Opioids are effective medications that are used in pain relief and pain management. However, the recent opioid crisis is a testament to the risk of narcotic medications.

Several kinds of opioids treat pain symptoms, including fentanyl and hydromorphone, which is better known by its brand name Dilaudid. However, the recent opioid crisis is a testament to the risk of narcotic medications. Opioids have a significant risk potential for chemical dependence and addiction. Many people use these medications without significant side effects. However, people who use them for too long or as a recreational drug risk a potentially deadly substance use disorder.

Though taking these drugs as prescribed is relatively safe, long-term use or abuse can lead to dependence and addiction. It’s important to understand the difference between opioid medications and their effects. Fentanyl and Dilaudid are two common opioid pain relievers. What are they and how do they compare?

What Is Dilaudid?

Dilaudid is the trade name for a drug called hydromorphone, which is an opioid medication. But what is Dilaudid used for? Hydromorphone is used to treat moderate-to-severe pain symptoms, and it’s usually reserved for short-term therapeutic use. In some cases, it can be used to treat long-term pain symptoms that cancer causes.

Dilaudid can cause euphoria and sedation, especially when it’s taken in high doses. If it’s abused, the drug can lead to chemical dependence and addiction. In very high doses, it can cause a loss of consciousness, slowed heart rate, and respiratory depression.

Abusing prescriptions like Dilaudid can lead to the use of illicit substances like heroin. When prescription opioids become too hard to obtain, people with severe opioid use disorders often turn to illicit sources. According to the National Institute on Drug Abuse, nearly 80 percent of heroin users report starting their substance abuse with prescription opioids.

What Is Fentanyl?

Fentanyl is a powerful synthetic opioid that’s used to treat moderate-to-severe pain symptoms. As a synthetic opioid, it’s made in a lab without the use of naturally occurring opioids like morphine or codeine. Fentanyl is typically used in medical settings and in battlefield settings to treat severe pain. It can also be prescribed as a transdermal patch. Fentanyl begins to work quickly, even compared to other opioids. For that reason, it’s an effective painkiller to use in response to acute pain like a severe injury.

Fentanyl is also produced by secret laboratories that are involved in the illegal drug trade. The drug is cheap and easy to produce and transport. Because it’s so powerful, it can be moved in smaller packages that may be as profitable as larger packages of other illicit opioids like heroin. This can make it difficult for law enforcement to detect fentanyl that’s being smuggled in shipments.

As a recreational drug, fentanyl causes effects that are similar to other opioids like heroin. It can cause intense physical and cognitive euphoria, sedation, relaxation, and pain relief. However, it’s more powerful than other illicit opioids, so it’s also more likely to cause adverse effects like respiratory depression.

How Do They Compare?

Both Dilaudid and fentanyl are used for similar purposes. They can both be used to treat pain and encourage restfulness in recovery. Dilaudid can take up to a half-hour to begin working before it lasts for several hours. Fentanyl works faster, sometimes within a minute, depending on the route of administration. However, fentanyl’s pain-relieving effects will start to diminish within 90 minutes. For that reason, Dilaudid is more often used in pain management, while fentanyl is more useful in emergency situations.

Fentanyl also has some unique means of administration. It’s often used in hospital settings. Because of its relative strength, it’s best used with a doctor’s supervision. However, it has been formulated to be used in transdermal patches placed on the skin to deliver a safe dose for up to 72 hours. This long-acting duration of action can help provide relief from long-lasting pain that can occur with injuries and surgery recovery. Fentanyl is also used as a quick pain relief option in battlefield medicine. In active military situations, it can be administered as a lozenge to provide fast-acting pain relief.

Dilaudid and other forms of hydromorphone are typically used in tablet form. They are also available as extended-release tablets and in liquid solutions. 

How Strong Is Fentanyl?

One of the clearest differences between the two drugs is their relative strengths. Fentanyl is one of the most potent opioids available. Stronger options are analogs of fentanyl, like carfentanil, which are typically only used to treat large mammals like elephants. Fentanyl’s strength makes it cheaper than other drug options. It can also compensate for opioid tolerance with guidance from a doctor. However, it also makes it more dangerous when it comes to overdose risk.

An oral tablet of Dilaudid is about 2 mgs to 4 mgs, which is around the same weight as a snowflake. The same dose of fentanyl could cause a deadly overdose. Fentanyl is effective at the microgram level, and a 100-microgram dose of the drug is equal to an average dose of morphine (10 mg). So, it’s about 100 times stronger than morphine, while Dilaudid is not quite twice as strong as morphine. 

How Addictive Are Dilaudid and Fentanyl?

Dilaudid and fentanyl are both opioids, which have significant liability for chemical dependence and addiction. Both drugs are federally controlled substances under the classification of Schedule II. This means it’s considered to have significant abuse liability with some medical uses as well. Both are used as legitimate prescriptions, which can cause substance use problems when they are taken for too long. However, prescription opioid overuse can lead to the use of illicit drugs after they cause dependence and addiction. Prescription drugs are more difficult to get over time, and they may be extremely expensive. 

Fentanyl that is used as an illicit drug is unlikely to come from legitimate prescription sources. Instead, it’s made outside of the country and trafficked into the United States. Fentanyl is more common than Dilaudid when it comes to recreational opioid use. However, drug users may not seek out fentanyl intentionally. Rather, it may be mixed into heroin, and other drugs, without them knowing. 

Despite Dilaudid’s strength compared to fentanyl, both drugs can be extremely hard to quit once you’ve become dependent on them. Opioid dependence can cause extremely uncomfortable flu-like symptoms when you stop taking the drugs, along with drug cravings. This can encourage continued use. When a doctor prescribes an opioid to you, it’s important to make sure you work out a tapering plan, especially after long-term use. 

However, if you develop a substance use disorder involving one of these two drugs, fentanyl and Dilaudid rehab options are available. 

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