Hydromorphone is among the world’s most potent opioids, with effects that are five to eight times the strength of morphine. Despite stringent restrictions on its use both in the UK and globally, hydromorphone abuse and misuse remain prevalent, affecting both individuals with legitimate prescriptions and those abusing it recreationally. Taking hydromorphone in a way other than prescribed and without medical guidance can quickly result in hydromorphone addiction, a serious condition which can have life-threatening consequences. To prevent the risk of hydromorphone addiction, a full understanding of how hydromorphone works and its dangers is crucial for both users and medical professionals.

What is hydromorphone?

Hydromorphone is a lab-produced opioid that is prescribed for moderate to severe pain. This may be acute pain, chronic pain caused by conditions like cancer and, rarely, chronic cases of mild pain. Hydromorphone is usually administered in pill form but is also available as both intravenous and intramuscular injection. The effects of hydromorphone usually begin within the first thirty minutes to an hour of being administered the drug and last for around five hours.

Common brand names of hydromorphone include:

  • Dilaudid
  • Palladone
  • Hydrostat
  • Hymorphan
  • Sophidone LP
  • Opidol
  • Laudicon
  • Hydromorph Contin
  • Hydal
  • Dimorphone

 

In the UK, hydromorphone carries the most serious class-A classification as a reflection of its potential and addiction. There are serious legal penalties for unlawful hydromorphone possession and supply, including a seven-year custodial sentence for hydromorphone possession and a life sentence in prison for production and supply.

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How does hydromorphone work?

Hydromorphone’s pain-relieving abilities are a result of its effects on the central nervous system. Like other opioids, hydromorphone binds to the mu-opioid receptors located in the spinal cord and brain and spinal cord which are integral to the body’s system for managing pain and pleasure.

By engaging with these receptors, hydromorphone modifies how pain is interpreted by the brain, lessening the pain sensations experienced by the user.

Hydromorphone also triggers the release of large quantities of dopamine, which causes euphoric sensations that further aid in alleviating pain.

The risks of hydromorphone abuse misuse

Hydromorphone can be both abused for the euphoric effects it abuses and deliberately or inadvertently misused for its pain-relieving abilities.

In the case of recreational abuse, users may attempt to intensify or accelerate the effects by crushing and snorting hydromorphone pills, dissolving them for injection or mixing hydromorphone with alcohol or other drugs.

In terms of medical misuse, hydromorphone may be taken without a prescription, in larger doses than prescribed or for longer than is advised.

Whatever the reason and nature of hydromorphone abuse and misuse, the risks can be serious and potentially even deadly. They include:

  • Severe respiratory depression: This is one of the most serious dangers of hydromorphone abuse, particularly when the drug is taken in high doses or when mixed with other depressants like alcohol, benzodiazepines or other opioids and opiates. Severe respiratory depression can rapidly cause an increase in oxygen levels, resulting in coma and potentially death.
  • Hydromorphone overdose: Hydromorphone is incredibly potent, and there is a high risk of hydromorphone overdose when the drug is taken without medical supervision and in large doses. Hydromorphone overdose often leads to severe respiratory depression and failure, which can be lethal.
  • Physical health damage: Long-term hydromorphone abuse can cause damage to the kidneys and liver, a weakened immune system and a number of gastrointestinal issues.
  • Mental health complications: Hydromorphone abuse, particularly over a long period, can trigger or worsen mental health disorders like anxiety and depression and can even result in psychosis.
  • Risk of infections: Injecting hydromorphone, especially if needles are being shared with others, can increase the spread of hepatitis, HIV and other infectious diseases.
  • Financial and legal problems: Hydromorphone can often be bought on the black market for illegal abuse, which carries serious penalties. It is also very expensive, so the cost of feeding a hydromorphone habit can create financial problems.
  • Social and relationship damage: Hydromorphone abuse and the resulting harm can create issues between couples, parents and children and with friends and colleagues. It can also affect job and education performance, which can add to the mental health burden and financial woes.
  • Dangerous behaviours: Using hydromorphone without medical supervision can lead to dangerous behaviours like risky sexual practices and driving while intoxicated.
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How does hydromorphone addiction develop?

Hydromorphone addiction is a condition that causes an individual to keep taking the drug compulsively even though it is harming their health, relationships or other aspects of life. Addiction to hydromorphone usually develops through gradual stages, and the individual may not even realise they are losing control of their drug use.

These stages typically include:

Initial recreational or medical use
To begin, the individual may start recreationally experimenting with small doses of hydromorphone on irregular occasions, take the drug according to their prescription or self-medicate in low doses for stress or mental or emotional issues.
Exacerbated use
Over time, recreational users may start taking hydromorphone more regularly or in greater doses because they enjoy the effects, while those taking the drug on prescription or for self-medication may also increase dosage and frequency for heightened pain or distress relief.
Hydromorphone tolerance
This escalation in use can then lead to the individual becoming tolerant to hydromorphone’s effects. They may then need to increase dosage and frequency even further to relieve pain and distress or get high.
Hydromorphone dependence
With a large concentration of hydromorphone now in constant presence, the body starts to depend on it for normal function. Once a physical dependence has been established, if the person then tries to stop taking hydromorphone, the sudden drop in levels causes the body’s systems to fall out of balance. This leads to unpleasant and potentially dangerous hydromorphone withdrawal symptoms, which can cause the person to start taking the drug again. Potential withdrawal symptoms include:

  • Agitation and restlessness
  • Anxiety
  • Depression
  • Diarrhoea
  • Tremors
  • Body cramps
  • Extreme sweating
  • Bone and muscle aches
  • Nausea and vomiting
  • High blood pressure

The sedative effects of hydromorphone can also create a psychological dependence over time where the individual feels like they can’t manage the stresses and difficulties of daily life without the drug.

Hydromorphone addiction
With the establishment of both psychological and physical hydromorphone dependence, the individual becomes fully trapped in the cycle of drug addiction. Even though they may see that they have lost control and their hydromorphone use is harming them, they will be unable to stop taking it.

Telltale hydromorphone addiction symptoms include:

  • Being preoccupied with hydromorphone use and supply
  • Deceiving loved ones about hydromorphone use
  • Obtaining hydromorphone illegally, online or through “doctor shopping”
  • Disregarding physical and mental health problems
  • Getting into debt or financial woes to fund hydromorphone use
  • Neglecting relationships and friendships and performing poorly at school and work
  • Wild mood swings, personality changes and erratic behaviour
  • Being in denial about hydromorphone addiction and its impacts
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What factors contribute to hydromorphone addiction?

While everyone who uses hydromorphone is at risk of becoming addicted, it is clear that not everybody does. There are a number of potential factors that can increase the likelihood of use rising to hydromorphone addiction, including:

Genetics

There is a significant genetic element to addiction, so those with a family history of substance abuse often carry an inherently higher risk of becoming addicted to hydromorphone.

Mental health

Underlying mental health can also be a factor, as some people may use hydromorphone to soothe symptoms or self-medicate. Conditions such as PTSD, anxiety and depression all commonly co-occur with substance addiction, including addiction to hydromorphone.

Environment

Peer pressure, living in a home where drug use is normalised, early exposure and poverty-related issues can all increase substance abuse tendencies, resulting in addiction.

Chronic pain management

Those who are prescribed hydromorphone for chronic pain (which is rare in the UK) may develop a tolerance, dependence and resulting addiction. Close medical monitoring is crucial to spot early signs of dependency and reassess treatment methods.

A stressful life

Individuals with a particularly stressful life may use hydromorphone to deal with stress day-to-day. This can escalate to a dependence where they are unable to cope at all without it.

Misconceptions about addiction

Some people may be unaware that prescription medication like hydromorphone can be addictive, so they may not take the necessary precautions.

A lack of support

Social isolation, a lack of family support and limited medical resources nearby can all contribute to risky hydromorphone use and addiction.

How is hydromorphone addiction treated?

Hydromorphone addiction treatment includes detox, rehab therapy and aftercare to address the complex nature of the condition and prevent relapse. This can take place either in an inpatient rehab centre where the individual lives as a resident for the duration of treatment or through an outpatient rehab programme where they live at home and regularly attend a centre for therapy.

Hydromorphone detox

Hydromorphone detox is the process of medically supervised elimination of the drug from the body. This phase can be tough as hydromorphone withdrawal symptoms can be very unpleasant and even dangerous. 24/7 monitoring by a professional detox team and possibly opioid replacement therapy help to alleviate these symptoms and make withdrawal more manageable.

Hydromorphone rehab therapy

To address the psychological and personal causes of hydromorphone addiction, a range of therapies are then provided. These can differ between different rehab facilities and programmes but may include:

  • Individual counselling: These are one-to-one therapy sessions which enable the individual to dive deep into their own personal addiction experience. Individual counselling helps to identify hydromorphone addiction causes, learn new strategies for coping with cravings and triggers and allows for close monitoring of co-occurring conditions.
  • Group therapy: This is a very important part of hydromorphone addiction recovery as it allows individuals to share their stories, create a sense of connection and enable them to learn from each other. It can also help to build confidence and self-esteem, which are often harmed by addiction.
  • Family therapy and support: Hydromorphone addiction can have a huge impact on loved ones. Family therapy helps repair damaged relationships, guides families through treatment, and teaches families how to support their loved ones during and after rehab.
  • Cognitive behavioural therapy (CBT): CBT has been a cornerstone of addiction treatment. It helps individuals suffering from hydromorphone addiction to recognise and modify the thoughts and behaviours that are fueling their drug use.
  • Holistic and alternative therapies: These are designed to treat the individual’s mind, body and soul. They include meditation, art and sound therapy, yoga and fitness and can help create a sense of calm and a safe place for expression.

Relapse prevention

Relapse prevention helps the individual to stay free from hydromorphone and other substances after they finish rehab. Most rehab programmes provide aftercare, which may involve ongoing outpatient therapy and other forms of support and advice. Further relapse prevention strategies include:

  • Developing healthier habits and lifestyle choices
  • Creating a support network of friends, family and recovery peers
  • Attending support groups such as NA (Narcotics Anonymous)
  • Trying new hobbies to stay active and meet new people
  • Getting regular checkups to monitor physical and mental health progress

This comprehensive approach to hydromorphone addiction treatment gives individuals the best chance of recovery and the necessary support to sustain sobriety long-term.

Begin hydromorphone recovery today

If you are struggling with hydromorphone addiction, then you should seek professional help immediately. Your local GP, NHS rehab services and private addiction treatment centres can all give you important advice and help you get started. It can be a little scary to admit you need help, but it is the first and most important step towards recovery.

FAQs

What are the long-term effects of hydromorphone addiction?
Long-term addiction to hydromorphone can lead to a range of serious health issues, including respiratory depression, liver and kidney damage, gastrointestinal problems and weakened immune system. Additionally, prolonged use can cause cognitive impairments such as memory and decision-making issues, exacerbate or contribute to mental health disorders like depression and anxiety and have wide-ranging personal and social impacts.
How addictive is hydromorphone?
Hydromorphone is a highly addictive opioid. Its ability to produce intense feelings of euphoria and pain relief makes it susceptible to abuse, leading to physical and psychological dependence. The risk of addiction increases with the duration of use, higher dosages and misuse of the drug (such as taking it more frequently or in higher doses than prescribed). Even individuals taking hydromorphone as prescribed can develop dependence, highlighting the importance of careful monitoring by healthcare providers.
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