Dilaudid (Hydromorphone) Overdose | Signs, Symptoms, & Treatment

Hydromorphone hydrochloride is a powerful opioid analgesic made from the natural opiate drug morphine and sold under the brand names Dilaudid, Dilaudid-5, Exalgo, and Palladone.

It is prescribed for the treatment of moderate or severe pain, including chronic pain through the use of hydromorphone extended-release formulations.

Like other opioid drugs, hydromorphone is classified as a schedule II controlled substance with a high potential for abuse and addiction. If misused, hydromorphone can provoke serious and potentially life-threatening overdose effects.

Hydromorphone Overdose

When opioid drugs, like hydromorphone, are used therapeutically they can provide much-needed relief from pain due to surgery, accidents, or other serious medical conditions.

They do this by binding to opioid receptors in your central nervous system, changing how your nerves respond to pain and triggering a degree of sedation, or slowed nervous system activity.

However, at higher doses the effects of opioids become more profound. Rather than pain relief, opioids will trigger an intensely addictive euphoria. And rather than sedation, the drugs will begin to disrupt life-sustaining vital functions, especially your ability to breathe.

This may result in an opioid overdose, an extremely dangerous condition that claimed the lives of over 68,000 Americans in 2020 alone, according to the National Institute on Drug Abuse (NIDA).

Strong opioids like hydromorphone, which is between 2 and 8 times more potent than morphine and even more sedating, carry an even higher risk for harmful overdose if abused.

Signs & Symptoms Of A Hydromorphone Overdose

There are a variety of classic symptoms that you can use to recognize an overdose of hydromorphone, as well as other opioid drugs including hydrocodone, oxycodone, heroin, fentanyl, and others.

The signs and symptoms of opioid overdose can include:

• abdominal or stomach pain and cramping
• blue-colored fingernails and lips
• breathing problems, especially slow breaths, shallow breathing, gasping, or no breaths at all (respiratory depression)
• cold, clammy skin
• low body temperature (hypothermia)
• contracted, pinpoint pupils (miosis)
• confusion
• constipation
• dizziness
• drowsiness
• fatigue
• flushing
• itching
• lightheadedness
• loss of consciousness or coma
• low blood pressure (hypotension)
• muscle twitching
• muscle weakness
• nausea and vomiting
• slow heart rate
• weak pulse

Treating A Hydromorphone Overdose

If you believe an opioid overdose has occurred, it’s important to call for emergency medical attention as quickly as possible and apply the opioid antidote naloxone (Narcan) if you can.

Naloxone works by rapidly blocking off opioid agonists, like hydromorphone, from opioid receptors in the body, restoring normal life functions. It can be purchased at pharmacies over the counter without a prescription and is carried by most emergency service personnel.

You should also place the victim on their side in the recovery position.

Once healthcare professionals arrive they can treat the overdose by providing oxygen, breathing support, further doses of naloxone (if needed), hydration, or even life-support care.

Risk Factors For Hydromorphone Overdose

There are a variety of factors known to increase a person’s risk of overdosing on hydromorphone.

These include:

• changes in tolerance from not using hydromorphone or using less of it for a period of time
• switching to hydromorphone after abusing a less potent opioid
• mixing hydromorphone with other drugs of abuse
• being in poor health
• surviving a past overdose or overdoses

Hydromorphone Drug Interactions

The powerful effects of hydromorphone alone are strong enough to cause fatal overdoses in those who take too much of the drug. However, a variety of drug interactions can also greatly increase the effects of hydromorphone, complicating overdose events and increasing their severity.

These substances include other central nervous system depressants like benzodiazepines, alcohol, muscle relaxants, and other opioids including so-called weak opioids like codeine or tramadol.

Drugs and supplements that increase serotonin levels in the body may also interfere with hydromorphone’s effects, and should be used with caution only under the supervision of your prescribing doctor.

Hydromorphone Side-Effects

Common side effects of hydromorphone use not related to overdose events may include:

• nausea
• vomiting
• constipation
• lightheadedness
• dizziness
• drowsiness
• sweating
• flushing
• dry mouth

These effects are more common when individuals begin taking the medication, and often pass as the body adjusts.

Uncommon but serious side effects that should be referred to your healthcare provider include:

• sleep apnea
• mood changes
• agitation
• stomach or abdominal pain
• difficulty urinating
• unusual tiredness, loss of appetite, or weight loss

After any extended period of opioid use you may experience certain withdrawal symptoms when you stop taking the drug, due to the development of physical dependence. Hydromorphone withdrawal symptoms are often described as flu-like and can include intense drug cravings.

If you or a loved one struggles with prescription drug abuse, please contact us today.