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Signs That Someone Is on Dilaudid

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 14, 2023 • 8 cited sources

Signs that someone is on Dilaudid include tiny pupils, drowsiness, mood swings, poor motivation, isolation and an inability to control drug use, among others.

In 2018, doctors issued 2.7 million Dilaudid prescriptions.[1] This prescription opioid is indicated for the treatment of moderate to significant pain that can’t be addressed with other therapies, and it can be critical for people dealing with highly painful conditions like cancer. 

But Dilaudid is also a misuse target, especially for people with an existing opioid use disorder (OUD). As drug misuse deepens, people need stronger drugs to experience the sensations of euphoria or pain relief that once came easily. Someone who started an OUD with something mild like codeine might need a stronger drug like Dilaudid over time to achieve the same effect. 

Spotting Dilaudid misuse is critical, as it allows you to discuss treatment with the person you love. That conversation could encourage the person to enroll in programs that make a real difference. 

Common Signs of Dilaudid Misuse

Dilaudid is an opioid, and it works much like its cousins Vicodin, OxyContin and heroin. People may start using opioids through a prescription issued by a doctor to control pain, but they can transition to recreational use in time.

These are common symptoms of Dilaudid misuse: 

Lifestyle Changes

An opioid use disorder is time consuming, requiring a person to rearrange almost every single part of an average day. The primary focus of life eventually becomes Dilaudid use.

Lifestyle changes associated with Dilaudid misuse include the following:[2]

  • Avoiding contact with family and friends
  • Associating with new people and places 
  • Poor performance at work or school 
  • Secretive behavior 
  • Requests for privacy

As OUD deepens, people may steal money to pay for drugs. And since Dilaudid can be expensive, some people buy street drugs that are cheaper but likely more toxic.[3] These drugs may be contaminated with unsafe additives like fentanyl, and this makes overdose even more likely (a risk that is already high with Dilaudid misuse).

People may spend time in unusual neighborhoods in an attempt to find and buy more drugs. As they do so, this comes with its own set of increased risks.

Behavioral Changes 

As many as 85% of people who misuse drugs do so to self-medicate mental health symptoms.[4] But using drugs like Dilaudid repeatedly makes mental health worse over time. You may notice that the person seems low, sad or anxious with no known cause. 

While they might feel immediate relief from Dilaudid misuse, the declines in mental health on a long-term basis cause more damage overall. But then, they take more Dilaudid in an effort to feel better. This deepens a damaging cycle of misuse.

Other behavioral changes associated with Dilaudid misuse include the following:[5]

  • Poor decision-making abilities
  • Mood swings
  • Irritability 
  • Low motivation 

Physical Changes

Opioids like Dilaudid work directly on brain receptors, altering the way the person feels. But physical changes are common too, and many of them are visible. 

Physical changes associated with Dilaudid abuse include the following:[2]

  • Tiny pupils
  • Drowsiness
  • Decreased appetite 
  • Flu-like symptoms (which disappear when the person takes another dose)

Clinical Changes

Doctors are trained to spot misuse symptoms in their patients. If the person gets Dilaudid from a doctor, some changes that appear in appointments (or between them) could indicate a problem.

Doctors look for the following changes:[6]

  • Control: The person asks for frequent refills or claims the drugs were stolen.
  • Cravings: The person asks for stronger Dilaudid doses or claims pain isn’t controlled with the current strength.
  • Consequences: The person seems sedated or confused during appointments. The person also reports problems with functioning or relationships. 

When these signs appear, doctors might limit the refills they authorize. But without treatment, the person may crave the drug and switch to something more accessible (like heroin) instead. 

Dangers of Dilaudid Use & Misuse

Dilaudid is an extremely potent opioid, capable of slowing breathing rates within minutes. People with OUD often take enough with each dose to border on experiencing an overdose.

During an opioid overdose, people seem like they’re sleeping. Their breathing rates slow, and they may not respond to outside noises. Look closely, and you’ll notice that their lips and fingertips are blue-tinged due to lack of oxygen. Their brain cells are starving and dying by the minute. 

Quick response with an opioid agonist like naloxone renders Dilaudid inactive. Someone can awaken immediately after just one dose of this medication. 

Researchers say people with a history of surviving an opioid overdose often prefer Dilaudid over other opioids.[7] Statistics like this suggest anyone who misuses Dilaudid runs the risk of overdosing. And the next episode could be fatal. 

People who misuse Dilaudid also experience life-threatening withdrawal symptoms when trying to quit. They may develop diarrhea and vomiting simultaneously, leading to organ-harming dehydration. 

Relapse is common in those who experience painful withdrawal. They return to drugs to make the pain stop.

But even a day or two of sobriety can lower Dilaudid tolerance. A dose that seemed right before can lead to an overdose, which could be fatal. 

Getting Help for Dilaudid Misuse

Many people who misuse Dilaudid move through multiple cycles of cold-turkey withdrawal and relapse. There is a better way.

Medication for Addiction Treatment (MAT) programs are considered the gold standard of OUD treatment.[8] Medications like Suboxone (buprenorphine/naloxone) address brain imbalances caused by opioids like Dilaudid. Withdrawal symptoms are reduced, as are drug cravings. This makes recovery feasible when it has seemed impossible in the past.

Some MAT teams use therapy to help people develop sober habits, and a combined approach of medication and therapy is usually recommended. But researchers say medications are also effective on their own.[8] While therapy will help to form the foundation of a new life in recovery, medication is a key ingredient to sustain recovery. 

Bicycle Health uses telemedicine techniques to deliver MAT to people in need. You’ll meet with your doctor in a video appointment, and pick up your prescription at your local pharmacy. 

In this format, you can get help from your team when you need it, without violating your privacy. Your treatment is both discrete and effective. Contact us to find out if this model of care is right for you.

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. Drug Enforcement Administration. September 2019. Accessed April 2023.
  2. Opioids: Recognizing the Signs. New York State Department of Health. December 2017. Accessed April 2023.
  3. Examining Factors That Shape Use and Access to Diverted Prescription Opioids During an Overdose Crisis: A Qualitative Study in Vancouver, Canada. Journal of Substance Abuse Treatment November 2021. Accessed April 2023.
  4. The Role of Lifestyle in Perpetuating Substance Use Disorder: The Lifestyle Balance Model. Substance Abuse Treatment, Prevention, and Policy January 2015. Accessed April 2023.
  5. Opioid Addiction. American Academy of Family Physicians. April 2021. Accessed April 2023.
  6. Recognizing Opioid Abuse. National Institute on Drug Abuse. Accessed April 2023.
  7. Patient Preference for Pain Medication in the Emergency Department Is Associated with Nonfatal Overdose History. Western Journal of Emergency Medicine. July 2018. Accessed April 2023.
  8. Opioid Use Disorder. American Psychiatric Association. December 2022. Accessed April 2023.

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