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Hydromorphone Addiction And The Best Rehab Centers For Treatment

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

February 12, 2019

Hydromorphone is an effective opioid analgesic drug used to treat chronic or severe pain relating to cancer, physical trauma, surgery, or burns. Hydromorphone is prescribed under the brand name Dilaudid, as well as in extended release form under the names Exalgo and Palladone. This drug is extremely potent and has a high potential for abuse and addiction.

Hydromorphone is eight times more potent than morphine and behaves similarly to morphine or heroin in depressing the central nervous system. Hydromorphone is also faster acting than morphine. Due to the drug’s potency, it is often prescribed for narcotic-tolerant patients in need of pain relief. Typically the drug is used after drugs like morphine, fentanyl, and oxycodone have failed.

Hydromorphone can be deadly if taken in conjunction with other medications, especially those that act as central nervous system depressants, like alcohol and other opioid drugs. Hydromorphone is most effective when delivered intravenously or as an intramuscular injection, though it can be ingested orally and via rectal suppositories.

How Hydromorphone Works

Hydromorphone, like all narcotics, works by increasing the body’s tolerance to pain. It attaches to opioid receptors located within the brain, along the spinal cord, and within the digestive tract and other vital organs. When synthetic opioids like hydromorphone attach to these opioid receptors, sensation relating to pain is reduced or blocked and the body’s threshold for pain significantly elevated.

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If you’ve ever heard of a runner speak of a “runner’s high,” the process is similar. When the body experiences strain, as is seen in challenging physical activity including running, natural childbirth, and other endurance activities, natural opioid neurotransmitters, known as endogenous, attach to opioid receptors, reducing levels of pain sensation via the release of dopamine. This physiological response generates the sensation of euphoria we associate with “runner’s high.”

With a drug like hydromorphone, this effect is magnified hundreds of times over and the brain begins to associate the act of taking the drug, with other survival mechanisms, making it a highly addictive and potent narcotic.

Hydromorphone Addiction

The body associates the release of dopamine with positive survival mechanisms like breathing, eating, drinking, or sex for procreation of the species. As drugs like hydromorphone trigger excess levels of dopamine, more so than occur naturally, the body’s reward system begins associating the use of drug with survival. The craving for the drug becomes stronger than those fundamental desires to eat, drink, and breathe.

When initially taken, hydromorphone can generate feelings of euphoria. In a person suffering from prolonged chronic pain, this immediate feeling of euphoria accompanied by relief from pain, can generate a powerful psychological dependency.

Someone taking the drug to control pain may begin increasing their dose to chase the euphoria. This is a dangerous game as the drug works to suppress the central nervous and the slowing of breathing becomes life-threatening.

Similarly, as the body develops a tolerance to the strong narcotic, more is needed to achieve similar levels of pain relief or to feel “normal.” When someone reaches this stage, they have become physically dependent on the drug and perpetuate use to avoid strong withdrawal symptoms.

Hydromorphone Withdrawal Symptoms

Withdrawal side effects can be severe and include agitation, nausea and vomiting, diarrhea, and other flu-like symptoms. While these symptoms are not life-threatening, they can be severe, even with withdrawal from low to moderate use of the drug. Treatment for hydromorphone includes detoxification from the drug with medications to manage related symptoms.

While physical symptoms from withdrawal can be managed and overcome quickly, it is the memory of the efficacy of the drug and desire to perpetuate the euphoria that results in relapse after treatment for hydromorphone dependency.

Signs Of Hydromorphone Overdose

Those abusing opioid drugs like hydromorphone are best served when someone in their lives is aware of the addiction and can monitor for signs of overdose from the drug. These symptoms may be a sign of hydromorphone overdose, may be life-threatening, and require immediate medical attention:

  • cyanosis
  • clammy skin
  • extreme fatigue
  • loss of consciousness
  • muscle spasms
  • shallow breathing
  • weak pulse
  • convulsions
  • confusion
  • coma

Hydromorphone depresses the breathing reflex, while also generating hypotension within the body. If taken in conjunction with other medications or with alcohol, these effects can be magnified. Deaths have been associated with use of hydromorphone with more than 77 percent occurring with first use of the drug. The majority of these deaths relates to respiratory suppression.

Normal side effects of the drug include blurred vision, nausea and other gastrointestinal discomforts, dizziness, and dry mouth. Long term use of the drug can result in physical dependency and liver damage.

Treatment For Hydromorphone Dependency

Treatment for hydromorphone dependency typically includes detoxification accompanied by medications to treat more severe associated symptoms, counseling, and in-house monitoring followed by ongoing counseling for support.

Opioid addiction demands a broad spectrum of care in addressing the physical discomforts of withdrawal to addressing psychological dependency and underlying issues resulting in the addiction. Appropriate pain management may be a part of your long-term recovery strategy.

Contact to find an opioid addiction treatment based on your personal needs.


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