Hydromorphone - Usage Trends

Usage Trends

According to the Monitoring the Future study, theft and abuse of prescription drugs is one area of growth in the illicit, or illegal, drug market. Abusers seeking a rush of euphoria will open OxyContin tablets, crush the contents, and swallow the ground-up particles. Dilaudid also has a history of being ground into a powder and snorted or injected. How the drug Palladone will enter this illegal arena remains to be seen. Palladone is stronger than OxyContin. Purdue Pharma has issued strict warnings that crushing the contents of a Palladone capsule and swallowing the powder could be immediately fatal. For that reason, the drug may not appeal to thieves and dealers.

A Prescription for Abuse

Opiate abuse and addiction is a problem not just for the young. Men and women of all ages have been killed by, or treated for, prescription opiate abuse. Some people resort to "doctor shoppingA practice in which an individual continually switches physicians so that he or she can get enough of a prescription drug to feed an addiction; this makes it difficult for physicians to track whether the patient has already been prescribed the same drug by another physician.." They visit more than one doctor and describe the same symptoms in order to double up on prescriptions. Doctor shoppers are more likely to be adults than teenagers. And no matter how careful doctors and patients are with their pain management, some legal users will become addicted to the drug.

According to the U.S. Drug Enforcement Administration's Diversion Control Program, Dilaudid was one of the "leading opioid products for abuse and diversion during the 1970s and 1980s." The DEA has prosecuted people who forged prescriptions, criminally minded doctors and pharmacists, and thieves who rob hospitals, drugstores, and nursing homes in search of hydromorphone. On its Web site in October of 2004, the DEA noted: "Recently the diversion of Dilaudid has been reported by a number of DEA field offices including, New York, Chicago, St. Louis, San Antonio, Atlanta, Boston, Dallas, Detroit, Houston, Los Angeles, and Washington, DC." The problem also exists in suburban areas. In October of 2002, a South Florida Sun-Sentinel feature story confirmed "almost 400 deaths during the past two years in seven South Florida counties from prescription drug abuse, many ordered by doctors to control discomfort."

Middle-aged and upper- or middle-class people are far more likely to abuse prescription painkillers than to smoke marijuana or buy illegal street drugs. Even the doctors who prescribe such medications can fall victim to them. On November 30, 2003, the South Florida Sun-Sentinel reported on a doctor who died just two days prior to his forty-seventh birthday from an overdose of cocaine, oxycodone, and a muscle relaxant. He had been working as a pain specialist at a local clinic. Nurses have been prosecuted for stealing hydromorphone from their workplaces as well.

One of the stranger stories reported in the press is a 2002 case in Brighton Beach, New York. Two elderly women—one seventy-nine, the other seventy-seven—were arrested for selling their prescription hydromorphone tablets on the street. Their customers, who were willing to pay as much as $10 for a single pill, included local teenagers. Both women were charged with possessing and selling a controlled substance.