Hydromorphone Addiction Treatment

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What is Hydromorphone?

Hydromorphone is a painkiller prescribed for acute, chronic or long-lasting pain. Hydromorphone is an opioid, meaning it is a synthetic compound that mimics the effects of opiates, derived from the opium poppy flower. Misuse of hydromorphone and other prescription opioids can result in physical dependency, abuse and addiction.

Hydromorphone is a controversial medication for its role in the recent and ongoing opioid epidemic. Hydromorphone is prescribed to patients dealing with difficult chronic pain problems, although it should only be prescribed for acute pain in non-cancer pain patients. If the pain-relieving effects of hydromorphone wear off and leave the patient in pain, he or she may resort to excessive self-medication beyond a doctor’s recommendations.

Hydromorphone is a Schedule II controlled substance for its addictive properties, making it dangerous to increase your dosage without your doctor’s instructions. Brand names for prescription hydromorphone include Dilaudid and Exalgo, and can be prescribed as a tablet or oral solution (liquid). Hydromorphone is also sold illicitly on the street, under names such as dillies, hydro, Super 8 and hospital heroin.

Hydromorphone side effects and dangers

When treating chronic pain with prescription hydromorphone, there are common side effects even when taking it correctly. Hydromorphone side effects include:

  • Constipation
  • Nausea
  • Sleepiness
  • Vomiting
  • Headache
  • Dizziness
  • Abdominal pain

Hydromorphone use crosses the line into abuse and addiction when it is misused. Taking more than the prescribed dosage is considered misuse because it goes against your doctor’s instructions. If your current hydromorphone dosage is not providing effective relief, it is important to talk to your doctor about what to do, instead of self-medicating with excessive additional doses.

There are serious risks to hydromorphone misuse. It is illegal to share, give away or sell hydromorphone because of its dangerous overdose risks. Prescriptions are filled for specific people in specific doses, and its effects have adverse reactions on others. Taking excessive hydromorphone can result in a life-threatening overdose.

Hydromorphone overdose signs include:

  • Trouble breathing
  • Cold and clammy skin
  • Constricted pupils
  • Extreme drowsiness leading to coma
  • Fast heartbeat or chest pain
  • Fluid in lungs (pulmonary edema)
  • Airway obstruction or atypical snoring
  • Death

These symptoms can be deadly if not treated immediately.

The path to serious abuse of hydromorphone can begin when the desired effect is the high produced by the drug instead of pain relief. When hydromorphone is tampered with, such as crushing, chewing or dissolving the pills (or drinking too much of the liquid form), it allows the body to absorb the drug faster.  This absorption is even more damaging when the drug is snorted or injected. The euphoric high comes faster, but so does bodily harm and the potential for addiction.

If a person addicted to hydromorphone is unable to access the drug, they may look for ways to buy it illegally. Because illicit hydromorphone is not controlled by a pharmacy, it frequently contains unknown and harmful ingredients. Even worse, a person’s craving for hydromorphone can be relieved by a cheap, plentiful alternative: heroin. This is a common scenario in today’s opioid epidemic.

Hydromorphone abuse and addiction signs

Any use of hydromorphone outside of a doctor’s instructions is considered drug abuse. This includes tampering with hydromorphone pills by chewing, crushing, cutting or dissolving them in order to ingest, snort or inject a higher dose than prescribed. Even if the hydromorphone pills are not tampered with, taking more pills than prescribed is also abuse of the drug.
Hydromorphone addiction signs include:

  • Taking more than the prescribed dosage
  • “Doctor shopping” for multiple prescriptions
  • Not correctly measuring doses (if prescribed liquid hydromorphone) by using other utensils
  • Tampering with hydromorphone before taking it
  • Refusal to undergo appropriate examination, testing or referral
  • Repeated “loss” of prescription

Hydromorphone withdrawal symptoms and treatment

It is possible to develop a physical dependency on hydromorphone, which should be discussed with your doctor. A physical opioid dependency occurs when the body adjusts to the presence of the medication and depends on that medication to function normally. A hydromorphone prescription can include dosing instructions from your doctor to taper off the dosage to reduce and eliminate this physical dependency. This type of medication management is important—those who are physically dependent on hydromorphone will experience opioid  withdrawal symptoms if they stop their hydromorphone prescription too suddenly. If the withdrawal symptoms are extreme, they could drive the patient to continue using the substance despite significant harm—the definition of addiction.

Opioid withdrawal symptoms can include:

  • Restlessness
  • Runny nose and eyes
  • Yawning
  • Sweating
  • Chills
  • Aches and joint pain
  • Dilated pupils
  • Nausea
  • Anxiety
  • Vomiting
  • Diarrhea
  • Increased blood pressure
  • Increased breathing or heart rate

Opioid withdrawal stabilization, also known as detoxification or detox, is usually done in a similar way as other opioid withdrawal treatment. In general, the opiate withdrawal stabilization procedures resemble those used for withdrawal from sedatives: longer-acting opioid are substituted for shorter-acting ones and the patient is stabilized on the longer-acting opioid medication, such as Suboxone. The patient will be most uncomfortable during the first one to three days of the opioid withdrawal phase, so a combination of clonidine (an alpha-adrenergic agonist), a sedative such as phenobarbital, and a non-steroidal anti-inflammatory such as Motrin (generic name ibuprofen) is frequently combined with the longer-acting opioid to help make the patient more comfortable for the first two to three days of the conversion to Suboxone. Usually after day three of the correct dose of Suboxone, a patient’s opioid withdrawal symptoms and cravings have almost completely subsided.

Treatment options for opioid addiction

Most opioid users need help getting clean and require residential drug treatment. Few people can safely stop using without a certified detoxification and evidence-based addiction treatment program.
Withdrawal and recovery from opioid addiction is most effectively accomplished under the supervision of board-certified medical professionals, who are able to assist with the intense cravings for the drug, along with dangerous withdrawal symptoms, such as disturbed sleep patterns, high blood pressure, abnormal heart rate, nausea, vomiting and diarrhea, muscle aches and flu-like symptoms.

Typically, opioid abusers go through a detoxification program – or withdrawal stabilization – before beginning a long-term treatment program. Patients can be prescribed anti-addiction medications to lessen the withdrawal symptoms.

The detoxification process alone is not a cure for opioid addiction. A comprehensive, personalized addiction treatment program, like the program at Enterhealth, is crucial for a successful recovery. A combination of therapeutic and pharmacological addiction treatment can help those with opioid addiction regain a stable and productive life and address the underlying issues creating the desire to use. Research shows that integrating both types of treatment is the most effective approach to restoring a degree of normal function to the brain – and provide a more positive, life-long outcome.

Effective behavioral treatments for opioid addiction can be administered in a residential or outpatient setting after withdrawal stabilization. A treatment plan may include:

  • Individual counseling
  • Group therapy
  • Family therapy sessions
  • Intensive Outpatient Programs (IOP)
  • Wellness, nutritional and stress management treatment services

Anti-addiction medications approved for opioid addiction treatment work through the same opioid receptors in the brain that hydromorphone affects. Medications such as Suboxone (buprenorphine) and Vivitrol (naltrexone), block the effects of opioids, reduce cravings and allow healing to continue. These medicines treat opioid addiction through the same receptors as the addictive drug, but are safer and less likely to result in addiction.

Hydromorphone addiction recovery with Enterhealth

People suffering from opioid addiction may feel hopeless, but they are not alone. Enterhealth Ranch and Enterhealth Outpatient Center of Excellence can help you or a loved one begin recovery at our 43-acre residential opioid addiction treatment center just north of Dallas-Fort Worth in Texas, and our outpatient opioid addiction treatment center located in the Preston Center area of Dallas.

At Enterhealth, our goal is to treat the whole person for a lifetime. We offer a better chance to recover through our advanced, evidence-based treatment approach, designed and administered by board-certified addiction psychiatrists, physicians and other experts, that is proven to be more effective than traditional twelve-step approaches.