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Dilaudid vs. Oxycodone: What’s the Difference?

Both Dilaudid and Oxycodone can both effectively manage pain when less potent pain relievers, such as acetaminophen or ibuprofen, are not effective. While their potency and associated risk of abuse may vary, both substances are associated with dependence, addiction, and overdose.

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Dilaudid and oxycodone present with similar benefits and risks, when used in a medical setting. Dilaudid is more potent than oxycodone, and it can treat pain and coughs.

What Is Dilaudid? 

Dilaudid, the brand name for hydromorphone, is marketed for the relief of moderate to severe pain. It is a legally prescribed medication in the United States, though it is also abused. 

Dilaudid is most safely used for the short-term management of pain that does not respond to non-opioid medications. As an effective opioid that can produce a pleasurable high, it also has a high potential for abuse and addiction. 

Hydromorphone is consumed in a variety of forms, including these: 

  • Oral tablets
  • Capsules
  • Oral solutions 
  • Injectable solutions 

When abused, hydromorphone tablets may also be crushed and dissolved into a solution that can be injected like heroin. D, juice, and smack are common illicit names for hydromorphone. 

Dilaudid affects both the body and mind. While it alleviates physical pain and can treat certain coughs, it can also produce a sense of relaxation, reduced anxiety, relaxation, and euphoria as well as nervousness, restlessness, and changes in mood. Dilaudid should only be taken as prescribed by a doctor, as it is well associated with psychological and physiological dependence. 

What Is Oxycodone? 

Oxycodone is another type of prescription opioid. It is synthesized from ingredients derived from the poppy plant and prescribed for the immediate relief of moderate to severe pain, such as following a serious injury, operation, or to treat cancer pain. 

Like Dilaudid, oxycodone is known to be very addictive. It should only be used to treat pain in people who have become tolerant to the effects of other pain medications and less potent opioids. 

As a widely prescribed pain medication, oxycodone is closely associated with the national opioid overdose epidemic. It is one of the most common drugs involved in overdose deaths related to prescription opioids. Since 1999, the number of drug overdose deaths in the country has increased fourfold, with a 30% increase from 2019 to 2020. 

Of the more than 91,000 overdose deaths in 2020, nearly three-quarters of them involved an opioid. From 2019 to 2020, the rates of deaths involving prescription opioids increased by 17%, with an increase of 38% in all opioid-related deaths. 

According to the DEA, oxycodone is abused in many ways, including these: 

  • By orally consuming too many tablets or capsules 
  • By crushing tablets to be snorted or dissolved into water and injected
  • By heating tablets on a foil and then inhaling the vapors

Effectiveness for Treating Pain 

Both Oxycodone and Dilaudid are effective painkillers. Determining which is more effective depends on the individual’s needs and response to the substance. 

Regarding potency, Dilaudid is approximately two to eight times more potent than morphine, says the Drug Enforcement Administration (DEA). It has a rapid onset of action, meaning its pain-relieving effects are felt quickly. 

Oxycodone is also an effective way to treat pain, though it may not be as strong as Dilaudid. It is approximately twice as potent as morphine. The pain-relieving effects are often felt within an hour. Prescribing physicians are recommended to begin with low doses of oxycodone, at approximately half of an oral morphine dose. 

Long-term or chronic pain can be managed with slow-release prescription opioids like oxycodone. Such tablets gradually release oxycodone into the patient’s system over the course of 12 to 48 hours. While the pain-relieving effects last longer, they also typically take longer to kick in. 

Despite a lack of evidence for the long-term effectiveness of prescription opioids in managing pain, doctors have been more widely prescribing opioids like oxycodone, explains the Centers for Disease Control and Prevention (CDC). The over-prescription of such medication to manage chronic conditions, like back pain and osteoarthritis, has exposed millions of Americans to the risks of opioid abuse. 

Potential for Abuse 

Both Dilaudid and oxycodone have a high potential for abuse, tolerance, and dependence. According to information collected by the DEA, Dilaudid products were initially the leading types of opioid products that were illegally diverted and abused. However, in recent years, the popularity of oxycodone among people who misuse drugs has grown significantly. 

Both types of opioids are often misused by people who fake prescriptions or “doctor shop,” meaning they obtain prescriptions from various doctors. Some people resort to robbing pharmacies to acquire prescription medications. 

Data from the 2021 National Survey on Drug Use and Health found that approximately 1.62 million people used hydromorphone products in 2021, and 190,000 people misused them. 

Due to the role oxycodone has played in the current national opioid crisis, the FDA has released additional warnings about the safe use of opioid medications. When prescribed, these medications should only be taken exactly as directed by a doctor. They should not be taken more often, in greater doses, or in any ways other than as prescribed. Additionally, the medications should not be taken any longer than absolutely necessary. Even when taken as prescribed, tolerance and dependence can occur. The CDC has found that up to one in four patients who use opioids for long-term pain management, as prescribed by their doctor, develop an opioid addiction. 

Updated October 16, 2023
  1. Hydromorphone. (April 2023). Drug Enforcement Administration.
  2. Hydromorphone. (October 2022). Drug Enforcement Administration.
  3. Oxycodone. (May 2023). U.S. National Library of Medicine.
  4. Oxycodone. (April 2020). National Health Service: Scotland.
  5. Prescription Opioids. (August 2017). Centers for Disease Control and Prevention.
  6. Understanding the Opioid Overdose Epidemic. (June 2022). Centers for Disease Control and Prevention.
  7. Differences Between Opioids: Pharmacological, experimental, Clinical and Economical Perspectives. (January 2013). British Journal of Clinical Pharmacology.
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