play a large role in determining this, always be open and upfront with your doctor about your drug history when considering opioid pain relievers. It is a discussion that could very well save your life.

Get Help for Opioid Addiction Today

If you have a loved one that is struggling with a dependency on Dilaudid or morphine, or if you struggling with opioid dependency, seeking out help immediately is the right answer. Opioid dependency can turn into other drugs, such as heroin, quickly, and it is difficult to fight the body’s natural craving for more.

Our addiction treatment specialists are specifically trained to help you find a rehab program that will treat both the mental and physical facets of opioid abuse and addiction. Your call is always 100% confidential, and our addiction treatment specialists are available 24/7. Call today, and begin your journey of recovery.

British Journal of Anesthesia - Comparative Clinical Effects of Hydromorphone and Morphine: A Meta-Analysis

Healthline - Drug Features

Hindawi - Morphine versus Hydromorphone: Does Choice of Opioid Influence Outcomes?

Iodine.com - Compare Dilaudid vs. Morphine Sulfate

Pharmacy & Therapeutics Journal (via NCBI) - Morphine and Hydromorphone

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