Demerol vs. Dilaudid: Differences & Similarities

Demerol and Dilaudid are brand-name medications that contain powerful opioid painkillers. If your doctor recommends one of these therapies, you’ve tried a less potent approach (like Vicodin) and didn’t get the relief you needed. 

Dilaudid is the weaker of the two medications. But if you have chronic pain, this is the therapy your doctor might choose. Demerol causes severe health problems when used for long periods. Dilaudid is safer. 

Both can lead to misuse and the development of opioid use disorder (OUD).

This table can help you understand both drugs at a glance:[1,2] 

What Is Demerol?

Demerol is a brand-name medication that contains meperidine. Tablets and liquids are available, and they’re both designed for oral use.[1] Doctors use Demerol for pain issues that can’t be controlled with other methods.

Demerol is typically dosed every three to four hours.[3] But you’re not required to take the medication right on schedule. Doctors encourage their patients to pay attention to their pain and only take the medication when it’s required.

Meperidine is an opioid medication. Each dose sparks the release of dopamine deep within the brain. Street drugs like heroin do the same thing. 

Sometimes, people buy Demerol from dealers to get high. Slang names for this medication include demmies and pain killer.[4] 

While Demerol is an effective painkiller, it’s not designed for chronic use. Metabolites from the medication can build up within the body to toxic levels, causing seizures.[1] 

Withdrawal

Long-term use can also cause physical dependence. Cells within the brain and body become used to the drug’s continued presence. 

Once dependence is present, quitting abruptly can cause a score of symptoms, including the following:[1]

• Agitation 
• Irritability 
• Watery eyes
• Yawning
• Sweating 
• Chills 
• Overall discomfort
• Nervousness
• Backache
• Joint pain 
• Weakness
• Insomnia 
• Nausea
• Gastrointestinal issues
• Heightened blood pressure 
• Rapid heartbeat 
• Anorexia 

Doctors are encouraged to taper doses instead of asking their patients to quit use suddenly. But people who buy the drug from dealers may be forced to quit abruptly if they can’t access the substance. Fear of withdrawal from Demerol often perpetuates a cycle of continued misuse.

What Is Dilaudid?

Dilaudid is a brand-name painkiller that contains hydromorphone. This potent opioid works quickly, and it’s an effective solution for both short-term and long-term pain.[5]

Dilaudid comes in multiple forms, including tablets, oral solutions and injections. These options allow doctors to treat all sorts of patients, including those who aren’t well enough to swallow pills. 

Hydromorphone is an opioid, and it works within the brain just like illicit drugs like heroin. A dose makes people feel relaxed, and it can boost feelings of comfort and self-worth. Sometimes, people buy Dilaudid from dealers as a substitute for stronger drugs. 

Drug users may seek out injectable Dilaudid, so they can place it directly within the bloodstream. But if they can’t get an injectable form, they can crush pills and dissolve them in solutions to inject. Street names for Dilaudid are plentiful and include dillies, foosballs, juice and smack.[5]

Withdrawal

People who use Dilaudid regularly can develop physical dependence. When they quit using it abruptly, they can develop the same withdrawal signs seen with Demerol. A flu-like set of symptoms, accompanied by a significant amount of drug cravings, characterizes this process.[2]

What’s the Difference Between Demerol & Dilaudid? 

While both Demerol and Dilaudid are powerful opioid painkillers that share several characteristics, important differences separate them. Here’s what you should know: 

Potency 

Researchers have performed head-to-head comparisons of these medications in addressing significant pain. In one study, researchers gave participants either 1 mg of Dilaudid or 50 mg of Demerol.[6]

Studies like this suggest that Demerol is about twice as potent as Dilaudid. If researchers need to give twice as much for a solid comparison, it’s clear that one is significantly stronger than the other. 

Onset of Action 

Researchers say that Demerol works slightly faster than Dilaudid. Studies suggest that Dilaudid starts working within about 30 minutes.[8] That means Demerol can get started faster. 

However, Dilaudid comes in an IV format. Using a medication this way means putting the medication in direct contact with brain cells very quickly, bypassing the digestive tract. This method can make any drug work faster. 

Duration of Effect 

Demerol lasts between three and four hours.[1] That’s why doctors administer the medication on this type of schedule. 

Dilaudid lasts three to four hours too.[8] Doctors administer the medication on this schedule as a result. 

Administration 

Demerol is available in oral liquids and tablets. Dilaudid is more flexible, as it’s available as tablets, oral liquids and IV injections. 

Side Effects 

The opioids within Demerol and Dilaudid cause similar side effects. They can include sedation, lightheadedness, nausea and vomiting. There are no significant noted differences in side effects between these two medications. 

Medical Uses

Demerol is approved for pain management for people with significant pain that hasn’t responded to other forms of treatment, including weaker opioids. This medication can’t be used for chronic conditions.[1]

Dilaudid is approved for pain management. People with severe short-term or long-term pain that hasn’t responded to other forms of treatment can use this medication.[2]

Is Demerol Stronger Than Dilaudid? 

Demerol is stronger than Dilaudid. In head-to-head studies, researchers give twice as much Dilaudid than Demerol.[6] They wouldn’t have to make this adjustment if they were of the same strength and potency. 

Know that both of these drugs are dangerous. Dilaudid may be a weaker drug, but it can cause significant problems, even in people accustomed to using the drug. 

What Is the Misuse Potential?

All opioids come with significant misuse risks. Demerol and Dilaudid are no different, and they are both considered prone to misuse, which can lead to OUD.

The meperidine inside Demerol is a Schedule II controlled substance.[1] Researchers say this drug can expose people to addiction risks, including abuse and misuse. People can develop an addiction even if they’re using it at the recommended dose.[1] It’s important to always take precautions when using any opioid as a result.

The hydromorphone inside Dilaudid is a Schedule II controlled substance.[2] Researchers say this drug can increase the risk of addiction and abuse. People can develop these problems even if they’re using Dilaudid at the recommended dose.[2]

MAT for Opioid Misuse

Withdrawal symptoms and deep cravings can make quitting opioid misuse difficult. People may feel so sick and upset that they keep using it, even when they don’t want to do so. Medication for Addiction Treatment (MAT) can make a big difference. 

MAT programs use medications like buprenorphine or methadone to manage opioid withdrawal. Suboxone, a combination of buprenorphine and naloxone, is considered the gold standard in treatment for OUD. 

Some people need MAT to help them get past uncomfortable withdrawal and the early stages of recovery, when they are most vulnerable to relapse. Others need MAT for longer periods to ensure they don’t relapse due to cravings. Some people remain on Suboxone indefinitely since it continues to support their recovery.

Bicycle Health offers MAT via telemedicine. You don’t have to go to a clinic or hospital for therapy. You can meet with a team in a video appointment, and pick up your prescription at a local pharmacy. 

You’ll have support throughout the entire recovery process, as you stay in touch with the team via more video appointments. If you’ve struggled to quit opioid misuse independently, MAT could be just the solution you need. Contact us to find out more.