Hydromorphone Symptoms and Warning Signs

Hydromorphone Abuse: Signs and Symptoms

Hydromorphone is a prescription medication that is used for the long-term treatment of moderate to severe pain, in cases where other medications and other non-pharmacologic options have not been able to yield the right results.  This opioid pain medication is available for use as an oral liquid, immediate-release tablet, suppository, injectable solution, and/or an extended-release tablet.

As is the case with other opioid medications in its class, the efficacy of hydromorphone is a result of how it changes the perception of pain when you use it. It doesn’t cure the cause of your pain; instead it just makes it more bearable. When you inject the drug or swallow the tablet, you will start to enjoy pain relief within 15 to 30 minutes.  The painkilling effect of hydromorphone can last for up to 5 hours. The drug’s potency is around two times the potency of morphine.

Hydromorphone is usually available as a prescription medication. To get the drug without a prescription, and outside of a medical environment generally, invariably means obtaining it legally. Some of the ways people obtain hydromorphone is to illegally forge prescriptions, or to bribe dishonest medical personnel to provide the prescription when there is no legitimate reason to do so.  Some people can stoop to the level of robbing pharmacies, nursing homes, and medical facilities for the tablets.

People addicted to hydromorphone report that they prefer intravenous injection of the substance, as this is when it is at its most potent. This risky approach to using the substance is why people addicted to hydromorphone find it very difficult to get help.

The Dangers of Hydromorphone Abuse

Hydromorphone is a beneficial painkiller in a hospital-based setting due to its potency as an opioid. However, it is still one of the most desirable street drugs for addicts. The tablet is referred to by various pseudonyms to avoid suspicion. Some of these include: footballs, dust, morph, dillies, smack, juice, etc. The abuse of prescription drugs, like hydromorphone, is a huge problem around the world, with only marijuana and hashish abused more.  It is worrying for drug enforcement that the scourge of prescription painkillers is a bigger problem than the more commonly maligned substances, such as heroin.

Although hydromorphone is viewed as less dangerous than heroin, you are still going to gradually progress towards addiction with continued use. In many cases, people that were legitimately prescribed hydromorphone still end up abusing it at some point. People that abuse hydromorphone do so by taking the medication in a way that wasn’t prescribed, often in doses that are higher than recommended. They are also more likely to crush or snort the substance. Most importantly, they take the substance solely for the purpose of getting high.

If you abuse hydromorphone, you will find pleasure in abusing the substance for its intoxicating nature.  However, the high doesn’t last. You will end up using more of it, risking life-threatening side effects. If your addiction continues to grow unchecked, you run the risk of overdose, which can quickly turn fatal.

Recognising a Hydromorphone Addiction

Regardless of the dangers of a hydromorphone addiction, a large number of people still abuse it for its intoxicating effects, which supposedly mirror the effects of more dangerous substances such as heroin. You know you are abusing hydromorphone if you are taking it to obtain the following effects:

  • Increased drowsiness
  • Decrease in anxiety and worry
  • Intense pleasure
  • Physical relaxation
  • Decreased tension

Hydromorphone addiction can also be recognised by some of its negative side effects, which include:

  • Increased perspiration
  • Depression
  • Decreased appetite
  • Headaches
  • Constipation
  • Vomiting
  • Nausea
  • Lightheadedness
  • Pains in the extremities

Some more dangerous symptoms of hydromorphone use include:

  • Fainting
  • Seizures
  • Rash or hives
  • Troubled breathing
  • New and unexplained swelling
  • Extreme drowsiness

When you start seeing this group of dangerous symptoms arise, you need urgent professional help.

Some of the signs and symptoms listed above can still occur with standard hydromorphone use. However, they are at their most visible when someone is abusing the substance. For instance, someone that abuses hydromorphone will be too sedated, in many cases, to hold conversations and might skip work or school many times because they cannot, or don’t want to, leave their home.

Addiction to hydromorphone starts with regular abuse, and the individual will take several dangerous steps just to seek out the substance and use it compulsively, regardless of what might happen as a result. Behavioural elements of hydromorphone abuse include:

  • Lying in a bid to trick other people into parting with money to buy more of the substance.
  • Remaining in isolation most of the time and spending time with a new group (possibly other users or dealers) when the need to socialise arises.
  • Setting up appointments with many doctors at the same time, just to get different prescriptions.
  • Inability to keep up with financial obligations as a result of the overwhelming burden of the addiction on their finances.

Hydromorphone Addiction and the Brain

The impact of hydromorphone is a result of the biomolecular interaction between hydromorphone and specific structures that are spread throughout your brain and spinal cord, known as opioid receptors.  Once the drug gets to these receptors, a reduction in the perception of pain is achieved.  When these receptors are triggered, dopamine is also released. This gives the feeling of reward in users, who then proceed to continue using hydromorphone in an attempt to keep recreating this feeling of reward.

What are the Immediate Side Effects of Hydromorphone Abuse?

Anyone that uses or abuses hydromorphone will start to feel a wide range of pleasurable effects, which are produced by the hydromorphone as soon as the substance is taken. If you inject the substance, or swallow the pills, you can expect the effects to kick in within 30 minutes from when you last took the substance, and the effects can remain for up to five hours. Some of these short term effects include:

  • Drowsiness
  • Decreased stress and anxiety
  • Increased physical relaxation
  • Decreased feeling of pain
  • Euphoric high
  • Slowed speech
  • Slowed movements

What are the Long Term Side Effects of Hydromorphone Abuse?

Some of the main long term effects of hydromorphone abuse manifest as tolerance, eventually progressing to addiction.

During the tolerance stage, you will find yourself needing to take more hydromorphone as your body adjusts to the previous dose. If you take the exact dosage level you used the last time, you will not get the same feeling of pain relief, or high, as you previously did.

When you are fully addicted to hydromorphone, your body will find it difficult to function when you don’t have the drug in your body.  If you ignore the cravings for the drug, your body will gradually slide into withdrawal.

Some of the long-term health consequences of hydromorphone abuse include:

  • Seizures
  • Vomiting
  • Endocarditis
  • Blood related infections, such as HIV and Hepatitis B andC (as a result of injecting the substance)
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Intervention for a Hydromorphone Addiction

Helping someone who is struggling with hydromorphone addiction is often a challenge. At this point, the focus has to be on providing all the support they need to quit the substance, instead of enabling them towards continued use.  Some of the things you can do include:

  • Gaining as much knowledge as you can about hydromorphone addiction, so as to make it easier for you to understand and provide help.
  • Avoiding shaming or blaming, but instead showing love, concern and care.
  • Showing understanding, support, and concern for the problem.
  • Gradual encouragement of professional treatment.
  • Avoiding talk of quitting without seeking professional help.
  • Having the willingness to provide the support needed post treatment, in order to reduce the chances of relapse.
  • Talking about the addiction treatment first before bringing professional help.
  • Seeking professional help with intervention, if you are struggling to make them see reason.

Before you proceed with the intervention, however, you need to keep some key facts in mind:

  • The focus of a hydromorphone intervention is to give the individual an opportunity to seek help and make changes to their lifestyle.
  • The intervention is incomplete if it doesn’t include information, education, and support from friends and family.

Professionals can also get involved in some cases. In fact, it is important to avoid staging an intervention without professional help, especially if the individual in question has documented mental illness, is aggressive or violent, is abusing multiple substances, or has a history of attempting suicide.

Detox and Withdrawal from Hydromorphone

Hydromorphone detox and withdrawal is rarely dangerous from a medical perspective. However, it is usually uncomfortable. This is why you are more likely to return to drugs if you attempt to do it alone. As the body is processing and removing the hydromorphone, in a process known as detoxification, you will begin to feel uncomfortable, as a result of the withdrawal symptoms.

  • Going through a medically supervised withdrawal and detox will make the process more tolerable for you. Your vital signs will be monitored, in a safe and properly- environment.
  • During this process, other medications may be used to help facilitate the process for you. Some of them include:
  • Naltrexone: This drug will block the effect of opioids, such as hydromorphone, but is usually administered after the detox process. This is because it can worsen withdrawal symptoms if it is used too early.
  • Buprenorphine: This drug basically works against the hydromorphone, and also reduces cravings while fighting the withdrawal symptoms you may be experiencing.
  • Probuphine: This is basically an implant variant of Buprenorphine, that will slowly be released into your bloodstream over a period of 6 months.
  • Methadone: This drug also fights the impact of hydromorphone, and eases withdrawal symptoms without producing a high.
  • Clonidine: This drug is used to fight withdrawal symptoms without leaving an intoxicating effect.

Treatment and the Next Steps in Hydromorphone Abuse

At the end of the withdrawal and detox stage, you will now proceed to other levels of treatment based on your specific needs. These will include one or more of the following:

Inpatient assistance: This is a generally short-term, and hospital based programme, where the emphasis is on stabilising you medically and mentally.

Outpatient/Inpatient therapy:  The focus here is often on using a collection of different forms of therapy to provide you with the coping mechanisms and techniques to ensure your withdrawal/detox is successful. With the outpatient variant, you get to go home at the end of the process each day, while inpatient treatment requires you to remain in a controlled environment over a period of time.

Questions About Treatment

Is it important to stop abusing Hydromorphone?

Yes. Hydromorphone is not a harmless substance to abuse. In fact, it can be highly dangerous. It should never be used outside of a hospital setting, so if you are abusing the substance, you are risking the possibility of developing serious health consequences. Some of the effects include seizures and convulsions. Your behaviour can also expose you to, opportunistic but life-changing infections, such as HIV and hepatitis. If you are still unsure of how dangerous hydromorphone abuse is for you, talk to a health professional.

Who Can I Talk to About Hydromorphone Abuse?

If your hydromorphone abuse started out with a prescription, you should talk to your doctor for alternative medications or ideas to manage the reason for the prescription. If you are using the substance for recreational purposes only, speak to an addiction professional right away for guidance on how to turn over a new leaf.

What Will happen to the Pain after I Stop Using Hydromorphone?

If you are using hydromorphone to manage chronic pain, but now find yourself taking the substance outside of the prescription, you can talk to your doctor for other possible pain management medications. Chances are that the worst stage of the pain has elapsed, so other medications, that can reduce the feeling of pain without leading to an addiction, can be explored.

Are There Safe Substitutes for Hydromorphone?

Your doctor will be in the best position to recommend substitutes to hydromorphone.

Is the Treatment Process Guaranteed to Work?

A properly-planned hydromorphone addiction treatment and rehabilitation process will work. However, this begins by talking to a professional openly and honestly, so that they can chart a responsible treatment plan for you.

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