There are certain prescription medicines that have been found to be illegally used that lead to dependency and abuse. Most of the drugs being abused are for symptoms to relieve pain. One of the commonly abused drugs is hydromorphone, also known as dihydromorphinone and is commercially known with the brand name Dilaudid.
What is hydromorphone?
Hydromorphone is a narcotic analgesic listed under Schedule II Controlled Opioid Agonist along with morphine, fentanyl and methanyl. This highly potent narcotic analgesic is said to be six to nine times stronger than morphine.
This drug is manufactured in two different kinds: extended release formula, and the instant release formula used in the hospital for surgery. Hydromorphone may come in any of the following dosage forms:
Its chemical name is 4,5α-epoxy-3-hydroxy-17- methylmorphinan-6-one hydrochloride.
Precautions in using hydromorphone
Prior to usage, patient and doctor should be able to assess if this drug is the right choice to treat the immediate complaint. Several factors need to be considered:
Test for allergy
Patients should inform the doctor for any kind of allergy that they may have (food, dye, or specific medication)
Age of the patient
The effect of hydromorphone may be good in treating pain, however prescribing it to children may not be a good choice because its side effects may be too much for children to handle or tolerate. For the elderly, they may become more sensitive to the effects of hydromorphone than younger patients, and so there should be caution in the dosage of the said drug. Failure to check the correct dosage may lead to complications with the use of other medications for the lungs, liver, heart or kidney.
Breastfeeding women are not to be prescribed hydromorphone because it may affect milk production. If there is no alternative medication, there is a need to check on the infant for possible side effects.
Hydromorphone comes in different forms, and the dosage varies in each form. This drug is prescribed to be used several times in a day. However, if one dose has been missed, patient should immediately take hydromorphone as soon as it is remembered. If, by the time you remember, it is almost time for the next dose, skip the last dose and continue with the second dose. Doubling the dose is not recommended.
There are certain medicines that need to be combined to give optimal effect in curing a condition. But on certain instances, there may be a need to use different drugs. With these, decreasing the dose may be needed to avoid dangerous drug interactions.
The doctor may lessen the dose of one or both of the medicines.The following medicines are just a few that can be prescribed along with hydromorphone but should still be taken with utmost care:
- Nitrous Oxiede
- Sodium Oxybate
It should be noted that certain food or medicine may cause interaction. The use of alcohol and tobacco can also be a factor, because they may interact with the drug.
Extreme care should also be taken by people who are diagnosed with the following medical conditions:
- Alcohol abuse
- CNS depression
- Brain tumor
- Chronic obstructive pulmonary disease (COPD)
Some individuals may not be satisfied using hydromorphone alone to have an intense “high” that they wanted. They would sometimes incorporate it with alcohol or benzodiazepines. The combination can increase the euphoric effect, but this poses greater risk like severe respiratory depression and even death.
Hydromorphone works on the central nervous system to block pain receptors. This medication is prescribed for those who need round-the-clock pain relief and could not be treated with any other kind of drug. It is taken every 3-6 hours (liquid form) or 4-6 hours (tablet form). It is advisable to take hydromorphone at the same time every day.
The following are signs and symptoms that a person may be using hydromorphone:
- Dilated pupils
- Abdominal pain
- Slow breathing
- Difficulty in urinating
- Inability to concentrate
- Decreased libido
- Cold skin
- Mood swings
Prolonged use of hydromorphone can be habit-forming, which may cause mental dependence. It should not be feared, however, if certain individuals are prescribed to use the said drug for a longer time because doctors prescribe them according to the amount that is only needed. Dependency on the drug only occurs if the individual wants to be on the euphoric state all the time. That is why this drug can only be dispensed with a medical prescription to be used according to what it is intended to cure.
Individuals who use this drug usually develop a tolerance quickly. They feel the need to quickly take another dose before the earlier dose wears off. When this happens, dependency steps in. The following are signs and symptoms of abuse in using hydromorphone:
- Psychotic disorder
- Body cramping
- Cold sweats
- Drug craving
- Difficulty in urinating
- Heart attack
Causes of hydromorphone addiction
Drugs taken without any prescription, most especially narcotic analgesics may lead to more serious health risks.
It is to be understood that individuals who become drug dependents are caused by several factors. Most often than not, individuals who resort to drug addiction are trying to avoid certain issues in their lives, that instead of facing these problems, their means of escape is to take these drugs.
The following are risk factors that increase the probability of succumbing to hydromorphone addiction and abuse:
- Individuals born to parents having the same drug dependency
- Imbalance on certain chemical components
- Influence from environment
- Starting with illegal substance use at an early age
- Under treatment for medical illness
Effects of hydromorphone addiction
When an individual has become addicted to hydromorphone – or to any drug for that matter – there is always a tendency of wanting to have more. The normal sensation for people engaged in drug abuse is experiencing the euphoric feeling.
Such behavioral changes may be evident in people who engage in hydromorphone addiction:
- Social isolation
- Forged prescription
- Reckless behavior
- Hiding hydromorphone in different parts of the house
- Lying on the amount of hydromorphone used
- Choosing to wear long sleeved shirts and pants to hide needle marks
There have been studies about the relation of drug addiction to mental illness. An individual with mental condition is more likely to have a drug addiction. Some disorders found with the use of hydromorphone are:
- Anxiety disorders
- Bipolar disorders
Mental illness can be exacerbated with unusual doses of hydromorphone. It is highly recommended that individuals who may be suffering from mental conditions must be given these medications by a family member instead of the individual themselves.
An individual may want to stop taking the drug because of the realization of the drug’s effects with prolonged and continued use. However, just like any individual who wants to discontinue the use of a drug after using it for a long time, withdrawal symptoms are likely to happen.
It may be difficult to abruptly stop because the body needs to adjust gradually. The only difference with regards to the withdrawal symptoms is that with hydromorphone, it can be a shorter process than other opiates.
Some withdrawal symptoms from hydromorphone addiction are:
- Sleep disturbances
- Drug craving
- Muscle and bone pain
- Suicidal thoughts
- Sleeping disorder
- No appetite
- Flu-like symptoms
Treating individuals with hydromorphone addiction may be much easier to handle compared to other kinds of drug addiction because its withdrawal symptoms are much bearable. The medicines used to treat such addiction may be in the form of other opiate derivatives. The only difference is that the dose is prescribed accordingly and that it is given to the individual under the care of a clinic.
Fortunately, rehabilitation centers are available to help individuals get over drug addiction. Confinement of certain number of months to a year may be necessary for completely getting treated from hydromorphone addiction. Some rehabilitation centers provide assistance to individuals that need medical intervention. Each facility may offer a program that can lead an individual to full recovery but this may be expensive.
Detoxification may be the first step in treating addiction. It would take 3-7 days to flush out the drug from the individual’s system. This way, withdrawal symptoms can be controlled. Stopping the intake of the drug abruptly is not recommended. In addition, relying solely on detoxification to fully recover from addiction may not be effective for every case.
There may also be a need for psychological treatment in the process to completely heal the patient. Some patients have turned into drug abuse because of some personal problems that they can’t face alone. Unless these issues are addressed properly, complete healing from hydromorphone addiction may not be achieved. Such counseling can be done inside a facility because the patient can be well taken care of without any distractions. This treatment includes peer counseling and individual therapy.
Discussions in a support group wherein fellow patients with the same condition are able to help themselves heal all together by way of sharing how they went through the ordeal.
Long term treatment on a patient decreases the chances of a relapse.Other forms of therapy include hypnotherapy, life skills development, and health and nutrition counseling. All of these can help an individual to fully recover. However, there should also be a support system in their individual homes after they have been discharged from the facility.
Patients who had been into hydromorphone addiction may need a lifetime of recovery. An aftercare program will be helpful in aiding a patient to stay away from the addiction and be able to fully recover and may be able to live a normal life.
Not everyone may be able to handle their problems the same way. While others may seek expert advice or choose to involve themselves with other activities to help them with their own struggles, some resort to drugs because of fear of facing such challenges alone and feel defeated. Medicines were meant to help people to be cured from different sicknesses. However, potent drugs can have a tendency for abuse.
Be aware if a family member or a loved one starts to avoid people and completely isolates himself from the rest of the world. Any change in behavior should be a cause of alarm. Never let a loved one waste his life due to drug addiction.