Dilaudid (hydromorphone hydrochloride) is a full opioid agonist that operates similarly to heroin and morphine, but it is many times more potent than those drugs.
All opiate drugs readily attach to the receptor sites in the brain that are specialized for neurotransmitters, such as endorphins, that are naturally involved in the control of pain, exertion, and stress. Opiate drugs are primarily designed to treat postoperative pain and pain associated with injury or some other chronic condition.
Dilaudid is most often used for postoperative pain because it has a quick onset of action and a rather short half-life. Thus, it works quickly and does not remain in the system very long.
Because the withdrawal symptoms that occur as a result of physical dependence on opiates like Dilaudid can be very discomforting, once an individual has developed physical dependence, the withdrawal symptoms become motivating factors for them to continue their drug abuse. When an individual begins to experience the onset of withdrawal symptoms, the easiest way for them to control the symptoms is simply to take more of the drug. This situation results in a downward spiral of continued drug abuse, short periods of abstinence followed by the onset of withdrawal symptoms, and continued use to avoid the full-blown withdrawal syndrome. The process of repeating a behavior to avoid undesirable consequences is referred to as negative reinforcement, and it is a very powerful mechanism that can prolong substance abuse issues.
injected or snorted typically produce more severe and longer withdrawal symptoms), individual differences in metabolism, and numerous other factors.
Individuals who become extremely distraught during withdrawal could also become suicidal.
During this process, individuals who have developed opiate use disorders are often administered an opioid replacement medication by an addiction medicine physician. Medications like methadone or Suboxone (buprenorphine and naloxone) are often preferred. The addiction medicine physician will establish an initial dosage of the drug that is sufficient to result in the recovering individual not experiencing any significant withdrawal symptoms. Over time, the physician will slowly taper the dosage of the drug and allow the individual to wean off it at a pace where they will not experience any significant withdrawal symptoms.
During withdrawal, if there are complications or other symptoms that surface, the physician can address them with other medicines or interventions. This includes addressing any co-occurring mental health disorders or medical conditions that also need treatment.
The withdrawal management process often lasts significantly longer than cold-turkey withdrawal; however, the potential for relapse and serious complications is drastically reduced.
Eventually, the opioid replacement medication can be totally discontinued.
Whether one chooses to withdraw from Dilaudid without assistance or to become involved in a physician-assisted withdrawal management program, simply going through the process of withdrawal is not a sufficient approach to recovery. Individuals who do not become involved in some form of long-term treatment program will relapse at rates that approach 100 percent even if they successfully complete the withdrawal process without relapsing.