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How Addictive Is Dilaudid? Understanding Dilaudid Tolerance

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 14, 2023 • 9 cited sources

Dilaudid is very addictive, like all opioids. With regular use, tolerance to the drug forms, and dependence can quickly follow.

Dilaudid is a prescription medicine frequently utilized to manage intense pain. It is chemically the same as its generic version, hydromorphone. 

This medication functions by attaching itself to certain receptors located within the brain and spinal cord, which can prevent the transmission of pain signals. This drug should only be used according to a doctor’s recommendations. Improper use may lead to misuse, possible dependence, and addiction.

How Addictive Is Dilaudid?

Dilaudid is highly addictive, which means it has an inherent potential for misuse and opioid use disorder (OUD); this needs to be kept in mind when deciding if the benefits for a patient may outweigh the risks.[1]

The drug has an impact on mood by creating euphoric sensations coupled with a sense of relaxation. These attributes can make its misuse appealing to individuals dealing with physical or emotional pain. 

Over time, however, misuse can cause chemical changes in the brain that essentially hijack the brain’s reward system. This can lead to a person feeling compelled to misuse the drug and thus developing an OUD.

Why Is It So Addictive?

Dilaudid is highly addictive in part because of the way it affects the brain’s reward center.[2] When an individual takes Dilaudid, it stimulates the release of dopamine. Dopamine is a neurotransmitter that contributes to feelings of pleasure and reward. 

Over time, the brain becomes dependent on Dilaudid to produce these feelings. This means that behaviors that were rewarding in the past, like sex or eating delicious food, are not as rewarding as they used to be. The brain signals that they are not as powerful or salient experiences as taking Dilaudid. This contributes to the misuse cycle that ultimately leads to OUD.

How Long Does It Take to Get Addicted to Dilaudid?

The amount of time it takes to develop an opioid use disorder related to Dilaudid varies between individuals due to factors such as their genetics and personal history of substance misuse or trauma.[3] The presence of any co-occurring mental health issues can also play a role.  

However, taking an opioid like Dilaudid for several weeks increases the probability of drug dependency significantly. This risk is even greater when consuming larger quantities of the drug, especially through alternate means that may produce a more powerful high, such as by crushing and snorting it.

How Tolerance Develops

Repeated Dilaudid use eventually requires individuals to elevate their doses over time to achieve the same effect because of their growing tolerance toward the drug.[4] Tolerance happens when the body starts to adapt to drug use, causing the person to not be as reactive to the drug and weakening its overall effects. 

This can cause a dangerous cycle of drug misuse. As tolerance rises, the person takes more, increasing the likelihood of an opioid use disorder and also overdose. 

Signs That Someone Is Misusing Dilaudid

Dilaudid addiction can cause physical symptoms in an individual, including these: 

  • Sleepiness
  • Small pupils
  • Nausea
  • Vomiting 
  • Difficulties when breathing

Some behavioral indicators of an opioid use disorder include the following:[5] 

  • Engaging in criminal behaviors, such as stealing cash to pay for Dilaudid or other opioids 
  • Disregard toward important work duties
  • Isolating oneself from family and loved ones
  • An inability to stop Dilaudid use despite damage to various areas of life

Psychologically, an addiction to Dilaudid can include mood swings, including depression, severe anxiety, and increased irritability. 

Getting Help for Opioid Use Disorder

If someone is struggling with an opioid use disorder related to Dilaudid or another opioid, it’s important to connect with help as soon as possible. Opioid use disorder is a serious and potentially life-threatening condition that requires medical intervention and support. Treatment for opioid use disorder will usually include medications to manage withdrawal symptoms and cravings, as well as behavioral therapies to help individuals learn new coping skills and behaviors.

Some of the most common treatments for opioid use disorder include Medication for Addiction Treatment (MAT), which combines medications such as buprenorphine or methadone with behavioral therapies as well as counseling and support groups.[6] Suboxone, which combines buprenorphine and the misuse-deterrent medication naloxone, is recommended for the treatment for opioid use disorder.[7] 

Other therapeutic options for opioid use disorder include behavioral therapies, such as cognitive-behavioral therapy (CBT) or contingency management, as well as support groups. It’s generally recommended that therapies are used in conjunction with medication for OUD.[8]
Opioid use disorder requires professional treatment. Though there is no cure for the condition, with MAT, you can effectively manage the disorder for the rest of your life.[9] People continue to use Suboxone for months, years, or even indefinitely. As long as it is supportive of your recovery, you can continue taking it.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Hydromorphone. U.S. National Library of Medicine. January 2021. Accessed March 2023.
  2. Opioid Addiction. StatPearls January 2023. Accessed March 2023.
  3. Relationship Between Interpersonal Trauma Exposure and Addictive Behaviors: A Systematic Review. BMC Psychiatry May 2017. Accessed March 2023.
  4. Tolerance and Resistance to Drugs. Merck Manual. September 2022. Accessed March 2023.
  5. Opioid Use Disorder. StatPearls June 2022. Accessed March 2023.
  6. Opioid Addiction Treatment. American Society of Addiction Medicine. Accessed March 2023.
  7. Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal Spring 2018. Accessed March 2023.
  8. Contingency Management for Patients Receiving Medication for Opioid Use Disorder. August 2021. Accessed March 2023.
  9. Drugs, Brains, and Behavior: The Science of Addiction, Treatment and Recovery. National Institute on Drug Abuse. July 2020. Accessed March 2023.

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