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Dilaudid vs. Morphine: How Do They Compare?

Dilaudid and morphine are powerful pain medications belonging to the opioid family. While both are effective for pain relief, Dilaudid packs a stronger punch milligram for milligram, as it is approximately 5 to 10 times more potent than morphine.[1]

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What Is Dilaudid?

Dilaudid (hydromorphone) is an opioid analgesic used to manage moderate to severe pain. 

By binding to specific opioid receptors in the brain and spinal cord, Dilaudid effectively reduces the perception of pain for people who are dealing with an acute injury or chronic pain.[2] 

While it is an effective pain reliever, patients who struggle with pain are urged to take great caution with a Dilaudid prescription, using the drug as minimally as possible. Users must be on the lookout for any signs that use of the habit-forming drug is evolving into abuse.

What Is Morphine?

Morphine, derived from the opium poppy plant, provides effective pain relief for moderate to severe discomfort and predates Dilaudid in its prescription and use. Morphine also binds to selective receptors in the brain and spinal cord, resulting in the reduction of pain perception and the feeling of being high. 

Morphine is almost never prescribed on an outpatient basis, even though it is generally less potent than Dilaudid. Rather, medical professionals often administer morphine in hospitals following surgeries or to provide relief for people in the end stages of terminal illness or those living with a chronic pain disorder.[3] 

Key Similarities Between Dilaudid & Morphine

There are many similarities between Dilaudid and morphine, such as these:

  • Opioid class: Both morphine and Dilaudid belong to the opioid class of medications. They work by binding to opioid receptors in the brain and spinal cord to relieve the sensation of pain.[1]
  • Strong pain relief: Both drugs are powerful analgesics that can effectively manage moderate to severe pain. They are often prescribed in medical settings for post-surgery discomfort, cancer pain relief, or other painful conditions.
  • Side effects: Due to their opioid properties, both morphine and Dilaudid share similar side effect profiles. Common adverse reactions for both drugs include drowsiness, constipation, nausea, vomiting, dizziness, and respiratory depression.[4] Both morphine and Dilaudid can make it harder to drive or handle responsibilities at home or work, including caring for dependent children and other family members. 
  • Risk of addiction: Both substances come with a high risk for tolerance, dependence, and addiction. These risks increase significantly if the drugs are taken outside their prescribed use limits or in combination with other illicit substances. 
  • Potential for overdose: Both drugs are opioids, and taking them in large amounts can cause a deadly overdose. 

How Are Dilaudid & Morphine Different?

  • Strength: Both of these drugs are potent opioids, but Dilaudid is stronger. Dilaudid is approximately 5 to 10 times more potent than morphine, meaning smaller doses of Dilaudid can provide the same amount of pain relief as higher doses of morphine.
  • Dosage: Due to their differing strengths, doses of morphine and Dilaudid will be very different. When switching from one medication to the other, careful adjustments must be made to maintain adequate pain management while maintaining safety and reducing the risk of abuse and overdose.
  • Onset and duration of action: Morphine generally provides more prolonged pain relief compared to Dilaudid. Dilaudid acts more quickly but provides relief from pain for a shorter period of time.[5]
  • Formulations: Both morphine and Dilaudid come in multiple formulations, including immediate-release and extended-release forms, but the dosage options will be different for each medication.
  • Availability: Dilaudid may be reserved for cases that require much stronger pain relief. Morphine is more easily accessible and widely utilized within healthcare environments.
  • Side effects: Because morphine is less potent than Dilaudid, it may be less likely to trigger overdose when taken in the same amount. Morphine’s side effects may also not be as significant as those associated with Dilaudid.
  • Clinical considerations: Given that Dilaudid is more potent than morphine, people should be careful about taking the drug for an extended period. Most often, both Dilaudid and morphine will only be prescribed for short-term use due to their risks of abuse and dependence.

Addiction Potential of Morphine & Dilaudid 

Opioids such as Dilaudid and morphine are highly addictive, as they produce intense feelings of euphoria and pleasure when misused. 

Prolonged use of either drug, or any opioid, can lead to physical dependence, meaning the body begins to rely on the drug to function normally. Once dependence has formed, stopping opioid use abruptly can result in uncomfortable withdrawal symptoms. This further fuels the cycle of addiction, as people seek to get more of the drug in order to quell those unpleasant symptoms.[6]

When either of these drugs interact with the brain’s reward system, dopamine production surges, which produces pleasurable feelings. This creates an addictive cycle in which users seek out these drugs again and again to experience those positive effects repeatedly. This psychological dependence in combination with physical dependence can lead to strong addictions.  

When it is clear that an addiction to Dilaudid or morphine is present, connect with addiction treatment professionals who can help you determine the safest way to stop using these drugs as well as how to create a life that guards against relapse. 

How Is Treatment for Addiction to Morphine or Dilaudid Similar?

Just as Dilaudid and morphine are similar in terms of how addiction to the drugs develops, treatment approaches for addiction to these drugs are similar.  

Because Dilaudid and morphine are both opioids, people considering recovery are often most concerned about the management of withdrawal symptoms that can feel overwhelming. Often defined as a terrible flu, these symptoms are both psychological and physical in nature. They can cause people to abandon their goals for recovery and return to active drug use. Medications can be crucial during this time.

Treatment is often centered on medication-assisted treatment (MAT) combined with behavioral therapies like cognitive behavioral therapy (CBT) or contingency management. Together, this two-pronged approach of medications and therapy addresses the physiological symptoms of withdrawal as well as the mental and emotional aspects of addiction.[7] 

Medications used to address opioid use disorder include methadone, buprenorphine, and naltrexone. These medications can provide stability during the detox process and long into recovery. Many people remain on MAT for months or years.

Behavioral therapies like CBT can address negative thought patterns, address core issues that lead to opioid abuse, and support the person in developing coping strategies that will help them avoid future relapse. In therapy, individuals can build skills that benefit every area of their lives.

For many, treatment forms the foundation of a lifelong support system that allows them to finally live a life of stability in recovery. 

Updated January 17, 2024
  1. Gulur, P., Koury, K., Arnstein, P., Lee, H., McCarthy, P., Coley, C., & Mort, E. Morphine versus hydromorphone: Does choice of opioid influence outcomes? Pain Research and Treatment. 2015;2015.
  2. Hydromorphone. AHFS Patient Medication Information. Published May 15, 2023. Accessed July 21, 2023.
  3. Pavid K. Aspirin, Morphine and Chemotherapy: The Essential Medicines Powered by Plants. National History Museum. Published February 19, 2021. Accessed July 21, 2023.
  4. Shim H. & Gan TJ. Side Effect Profiles of Different Opioids in the Perioperative Setting: Are They Different and Can We Reduce Them?. British Journal of Anaesthesia. 2019;123(3):266-268.
  5. Garimella V, Cellini C. Postoperative Pain Control. Clinics in Colon and Rectal Surgery. 2013;26(3):191-196.
  6. Opiate and Opioid Withdrawal. A.D.A.M. Medical Encyclopedia. Published April 30, 2022. Accessed July 21, 2023.
  7. Information about medication-assisted treatment (MAT). U.S. Food and Drug Administration. Published May 23, 2023. Accessed July 21, 2023.
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