Fentanyl vs Dilaudid Understanding the Differences

Fentanyl vs Dilaudid: Understanding the Differences

Opioids are a class of drugs that decrease activity in the central nervous system. Doctors use opioid medications to offer pain relief and treat chronic pain. That said, these substances can be incredibly addictive when abused or taken long-term. 

Opioids like hydromorphone and morphine have pain-relieving effects. On the other hand, they can cause feelings of euphoria and drowsiness. People who abuse these drugs often become addicted rather quickly. 

Unfortunately, addiction can lead to life-threatening opioid overdoses. According to the National Institute on Drug Abuse (NIDA), opioids were involved in 80,411 overdoses in 2021.

Two of the most potent opioids include fentanyl and Dilaudid (hydromorphone). While these medications are very similar, there are some key differences to be aware of. 

For starters, fentanyl is commonly used as an adulterant in the illicit drug supply. Most people who abuse Dilaudid are doing so intentionally. Additionally, fentanyl is a synthetic opioid while Dilaudid is derived from morphine. 

Being aware of the differences between hydromorphone and fentanyl can improve education on the dangers of opioid drugs.

What is Dilaudid (Hydromorphone)?

Dilaudid is a prescription opioid drug that is similar to morphine. As an opioid analgesic, it can lessen the symptoms of acute pain. Typically, doctors prescribe Dilaudid when non-opioid pain relievers will not be effective. 

Dilaudid comes in many forms, including pills, an oral solution, and rectal suppositories. While hydromorphone is effective in managing pain, it can be dangerous when abused. High doses of it can lead to respiratory depression and overdose.

The side effects of Dilaudid include:

  • Rush of euphoria
  • Relaxation or sedation
  • Reduced pain and anxiety 
  • Brain fog 
  • Changes in mood
  • Restlessness 
  • Constipation
  • Nausea and vomiting 
  • Impaired coordination
  • Lessened appetite 
  • Changes in blood pressure
  • Slow or rapid heart rate 

What is Fentanyl?

Fentanyl is a potent opioid used to treat moderate to severe pain. Doctors prescribe it when other opioids are not effective in managing pain. For example, fentanyl often treats cancer pain. 

Fentanyl is known for being 100 times stronger than morphine. While fentanyl is available by prescription, there is also an illicit form of it. People who misuse fentanyl are most likely abusing the street version of the drug. 

The side effects of fentanyl include:

  • Euphoria and relaxation 
  • Pain relief
  • Sedation 
  • Confusion
  • Dizziness and drowsiness 
  • Nausea and vomiting 
  • Small pupils 
  • Slowed breathing 

What is the Difference Between Dilaudid and Fentanyl?

Dilaudid and fentanyl are both opioid drugs. Doctors use them to treat the symptoms of pain. Keeping this in mind, they have tons of differences to be aware of. 

The main differences between fentanyl and Dilaudid include:

Type of Opioid

Dilaudid is derived from morphine, which means it is a naturally occurring opioid. On the other hand, fentanyl is created in a lab. This means that fentanyl is considered a synthetic opioid.

Both natural and synthetic opioids are dangerous to abuse. If you misuse Dilaudid or fentanyl, an opioid addiction treatment center can help you recover. 

Medical Uses 

Dilaudid is usually prescribed to treat pain that cannot be managed with non-opioid pain relievers. Additionally, doctors use it to treat all types of pain (i.e., quick, sudden, and chronic). 

Doctors do not prescribe fentanyl unless lesser opioids are not working to treat pain. In other words, usually, patients have already tried less potent opioids before receiving fentanyl. Additionally, fentanyl is usually used for long-term and chronic pain. 

Fentanyl and Dilaudid are both frequently used in hospital settings. If you experience a life-threatening injury or accident, it is more likely that fentanyl will be administered.

Length of Effects 

Dilaudid usually takes 30 minutes to kick in. Additionally the effects last for several hours. Adversely, fentanyl works almost instantaneously. 

While the effects of fentanyl are fast-acting, they do not last as long. Typically, the effects of fentanyl subside after 90 minutes.


Dilaudid is about 2 to 8 times stronger than morphine. While this means it is a strong opioid, it is way less potent than fentanyl. Experts say that fentanyl is about 100 times more potent than morphine. 

In other words, Dilaudid is only about one-tenth as strong as fentanyl. 

Overdose Risk 

While both opioids pose a serious risk for overdose, one of them is notorious for them. Fentanyl is often manufactured and sold illegally. Many drug dealers use fentanyl as an adulterant in other drugs. 

Because of the presence of fentanyl in the drug supply, it carries a heavier overdose risk. Additionally, criminals create it in illegal drug labs. This means that there is no way to tell exactly how potent the fentanyl is. 

Dilaudid is not usually used as an adulterant in other drugs. While taking large doses of it will result in an overdose, it is not likely that you will take it without knowing. 

Spotting an Opioid Overdose 

If you or a loved one abuse opioids, you are at risk of experiencing an overdose. Both Dilaudid and fentanyl can cause respiratory depression when used in high doses. Being aware of the signs of opioid overdoses can help you save a life.

The common symptoms of opioid overdoses include:

  • Small or pinpointed pupils 
  • Falling asleep or losing consciousness
  • Slowed and shallow breathing 
  • Choking or gurgling sounds 
  • Limp body 
  • Pale or blue-tinted skin 

If you notice someone experiencing an opioid overdose, you should contact 911. Thankfully, you cannot get in trouble for calling medical professionals to treat an overdose. In other words, there is no reason to avoid calling for help. 

Additionally, opioid overdoses can be reversed by naloxone (Narcan). If you have access to this medication, administer it immediately. 

Even if Narcan reverses an overdose, the individual will still require medical treatment. Oftentimes, it causes the person to experience withdrawal symptoms immediately. Additionally, if they took a time-released opioid they could overdose again later on. 

If you have experienced an opioid overdose, you should seek help. Frequent overdoses are a clear sign of addiction. Drug rehab programs will offer the tools and support you need to maintain long-term sobriety.

Get Connected to a Top-Rated Opioid Rehab Program

Opioid addiction is a serious condition that can be difficult to overcome. The longer you allow your addiction to go untreated, the more likely you are to overdose. Because of this, you should always seek professional help. 

At the Living Room at Princeton, we are dedicated to improving the lives of our clients. We will ensure you have access to every form of support you may need during your recovery journey. By combining evidence-based therapies with relapse prevention planning, we offer a strong foundation of recovery for you to rely on. 

Contact us today to learn more about our opioid addiction treatment program. 

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