Hydromorphone vs morphine: What is the difference between hydromorphone and morphine?
Dilaudid is the best-known brand name for the drug hydromorphone. It is a semi-synthetic opioid.
Morphine is a natural opioid that is derived from the opium poppy. While these two opioid analgesics used for pain relief are similar, there are some key differences.
In this article, we will discuss morphine and hydromorphone. For more information about how addictive morphine is compared to other opiates, please see the linked page and other articles on our website.
Both hydromorphine and morphine are used in hospitals to treat severe pain, such as cancer pain. Either may be administered by IV for acute pain or chronic pain.
Unfortunately, both medications have a high abuse potential. Dilaudid addiction and morphine addiction are serious problems.
In fact, heroin is so closely related to morphine, we can almost think of them as being the same drug. heroin is derived from morphine, and it breaks down into morphine in the human body.
Hydromorphine vs morphine for pain management: which drug works best?
Hospitals use both Dilaudid and morphine for pain management. The preference for one over the other may simply be an administrative choice.
Dilaudid is more potent, about 5-10 times more potent than morphine. Yet, relative potency is not too important, because the standard dosages are adjusted for relative potency.
Dilaudid is also a bit faster acting, crossing the blood-brain barrier faster than morphine. Still, when these medications are administered by the intravenous route, they both work quickly to relieve severe pain.
What about outside the hospital? Pharmacies do carry dilaudid tablets and morphine tablets for moderate pain and severe pain. Oral morphine and oral hydromorphone are both available in short and long-acting preparations.
Both drugs are less potent when taken orally, compared to IV. The dilaudid 8mg tablet may be about 25%-30% more potent compared to the morphine 30mg tablet.
Regarding side effects, both hydromorphone and morphine have similar side effects, including respiratory depression. Drug interactions are also similar.
Does hydromorphone have a higher addiction potential compared to morphine?
If you were to ask anyone who is familiar with these two drugs, they would usually say that Dilaudid is more addictive than morphine. At least it seems to be a drug that opioid abusers prefer.
Why would an opioid addicted person choose Dilaudid over morphine? Outside a hospital, these drugs are most often bought and sold on the black market in tablet form.
Opioid addicts know which tablets are easier to crush for IV use or for snorting. They look for opioid pills with less matrix material and additives, and pills that are softer.
There was a time when opioid addicts preferred the brand-name Dilaudid over the generic form of hydromorphone. The reason was because it could be snorted, injected, and even smoked easier than other opioid pills.
Pharmacists and doctors would see red flags when a patient requested the brand-name dilaudid tablets specifically. If a patient was given a prescription for morphine pills, or even generic hydromorphine pills, and they complained because “only branded Dilaudid worked for their pain,” the doctor or pharmacist would assume they were dealing with someone with an opioid addiction.
What opioid painkiller is the most popular prescription opioid for people with an opiate drug addiction?
People with opioid use disorder who prefer taking prescription opioid medication as their drug of abuse typically prefer oxycodone. For a while, Opana and Opana ER were also popular street alternatives, but those oxymorphone pills have been taken off the market.
The problem with buying illicit opioid analgesic pills on the streets is that many have been replaced with fake fentanyl pills. When a person buys a blue oxy on the street, they may be getting a highly potent opioid made in China or Mexico that is responsible for many overdose deaths.
Are hydromorphone (Dilaudid) and morphine tablets being counterfitted yet? While the blue oxycodone 30mg is probably the most frequently counterfitted pill out there, there have been reports of Xanax and Dilaudid testing positive for Fentanyl.
Another issue is that real opioid pills may be contaminated with fentanyl, because they are handled in the same environment as other illicit drugs. Unfortunately, this is true of any street drug at this time, including marijuana.
We are currently witnessing a fentanyl crisis, which some experts view as a form of chemical warfare. The best way to avoid fentanyl toxicity and fentanyl overdose is to avoid any drug that does not come from an official pharmacy or dispensary.
Which pain medication is harder to quit: hydromorphone or morphine?
A person suffering from substance abuse who uses morphine or hydromorphone will have a similar experience trying to quit either opioid drug. After quitting the opioid pain reliever, the person will experience withdrawal symptoms, usually within 24 hours or less.
Long-acting morphine, such as MS Contin, may present more difficulty because it stays in the person’s system longer. For patients waiting to start Suboxone, they will have to wait longer if they were taking a time-release opioid drug.
While there is a time-release version of hydromorphone, named Exalgo, it is not as commonly abused as other opioid medications. Exalgo is an expensive brand-name hydromorphone that is rarely prescribed.
Suboxone treatment is the gold standard of treatment for either hydromorphone addiction or morphine addiction. However, for patients who wish to forego Suboxone or other buprenorphine meds, they may be prescribed Lucemyra to help get through the opioid withdrawal symptoms.
To learn more about morphine addiction, please tune in to our morphine addiction podcasts for more information. We also discuss hydromorphone addiction as well on our addiction recovery and drug dependence podcast network.
