Dilaudid Treatment and Withdrawal
Dilaudid is an opioid pain medication that doctors typically prescribe to treat moderate to severe pain. It contains hydromorphone hydrochloride, a narcotic analgesic that depresses the respiratory reflex. According to the US National Library of Medicine, Dilaudid can be habit-forming, and even people who take it as directed by their doctor are at risk of developing a dependence on it and subsequent addiction to it.
From Tolerance to Addiction
Dilaudid increases the brain’s ability to tolerate pain and typically begins working within 30 minutes of taking it orally or within five minutes of injecting it. Even people who take Dilaudid as directed can experience negative side effects, which include:
- Nausea and vomiting
- Abdominal pain
- Difficulty sleeping
- Mood swings
- Inability to concentrate
- Labored breathing
Dilaudid is a powerful drug, but the body can still build up a tolerance to it through continued use. If a tolerance on Dilaudid develops, individuals may start abusing the drug by taking increasingly larger doses closer together to enhance the effects. Doctors who prescribe Dilaudid monitor their patients closely for signs of dependence or addiction, but the symptoms are not always present initially.
The American Society of Addiction Medication defines addiction as a primary, chronic disease that causes dysfunction of the brain’s reward, motivation, and memory circuitry. The disease is characterized by the inability to abstain from taking the substance, as well as diminished behavioral control, intense cravings, and a failure to recognize problems resulting from said addiction.
The National Institute on Drug Abuse (NIDA) reports that scientists have devised various explanations for addiction and why some individuals abuse drugs. One explanation cites biological causes, like having a family history of alcohol or drug abuse. Another explanation is that abusing drugs leads to affiliating with other people who abuse drugs which leads to abusing more and different drugs and eventually addiction. Though some people may be more likely to abuse drugs than others, anyone can ultimately get addicted to Dilaudid, and many people do. According to the 2014 National Survey on Drug Use and Health, 4.3 million Americans used prescription painkillers for nonmedical purposes within the span of one month.
Signs of Dilaudid Addiction
Doctors who prescribe Dilaudid know the risks of taking it for extended periods of time, and if they witness a patient developing a dangerous dependence on it, they can wean them off the drug slowly; however, if a budding dependence is not caught in time, it can lead to abuse and eventually addiction. Signs of an addiction to Dilaudid include:
- Constant drowsiness
- Dizziness or frequent fainting
- Taking laxatives to prevent constipation
- Nausea and vomiting
- Trouble breathing, especially while asleep
- Track marks on arms or legs from injecting it
If family members believe a loved one is addicted to hydromorphone, it is important to remember that the individual should not just stop taking it immediately, especially if the addiction has been going on for more than one month. Though withdrawal symptoms are usually manageable, life-threatening complications could arise, especially in pregnant women and medically debilitated individuals. According to NIDA, there are several effective treatment options for opioid addiction, and they all start with undergoing a medical detox phase.
What Happens during Medical Detox?
There are two main approaches to the detox phase of treatment for addiction. In the social model, no medications are used to ease withdrawal symptoms. Instead, individuals undergoing detox rely on a supportive environment that is not associated with a hospital or healthcare facility. In the medical model, physicians and nursing staff administer medication and guide clients through the various stages of withdrawal.
According to Treatment Improvement Protocols set forth by the Substance Abuse and Mental Health Services Administration, it is rare today to find an entirely social or entirely medical model. Instead, people who are trying to recover from a Dilaudid addiction get the benefits of both.
During the medical detox phase of treatment, clients have access to a qualified medical staff who can help make them more comfortable while they go through withdrawal. The extent of the addiction and various biological factors will ultimately determine how long the detox phase lasts, but there is a general withdrawal timeline that individuals can expect when quitting hydromorphone. It typically looks like this:
- First 24 hours: Individuals may experience the initial symptoms of withdrawal within a few hours after taking their last dose of Dilaudid. Symptoms include restlessness and anxiety.
- Days 1-2: Symptoms tend to peak within 14 hours of the last dose and will last for the first 48 hours. The most common withdrawal symptoms at this stage are nausea, shaking, chills, sweating, and muscle aches.
- Days 3-4: For most people, the worst of the withdrawal symptoms have passed by the third day. Clients may still experience some nausea or muscle aches, but many of the other symptoms have likely subsided by this time.
- Days 5-14: Symptoms may linger beyond the fifth day of detox depending on the severity of the addiction. Insomnia, depression, irritability, and anxiety are the most common symptoms that last beyond the first week of sobriety.
Opioid Replacement Therapy
Because individuals can develop a powerful dependence on Dilaudid, opioid replacement therapy is often necessary to minimize withdrawal symptoms, make detox more manageable, and even maintain sobriety for some time. For example, the Federal Bureau of Prisons Clinical Practice Guidelines reports that opiate withdrawal actually increases the risk of miscarriage and premature labor in pregnant women, and they should be treated with methadone under a doctor’s care when undergoing withdrawal.
According to the Office of National Drug Control Policy, the FDA has approved a few drugs for opioid replacement therapy. Naltrexone is a nonaddictive antagonist that blocks opioid receptors in the brain so they cannot be activated. Buprenorphine can reduce cravings and minimize withdrawal symptoms by providing effects similar to those of Dilaudid, and methadone is a popular replacement drug for those who are struggling to quit heroin.
Methadone is a synthetic opioid that blocks the effects of opiates on the brain when taken in controlled high doses. At lower doses, it can reduce withdrawal symptoms. According to a study conducted by The Cochrane Collaboration, people who are addicted to heroin and take methadone during recovery are more likely to stay in treatment and suppress heroin use than those who do not.
Some people are hesitant to start opioid replacement therapy; however, it is important to remember that taking medication like methadone or buprenorphine is not simply replacing one addiction with another. According to the American Association for the Treatment of Opioid Dependence, Inc., methadone has no adverse effects on mental capacity, intelligence, employability, reaction time, or cognitive function. Taking methadone is not the same as merely taking a lower dose of Dilaudid. In addition, doctors prescribe these medications in a controlled setting and monitor their clients’ health and recovery every step of the way. When individuals have reached a certain point in sobriety, doctors can also help them taper off the replacement medications.
Treating Dilaudid Addiction
After clients finish the medical detox phase of treatment, they have a variety of options regarding how to proceed. In residential treatment, clients are in a nonhospital setting, but they have access to healthcare professionals 24 hours a day. Residential treatment is especially beneficial for people who do not feel ready to face their everyday lives following detox. Because clients remain in a treatment facility during residential treatment, they do not have access to Dilaudid or other substances that they might begin abusing again.
The length of stay during residential treatment depends on a variety of factors. In a study originally published in The American Journal of Drug and Alcohol Abuse, researchers found that 68-71 percent of women who spent six months or more in residential treatment were not abusing substances 12 months after they were discharged, and success rates were lower among those who spent less time in treatment.
Short-term residential treatment programs typically take a 12-Step approach to combatting addiction and can be effective for clients who do not need long-term care. People with addictions that are not too severe may also opt for a partial hospitalization program following detox. Partial hospitalization programs are short-term, intensive treatment programs that are less involved than inpatient hospital programs but more hands-on than traditional outpatient care.
Outpatient treatment programs vary in their intensity and duration, and they are suitable for people who must continue working or take care of other obligations while in treatment. Outpatient treatment gives clients the flexibility of maintaining their daily routines while still receiving addiction treatment in a supportive and encouraging environment. According to a review originally published in Health Services Research, outpatient drug-free settings are the most cost-effective way to treat substance use disorders.
Many people take a multipronged approach to treating their addiction. For example, they may enter a residential program following medical detox before graduating to a partial hospitalization program and then to an outpatient treatment program. Moving from one treatment modality to another is an effective way to ease back into everyday life, with all the stressors that may have led to the addiction in the first place.
The Importance of Aftercare
Both clients and their loved ones need to keep in mind the fact that recovery does not end with a treatment program. A follow-up study originally published in Irish Medical Journal found that 91 percent of opiate-dependent patients reported having a relapse. In 59 percent of the cases, the initial relapse occurred within one week of discharge from a residential treatment. Relapses may not be entirely unavoidable, but they do not have to be inevitable either.
Family and friends can support loved ones by devising an aftercare plan following treatment. The first year out of treatment is often the hardest because that’s when individuals have to clean up the relationship and financial issues that arose from their addiction. Cravings also tend to be fairly strong immediately following treatment, and it can be tempting to relapse without the right support structure in place.
A good aftercare plan addresses all of the obstacles that a client is likely to face upon discharge. These obstacles include family interactions, strong cravings, financial stressors, and any long-term health effects that the addiction left in its wake. Aftercare plans are specific to individuals, but many of them address the same issues. For example, family-related stress is one of the leading causes of relapse.
Luckily, the risk of relapsing declines as more time passes, and various studies have found that relapse rates decrease significantly after the first year of sobriety. Staying in recovery is a long journey though, and follow-up care is critical for people who have struggled with addiction. Family members can help their loved ones stay in recovery by taking an active part in the treatment process. That means supporting individuals every step of the way, attending family therapy sessions, and helping to devise an aftercare plan that addresses the issues most likely to lead to relapse.