Dilaudid (hydromorphone) and Demerol (meperidine) are potent opioid medications designed to provide intense pain relief. Use of both drugs comes with similar risks of misuse, opioid use disorder (OUD) and potential side effects.
One of the biggest differences between the two is that Dilaudid is often prescribed after surgery under hospital supervision due to its high risk of misuse. It is only prescribed when other painkillers are ineffective.[1,2] Demerol is prescribed to manage moderate to severe pain on an inpatient as well as an outpatient basis.[3]
Both drugs should only be used under medical prescription and supervision.
What Is Dilaudid?
Dilaudid is an opioid analgesic, a medication that is usually prescribed to address severe pain after a surgery or severe trauma, when other less potent painkillers fail to provide relief.[1]
Because of its high potency and associated risks of dependence and misuse, Dilaudid should only be taken for a short period of time and in a controlled medical setting. This is intended to minimize diversion onto the black market as well as the development of OUD.
Side Effects of Dilaudid
In general, short-term and long-term side effects of Dilaudid may include some combination of the following:[1,2]
| Short-Term Side Effects | Long-Term Side Effects |
| Nausea and vomiting | Opioid dependence and OUD |
| Dizziness or lightheadedness | Tolerance to the medication |
| Stomach pain | Hormonal imbalances |
| Drowsiness or sedation | Immunological issues |
| Headache | Increased pain sensitivity (hyperalgesia) |
| Itchiness or skin rash | Impaired cognitive function |
| Difficulty breathing or swallowing | Respiratory depression |
| Flushing | Liver or kidney damage |
| Sweating | Cardiovascular issues (low blood pressure) |
| Seizures | Gastrointestinal disorders |
| Decreased sexual desire |
Side effects depend on multiple factors, including an individual’s metabolism, average dosage and length of use. Short-term side effects like nausea and drowsiness often decrease over time, as the body adjusts to taking the medicine. Most often, they begin to fade within a few days to a couple weeks.
Long-term side effects related to tolerance, dependence and OUD may persist until the problem is addressed.
Signs of Dilaudid Addiction
The signs of Dilaudid addiction, like its side effects, will be unique for each person, but in general, addiction to Dilaudid may be signified by the following:[1,5]
- Compulsive use of Dilaudid, even when there is no medical need for pain relief
- Increased tolerance, requiring higher doses over time in order to achieve the same effects
- Withdrawal symptoms when trying to discontinue or reduce Dilaudid use
- Spending an excessive amount of time and energy obtaining and using Dilaudid and other opioids
- Isolating oneself from friends and family in order to stay high
- Engaging in “doctor shopping” to illegally obtain multiple prescriptions
- Displaying physical signs of heavy use, such as significant drowsiness or nodding off during conversations or normal activities
- Experiencing financial problems due to excessive spending on the drug and lack of employment caused by behavioral issues related to OUD
- Mood swings, irritability and changes in behavior
What Is Demerol?
Demerol, which is known generically as meperidine, is a strong opioid pain reliever compared to most medications in this class. However, it is less potent than Dilaudid.[6]
Despite being less potent than Dilaudid, Demerol is still a very strong opioid. It is generally only prescribed after lesser opioids have failed to have the desired pain-relieving effect.
In most cases, it is prescribed after a severe injury or surgery to manage the initial stage of recovery that is often the most painful.[3] Due to its potential for misuse and dependence, it should only be used short term and under strict medical supervision.
Side Effects of Demerol
The side effects of Demerol may be less severe in those who are taking low doses of the drug or who are used to taking opioids in general. They may be worse for those who are new to taking opioids, when the dose is increased, or when there are underlying conditions or other medications being taken that augment the effects.
In general, some of the most common side effects of Demerol include the following:[3]
| Short-Term Side Effects | Long-Term Side Effects |
| Difficulty urinating | Opioid dependence |
| Nausea | Tolerance |
| Vomiting | Hormonal imbalances |
| Constipation | Decreased libido |
| Dizziness | Chronic constipation |
| Drowsiness and fatigue | Cognitive impairment |
| Confusion | Mood changes |
| Abdominal pain | Respiratory depression |
| Allergic reactions, such as rash, hives or swelling | |
| Difficulty breathing | |
| Slowed heart rate | |
| Fainting or loss of consciousness | |
| Seizure |
Demerol’s side effects vary in terms of duration depending on individual sensitivity, dosage and length of use. Short-term reactions, like drowsiness and nausea, usually subside within hours after taking the drug, while prolonged use could cause more serious effects like dependence and mood changes that persist over time.
Signs of Demerol Addiction
Signs of Demerol addiction are much like the signs of Dilaudid addiction because both are opioids. They have a similar impact on the brain and body as well as on behaviors.
Some of the most common signs of Demerol addiction include the following:[5]
- Frequent drowsiness or nodding off at inappropriate times
- Slurred speech or impaired coordination
- Frequent flu-like symptoms, such as nausea, vomiting or constipation
- Changes in weight, appetite or eating habits
- Frequent requests for early prescription refills
- Overusing or taking higher doses of Demerol than prescribed
- Neglecting responsibilities at work, school or home
- Withdrawal from social activities or hobbies once enjoyed
- Strong cravings for Demerol or other opioids
- Using Demerol as a coping mechanism for stress or emotional pain
- Development of tolerance, requiring higher doses to achieve the desired effect
- Withdrawal symptoms when attempting to cut back or quit use, such as anxiety, agitation, sweating or shaking
- Sudden mood swings or changes in temperament
- Irritability, restlessness or agitation
- Emotional numbness or reduced ability to experience pleasure (anhedonia)
Finding Addiction Treatment
Medication for Addiction Treatment (MAT) is considered the gold standard for treating addiction to Demerol and Dilaudid. MAT involves the use of medication like Suboxone (buprenorphine/naloxone) in conjunction with counseling and behavioral therapies to achieve lasting recovery.[4]
Suboxone can reduce cravings for both Demerol and Dilaudid and stave off withdrawal symptoms. This allows you to focus on the work you are doing in therapy to change habits and your lifestyle.
MAT can significantly enhance the chances of successful recovery by helping people to stabilize physically early in the process. MAT decreases risks associated with relapse and overdose.[7,8] It encourages a more rapid shift in focus to the therapeutic growth that needs to happen for long-term change to take place.
Getting Started With Bicycle Health
At Bicycle Health, we are committed to making MAT more accessible for people with OUD. Our telehealth services are available to you, whether you have been misusing Demerol, Dilaudid or any other opioid.
Reach out to us today to learn about our personalized treatment that can help you find your way to sustained recovery.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Dilaudid® and Dilaudid HP® injection. Food and Drug Administration. Accessed August 4, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019034s018lbl.pdf
- Hydromorphone. AHFS Patient Medication Information. Published May 15, 2023. Accessed August 4, 2023. https://medlineplus.gov/druginfo/meds/a682013.html
- Demerol. Validus Pharmaceuticals LLC. Published March 2021. Accessed August 4, 2023. https://dailymed.nlm.nih.gov/dailymed/medguide.cfm?setid=5cb2674c-a70d-4022-9188-3f711cccff5e
- Effective treatments for opioid addiction. National Institute on Drug Abuse. Published November 1, 2016. Accessed August 4, 2023. https://nida.nih.gov/publications/effective-treatments-opioid-addiction
- Dydyk AM, Jain NK, Gupta M. Opioid use disorder. StatPearls Publishing. Published January 2023. Accessed August 4, 2023. https://www.ncbi.nlm.nih.gov/books/NBK553166/
- Lowe A, Hamilton M, Greenall BScPhm MHSc J, Ma J, Dhalla I, Persaud N. Fatal overdoses involving hydromorphone and morphine among inpatients: a case series. CMAJ Open. 2017;5(1):E184-E189. Published 2017 Mar 2. doi:10.9778/cmajo.20160013
- Wakeman SE, Larochelle MR, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622
- Deyo-Svendsen M, Cabrera Svendsen M, Walker J, Hodges A, Oldfather R, Mansukhani MP. Medication-assisted treatment for opioid use disorder in a rural family medicine practice. J Prim Care Community Health. 2020;11:2150132720931720. doi:10.1177/2150132720931720
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