Hydromorphone

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Hydromorphone WHAT IS HYDROMORPHONE? sedation, and reduced anxiety. It may also cause Hydromorphone belongs to a class of drugs mental clouding, changes in mood, nervousness, called “opioids,” which includes morphine. It and restlessness. It works centrally (in the has an analgesic potency of two to eight times brain) to reduce pain and suppress cough. greater than that of morphine and has a rapid Hydromorphone use is associated with both onset of action. physiological and psychological dependence. WHAT IS ITS ORIGIN? What is its effect on the body? Hydromorphone is legally manufactured and Hydromorphone may cause: distributed in the United States. However, • Constipation, pupillary constriction, urinary retention, users can obtain hydromorphone from nausea, vomiting, respiratory depression, dizziness, forged prescriptions, “doctor-shopping,” impaired coordination, loss of appetite, rash, slow or theft from pharmacies, and from friends and rapid heartbeat, and changes in blood pressure acquaintances. What are its overdose effects? What are the street names? Acute overdose of hydromorphone can produce: Common street names include: Severe respiratory depression, drowsiness • D, Dillies, Dust, Footballs, Juice, and Smack progressing to stupor or coma, lack of skeletal muscle tone, cold and clammy skin, constricted What does it look like? pupils, and reduction in blood pressure and heart Hydromorphone comes in: rate • Tablets, capsules, oral solutions, and injectable Severe overdose may result in death due to formulations respiratory depression. How is it abused? Which drugs cause similar effects? Users may abuse hydromorphone tablets by Drugs that have similar effects include: ingesting them. Injectable solutions, as well as • Heroin, morphine, hydrocodone, fentanyl, and tablets that have been crushed and dissolved oxycodone in a solution may be injected as a substitute for heroin. What is its legal status in the United States? Hydromorphone is a Schedule II drug under the What is its effect on the mind? Controlled Substances Act with an accepted When used as a drug of abuse, and not under medical use as a pain reliever. Hydromorphone a doctor’s supervision, hydromorphone is taken has a high potential for abuse and use may lead to produce feelings of euphoria, relaxation, to severe psychological or physical dependence. Hydromorphone pills Hydromorphone injectable solution .

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1 Impact of Opioid Agonists on Mental Health in Substitution
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Urine drug screening Urine drug screens (UDS) are a valuable tool in our management of patients on chronic opioid therapy, however, the results can be misleading and clinical judgment is needed in interpreting results. The basic, initial UDS most clinicians use is usually done by immunoassay. It can identify drugs present in the urine by class (e.g. opioids, benzodiazepines, amphetamines). Immunoassay UDS will give positive results for both a drug being taken and for its metabolites. Codeine, for example, is metabolized to hydrocodone or morphine and then to dihydrocodeine and hydromorphone. Heroin is metabolized to morphine. All of these will be identified as opiates on the basic UDS. Oxycodone is metabolized to oxymorphone; these will be identified as oxycodone on immunoassay UDS. It is therefore important to consider drug metabolism in interpreting UDS test results: hydromorphone may be detected in a patient on morphine hydrocodone may be detected in a patient taking codeine oxymorphone may be the only drug detected in a patient on oxycodone since it is a long lasting metabolite morphine may be the only drug detected in a heroin user. When a basic urine drug screen gives results that do not fit or which cannot be explained, it is a good idea to send the sample for confirmatory testing. This testing is usually done by gas chromatography- mass spectrometry (GC/MS) and will provide more sensitive and specific results. Drug Detection Times (since last use): Drug or Class Detection Time Alcohol 6 - 12 hours Amphetamine or methamphetamine 48 hours Barbiturates, short acting 24 hours Barbiturates, long acting 3 weeks Benzodiazepines, short acting 3 days Benzodiazepines, long acting 30 days Cocaine 2 – 4 days Marijuana, single use 3 days Marijuana, daily use 2 weeks Codeine 48 hours Heroin 2 – 4 days Hydromorphone 2 – 4 days Methadone 3 days Morphine 2 – 3 days Oxycodone 2 – 4 days Detection of drugs can also be affected by other factors.
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