Opioid drugs like hydromorphone hydrochloride carry a high risk of addiction and can lead to life-threatening consequences when taken in ways other than prescribed.

Article at a Glance:

  • Hydromorphone hydrochloride can cause physical dependence and psychological addiction to develop.
  • The drug’s side effects may include respiratory depression, decreased consciousness and pinpoint pupils.
  • Hydromorphone hydrochloride use should not abruptly end if a person is physically or psychologically reliant on the drug.

Hydromorphone Hydrochloride Addiction Risk

Hydromorphone hydrochloride, also called hydromorphone HCL, is an opioid medication used to treat moderate to severe chronic pain. A person can become physically dependent on hydromorphone HCL after regular use. However, this does not mean they have a psychological addiction.

When someone becomes dependent on opioids like hydromorphone hydrochloride, their body is used to having the medication present and relies on it to help reduce pain. Addiction to hydromorphone HCL occurs when a person begins to experience strong cravings for the drug and takes it in ways other than prescribed to produce a much stronger feeling.

If a person becomes addicted to an opioid like hydromorphone HCL, they may show signs such as:

  • Taking the drug specifically for its euphoric effects, even when pain is not a problem
  • Showing little or no interest in other aspects of life, such as work, school and socializing with loved ones
  • Powerful cravings
  • Constantly seeking or mentioning the drug
  • Withdrawal symptoms that occur when treatment is stopped

Developing a tolerance for hydromorphone hydrochloride is possible, even if someone takes it in the recommended dosage. To reduce risks of misuse and addiction, it is important to never exceed or increase a dosage without medical approval.

Hydromorphone Hydrochloride Side Effects

Common side effects of opioids like hydromorphone hydrochloride can include:

  • Dry mouth
  • Lightheadedness
  • Nausea and vomiting
  • Feelings of euphoria
  • Constipation
  • Lack of coordination
  • Constricted pupils
  • Lethargy

If a person takes too much of the drug, they may experience an overdose. Common side effects of hydromorphone overdose include

  • Respiratory depression
  • Decreased consciousness
  • Pinpoint pupils, even in complete darkness
  • Urinary retention
  • Circulatory depression
  • Breathing problems

Hydromorphone Hydrochloride Long-Term Effects

Long-term use of opioids like hydromorphone hydrochloride can lead to several complications. In cases of long-term, high-dosage use, patients can experience neurotoxicity. This can cause a range of complications, including tremors, agitation, twitches and cognitive dysfunction. Heavy chronic use can also lead to a temporary hormone imbalance known as hypogonadism.

Treatment Options for Hydromorphone Hydrochloride Addiction Symptoms

Opioid addiction treatment options include inpatient and outpatient group therapy along with individual drug counseling. In cases of severe addiction, medical detox may be necessary before entering inpatient treatment.

Medical Detox

Withdrawal from opioids like hydrochloride HCL can involve intense drug cravings that are difficult to overcome alone. Symptoms are typically flu-like at first and become more severe over time, including abdominal cramps, anxiety, depression, insomnia and gastrointestinal issues.

During a medical detox, doctors closely monitor the patient and treat any severe or uncomfortable withdrawal symptoms. They may provide medications to help manage certain symptoms, such as nausea and anxiety. Over the course of the patient’s stay, the doctor will gradually reduce the dose of hydromorphone hydrochloride. Medications like buprenorphine — a less potent but longer-acting opioid — may be used to supplement hydromorphone until the patient is ready to stop taking the drug.

Hydromorphone hydrochloride should not be abruptly ended in patients who are physically or psychologically reliant on the drug. Doing so may result in severe withdrawal symptoms.

Related Topic: Hydromorphone HCL Withdrawal & Detox

Inpatient Rehab

Inpatient programs for opioid addiction last an average of four weeks, but patients may be asked to stay longer in some cases. The goal of inpatient therapy is to help patients avoid future substance use and learn how to cope with difficult life situations without turning to drugs or alcohol. Patients live at the facility full-time and are not allowed to leave unattended.

Outpatient Rehab

Patients are encouraged to enter an outpatient treatment facility immediately after inpatient treatment. In outpatient treatment, group therapy sessions are held two to three times per week. During these sessions, participants complete exercises and discuss the progress of their recovery with the group. Most outpatient programs also require the attendance of one to two support group meetings (such as Narcotics Anonymous) each week.

The Importance of Aftercare

Recovery is a lifelong journey that won’t always be easy. Difficult life situations, stress and even boredom can easily make the idea of going back to drug use seem tempting. Aftercare programs help prevent these relapses from happening by giving patients long-term support through routine check-ins, alumni services, peer support meetings and other invaluable resources. When a client is struggling, they can take advantage of these tools to avoid relapse, address their concerns and recommit themselves to recovery.

If you or someone you love is struggling with a hydromorphone hydrochloride addiction, help is available at The Recovery Village. Contact us today to learn more about treatment programs that can work well for your situation and needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Heena Joshi, PharmD
Dr. Joshi earned her Bachelor of Science in Physiology and Neurobiology from the University of Maryland. She went on to earn her Doctorate in Pharmacy from The Ohio State University. Read more

FAQs About Hydromorphone HCL

What is hydromorphone hydrochloride?

Hydromorphone hydrochloride is a narcotic pain reliever prescribed to treat moderate to severe chronic pain. It is classified as an opioidanalgesic, so it alters how the body responds to pain signals and reduces a person’s awareness of pain.

Hydromorphone HCL can be prescribed as an oral liquid, extended-release tablet, immediate-release tablet and intramuscular injection.

Compared to other opioids, hydromorphone hydrochloride has a much greater risk for psychological addiction and misuse. It is four times as strong as morphine, making it about as potent as heroin.

How is hydromorphone hydrochloride used?

Hydromorphone hydrochloride is meant to be used when severe flares of pain occur. Some forms, such as the extended-release version, are meant for pain management. Hydromorphone hydrochloride takes 15 to 30 minutes to take effect, peaks at 30 to 60 minutes and lasts for three to four hours. Tablet forms of the opioid are only meant to be taken by mouth; crushing and snorting the tablets is dangerous and a form of abuse. When using liquid forms of the opioid, carefully measure out the amount before taking it. People have accidentally overdosed on liquid hydromorphone hydrochloride due to errors made during measuring.


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Azadfard, Mohammadreza; Huecker, Martin; Leaming, James. “Opioid Addiction.” StatPearls Publishing, July 21, 2021. Accessed September 28, 2021.

Shah, Mansi; Martin, Huecker. “Opioid Withdrawal.” StatPearls Publishing, January 2021. Accessed September 28, 2021.

Drug Enforcement Administration. “Drugs of Abuse.” April 2020. Accessed September 28, 2021.

U.S. Food and Drug Administration. “Hydromorphone hydrochloride.” May 2009. Accessed September 28, 2021.

U.S. National Library of Medicine. “Hydromorphone.” MedlinePlus, January 15, 2021. Accessed September 28, 2021.

U.S. National Library of Medicine. “Hydromorphone overdose.” MedlinePlus, October 3, 2019. Accessed September 28, 2021.

American Academy of Family Physicians. “Opioid Conversion Table.” Accessed September 28, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.