Table of Contents
Dilaudid Addiction, Abuse, and Symptoms


The Basics

This guide explains the effects, trends, and dangers of Dilaudid use and provides an unbiased analysis of the medicinal and behavioral treatment methods for Dilaudid addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription opioid use, which includes morphine, codeine, hydrocodone, and oxycodone.

Primary Dilaudid Dangers

  • Addictiveness: Nutt et al. tested 20 drugs to determine their potential for addiction. They did not test Dilaudid, but they did test heroin, which has effects similar to the ones produced by Dilaudid. Out of the 20 drugs tested, heroin ranked number one based on how addictive it is. In fact, Nutt et al. found that heroin has a higher potential for addiction than cocaine and other illicit drugs.
  • Risk of overdose: Dilaudid can produce dangerous side effects, especially when it is not used as prescribed. In people with pain that is difficult to control, the risk of Dilaudid overdose is high, as people who continue to experience pain after taking one dose may take another dose too soon. Dilaudid comes in an oral solution that is measured in milliliters and a tablet form that is measured in milligrams. The risk of overdose increases if an individual confuses the two units of measurement. According to the Centers for Disease Control and Prevention (CDC), nearly 48,000 overdose deaths in 2017 involved some type of opioid.
  • Unintended side effects: One of the most serious side effects of Dilaudid is respiratory depression, which slows down a person’s breathing. Respiratory depression allows carbon dioxide to build up in the blood, preventing enough oxygen from reaching other tissues. Dilaudid can cause other serious effects, including chest pain, hallucinations, fainting, and seizures.
  • Legal risks: Dilaudid is a Schedule II controlled substance. Possessing Dilaudid without a valid prescription is usually charged as a misdemeanor when it is the individual’s first offense. The penalties for a conviction may include a fine or up to one year in jail.
Dilaudid Background Information
Derived From Synthesized, in part, from morphine and other substances
Ways Used Injected, ingested, chewed, snorted
Scientific Name Hydromorphone hydrochloride
Slang/Street Names for Dilaudid Dillies, D, Juice, Footballs, Dust, Smack
How Long in Bodily System Half-life: 8 to 15 hours

Eliminated in two to three days

Punitive Legal Measures: Using/Possession The penalties for Dilaudid possession depend on whether the offense is charged as a state or federal crime. For state crimes, a first offense is usually charged as a misdemeanor, with penalties including fines and up to one year in jail. A conviction on federal charges may result in up to five years in prison.
Punitive Legal Measures: Selling/Distributing Distributing Dilaudid is a more serious offense than simply possessing Dilaudid without a valid prescription. The offense may be charged as a felony, with penalties ranging from steep fines to up to 20 years in prison. Penalties are usually enhanced if the offense involved selling Dilaudid near a school or other public facility.
DEA Drug Rating Schedule II

Signs of Abuse

Behavioral Symptoms of Dilaudid Usage and Abuse

How Dilaudid affects the brain

The brain contains three types of opioid receptors: delta, kappa, and mu. Dilaudid binds to the mu receptors, triggering the release of dopamine, a chemical that plays several important roles in humans. Dopamine affects mood and motor control, which is why Dilaudid and other opioids can cause dizziness, stumbling, and mood swings.

Increased levels of dopamine may also play a role in Dilaudid addiction. After taking Dilaudid, the amount of dopamine in the brain increases. The individual experiences a pleasurable feeling, which is often referred to as a “high.” As a result, the brain learns that Dilaudid produces feelings of pleasure. Eventually, the brain no longer responds the same way to small amounts of Dilaudid, and the individual must keep taking more and more of the drug to experience the same reward.

Behavioral signs of Dilaudid use and abuse

Because Dilaudid affects the brain, it can also affect a person’s mood and behavior. Depression and anxiety are two of the most common behavioral symptoms of Dilaudid use. Taking Dilaudid may also cause an individual to take more risks than normal. For example, some people may engage in unprotected sex or make risky driving maneuvers. In severe cases, an individual who is addicted to Dilaudid can start to experience hallucinations.

Someone who is using Dilaudid may also start behaving unusually at home, at work, or at school. For example, an individual who usually attends work regularly may suddenly start arriving late or calling in sick. In adolescents, Dilaudid use can cause academic performance to suffer. A student using Dilaudid may also stop participating in sports and other after-school activities. Both adults and adolescents may distance themselves from current friends and start spending more time with new people when they are using Dilaudid. Additionally, they may start keeping secrets or acting in a suspicious manner, especially if they are trying to hide their Dilaudid use from others.

The Tennessee Department of Mental Health & Substance Abuse Services reports that people who are misusing drugs may display several psychological symptoms. These symptoms include paranoia, sudden mood swings, unexplained attitude changes, high levels of fear or anxiety, irritability, and sudden outbursts.

Physical Symptoms of Dilaudid Abuse

How Dilaudid affects the body

Dilaudid affects the central nervous system, which slows down a person’s breathing and also suppresses coughing. Using Dilaudid also affects an individual’s basal metabolic rate and sense of touch. The basal metabolic rate (BMR) is how much energy the body uses when it is at rest. Due to its effects on the respiratory system, Dilaudid can cause severe side effects in people who have chronic obstructive pulmonary disease and other lung problems.

Early physical effects of Dilaudid

Dilaudid can produce physical effects within as little as 15 minutes. Although Dilaudid may produce a pleasurable “high,” some of its physical effects are dangerous, especially in people with chronic medical conditions.

This table illustrates the possible short-term physical effects associated with Dilaudid.
Short-Term Physical Symptoms
Initial (direct effects of drug, 15-30 min.) Flushing
Lingering (within an hour of taking the drug) Itching
Extreme drowsiness
Post-Use (several hours to days after use) Anxiety
Decreased sexual desir
Dilaudid dependence

Severe and long-term physical effects of Dilaudid

Over time, some individuals become tolerant to the effects of Dilaudid, increasing the risk of dependency. Tolerance increases the risk of overdose, as it makes it impossible for an individual to experience the same pleasurable feeling with a small dose of Dilaudid. Therefore, some users start taking higher doses of Dilaudid just to experience the sensation of being high. Users may also take Dilaudid more often than recommended.

Dilaudid is especially dangerous when taken with other substances. Some substances, such as cold medicines, alcohol, medications used to treat insomnia (difficulty sleeping), sedatives, and antihistamines, are especially dangerous when combined with Dilaudid due to the way they affect the respiratory system. Mixing Dilaudid with stimulants can also be dangerous.

In a 2015 article published in the journal Pain Medicine, Chen and Ashburn reported that some people experience decreased heart function when they take opioids with benzodiazepines, which are typically used for treating anxiety. Dilaudid and other opioids can also cause swelling, low blood pressure, fainting, and reduced heart rate.

This table illustrates the possible long-term physical effects associated with Dilaudid.
Long-Term Physical Symptoms
Casual Headache
Dry mouth

Including all of the above effects for casual use

Slowed breathing
Loss of energy
Drop in blood pressure
Withdrawal Anxiety
Difficulty sleeping
Aching muscles
Abdominal cramps
Teary eyes
Dilated pupils
Runny nose

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of opioid addiction.

Dilaudid Usage

Use of opioids has increased dramatically throughout the world

Between 1998 and 2010, the global supply of hydromorphone increased by 500%, according to the 2019 World Drug Report produced by the United Nations Office on Drugs and Crime. In 1998, the hydromorphone supply was estimated to be less than 1,000 kilograms. By 2014, that amount had spiked to nearly 6,000 kilograms. Although Dilaudid is a prescription drug used for legitimate medical purposes, the increase in supply has made it easier for people to misuse Dilaudid.

North America accounts for 99% of the global hydromorphone supply

Almost all of the hydromorphone produced each year is used by Americans, according to the 2019 World Drug Report. This aligns with Gular et al.’s claim that Americans consume 80% of the world’s opioid supply even though they account for less than 5% of the global population. Opioid misuse is so prevalent in the United States that more than 130 Americans die from opioid overdose on a daily basis. The reason opioid use is much higher in the United States than it is in other countries is because of increased prescribing rates in recent decades. During that time, prescribers did not know that opioids could be highly addictive. By the time the addictive potential of Dilaudid and other opioids was known, overdose rates had already increased.

Opioid use is more common in Northern and Western Europe than in Eastern and Southern Europe

Bosetti et al. examined trends in opioid use for 40 European countries. Although opioid use did increase between 2014 and 2016, it has since leveled off in several countries, including Poland, Ireland, Finland, France, and Denmark. The European Union also reports lower levels of opioid use. According to the data reviewed in this study, opioid use is much more common among people in Western and Northern Europe than it is in people who live in Eastern and Southern Europe.

Oceania is among the regions with the highest levels of opioid use in the world

Oceania, which includes Australia, Polynesia, Micronesia, and Melanesia, has higher rates of opioid use than many other regions. The high prevalence of opioid use is due, in part, to the fact that Oceania is second only to North America in terms of the size of its opioid supply. In Oceania, the opioid supply is 12,563 daily doses per one million inhabitants, according to the 2019 World Drug Report. In contrast, Europe only has 8,812 daily doses per one million inhabitants, and Africa, Asia, and Central America all have an opioid supply of fewer than 500 daily doses per one million inhabitants.

Prescription Opioid Use Throughout the World
Highest Second Third
Regions with the Highest Number of Prescription Opioid Users North America Oceania Middle East/Southern Asia
Regions with the Largest Supplies of Opioids North America (30,814 daily doses per one million inhabitants) Oceania (12,563 daily doses per one million inhabitants) Europe (8,812 daily doses per one million inhabitants)

*This table includes data from users of opioids other than Dilaudid.

Source: United Nations Office on Drugs and Crime 2019 World Drug Report

Dilaudid Usage Demographics in the U.S.

Non-medical use of Dilaudid and other prescription opioids has increased in the United States

In 2016, approximately 4.4% of Americans aged 12 and older misused a prescription opioid like Dilaudid, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). This accounts for nearly 12 million Americans. Most of these users reported abusing a prescription opioid rather than an illicit drug like heroin.

Opioid use remains a concern for medical professionals and first responders, but the results of the Monitoring the Future Study: Trends in Prevalence indicate that opioid misuse may be decreasing in some age groups. For the study, students between the ages of 17 and 18 were asked if they had misused a narcotic within the past year or at some point in their lives. In 2018, 6% of the students surveyed reported any lifetime misuse of narcotics, a decrease from 7.8% in 2016. Additionally, only 3.4% of the students surveyed reported that they had misused a narcotic within the past year, a decrease from 5.4% in 2016.

Demographics of Prescription Usage
Past Year (2018) Lifetime
8th grade (14-15 yo) No data collected No data collected
10th grade (15-16 yo) No data collected No data collected
12th grade (17-18 yo) 3.4% 6%

How to Find Help

Long-term Dilaudid use causes users to become tolerant to the drug, which means they cannot receive the same “high” without taking higher doses or taking Dilaudid more often than recommended. Dilaudid also affects the reward center of the brain, causing users to crave the drug and satisfy their desire to experience pleasurable feelings. Over time, some users develop a dependence on the drug, which increases the risk of overdose and other serious consequences.

Stopping Dilaudid suddenly can cause severe withdrawal effects, so Dilaudid addiction treatment focuses on helping users slowly taper the amount of Dilaudid used each day. This slow process prevents severe withdrawal symptoms and reduces the risk of relapse. To find out more about Dilaudid treatment options, read our Dilaudid rehabilitation guide, which provides an overview of the available treatment options and explains how to find the right rehabilitation program.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.