Hydromorphone - Effects on the Body

Effects on the Body

In the book Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy, Cynthia Kuhn and her coauthors wrote: "Opiates act on specific receptor molecules for the endorphin/enkephalin class of neurotransmittersA substance that helps spread nerve impulses from one nerve cell to another. in the brain." This means that hydromorphone enters the brain and floods nerves that are searching for endorphinsA group of naturally occurring substances in the body that relieve pain and promote a sense of well-being. and enkephalinsPronounced en-KEFF-uh-linz; naturally occurring brain chemicals that produce drowsiness and dull pain.. The human brain produces its own endorphins and enkephalins, allowing people to experience happiness and peaceful feelings. Hydromorphone and its related compounds stimulate all of the endorphin/enkephalin receptors at once. These receptors serve several functions. They control the "fight or flight" response, govern the amount of pain a person feels, and suppress coughing.

After taking a normal dose of hydromorphone, a patient in severe pain will receive relief within forty-five minutes. The drug's effects last several hours. Continuous release capsules last even longer. Taken in the proper amounts, as prescribed, hydromorphone promotes pain relief with side effects of drowsiness, dizziness, slower breathing, and constipation. Usually the patient will not feel the rush of euphoria that characterizes abuse. The drug simply relieves pain and allows a patient to move about or interact without constant distress.

Healthy people who abuse hydromorphone do so for the high. This is a brief but intense rush of enhanced happiness, feelings of well-being, loss of anxiety, and relaxation. In Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse, Paul M. Gahlinger noted: "Opiates affect almost every part of the body…. The muscles are relaxed: speech becomes slurred and slowed, the eyelids droop, and the head may begin to nod. It may become difficult to walk. The pupils of the eyes become pinpointed and do not react to light." The natural opiates such as morphine also cause nausea and vomiting. Hydromorphone can also cause nausea, but it does not affect the stomach as severely as morphine or heroin.

Overdose Tragedy

Catya Sassoon, the daughter of world-famous hair-stylist Vidal Sassoon, died of an overdose of hydromorphone in March of 2002. She was thirty-three at the time.

Hydromorphone Abuse

When the effects of a dose of recreational hydromorphone begin to wear off, the user will experience a "rebound" that includes heightened anxiety, muscle tension, and diarrhea. It becomes highly tempting to take another pill to relieve these uncomfortable symptoms. Over time—days or weeks—the body builds a tolerance to the pleasurable effects of hydromorphone abuse, while the uncomfortable symptoms of withdrawal become worse.

A woman identified only as "Sadie" told Cosmopolitan magazine that she began using her father's Dilaudid while caring for him as he battled terminal cancer. After two months of moderate use, she suffered severe withdrawal symptoms. "It had a vise grip around me," she said of the drug. "I couldn't [quit]." The Cosmopolitan story also stated that women are more likely to receive prescription pain relievers than men, and that women also become addicted to them more easily than men. Culture may play a part in this: Men tend to view pain as something they can live through. Biology may play a role as well. Women are more likely to suffer from anxiety and depression—and to find relief in prescription medicines.

Suffocation and Death

Hydromorphone shares the dangers of the other opiates in terms of breathing. The drug works on the part of the brain that automatically orders the body to breathe. Pain patients and drug abusers alike have been known to stop breathing after a dose of hydromorphone. If found in time, these users can be revived using the drug naloxone (Narcan), a substance that quickly rids the body of opiates. Many victims are not found in time, however, and they die of asphyxiationDeath or unconsciousness caused by one of three things: 1) a lack of adequate oxygen, 2) the inhalation of physically harmful substances, or 3) the obstruction of normal breathing..

In a hospital setting, first-time users of hydromorphone are monitored closely until their tolerance level is established so that they do not quit breathing and die. Doctors may also prescribe some sort of laxative, a drug that brings on a bowel movement, to help with the constipation brought on by the drug's action on the muscles in the intestines.

On Opiates/Off Opiates

Each pleasant effect of an opiate like hydromorphone has a rebound withdrawal effect that can be severe. Paul M. Gahlinger discusses these effects in his book Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. They include:

  • Absence of pain becomes heightened sensation to pain.
  • Euphoria becomes anxiety and depression.
  • Constipation becomes diarrhea.
  • Slowed breathing becomes coughing.
  • Dry mouth becomes sweating, flu-like runny nose.
  • Relaxed muscles become cramps, twitching, uncontrolled reflexes.