Dilaudid & Oxycodone: What Are the Differences? (& Effectiveness)

Dilaudid, which contains hydromorphone, and oxycodone are opioid drugs.
Oxycodone is made in both an extended-release and immediate-release formulation, while Dilaudid is prescribed for immediate pain relief. Both are effective at managing pain.
Dilaudid is more potent than oxycodone. It may, therefore, be more hazardous when misused in smaller doses. More prescriptions are dispensed for products containing oxycodone than those containing hydromorphone.

Oxycodone is more commonly abused than Dilaudid. In 2016, nearly 4 million people in the United States misused an oxycodone product. As opioid medications, Dilaudid and oxycodone can be habit-forming. Both are often misused and have a risk for overdose and addiction.

Dilaudid vs. Oxycodone

Oxycodone is a semisynthetic opioid drug derived from thebaine, which is contained in the opium poppy plant. Oxycodone is commonly sold under the brand name OxyContin in both immediate-release and extended-release formulations as a pill, tablet, or liquid solution.
Dilaudid is a brand-name medication containing the semisynthetic opioid hydromorphone, which is derived from morphine. Dilaudid is an immediate-release formulation marketed as an oral solution and in tablet form.

Both Dilaudid and oxycodone are prescribed to treat pain. Since they can be so habit-forming and have such a high potential for abuse, they are often considered to be the last resort option after all other non-opioid methods have proven ineffective.
Extended-release OxyContin is meant to control pain around the clock. Both hydromorphone and oxycodone have been proven effective in controlling moderate-to-severe pain related to cancer.

Dilaudid works quicker and has a shorter onset and duration of action, with an average half-life of 2.3 hours. Oxycodone has an average half-life of between 3.5 and 5.5 hours, though extended-release formulations can stay active in the body for up to 12 hours.
While oxycodone may control pain for longer than Dilaudid, hydromorphone is a stronger opioid. Hydromorphone is five times more potent than morphine, while oxycodone is only 1.5 times more potent.

Choosing One or the Other

Before oxycodone and hydrocodone became popular drugs of abuse, Dilaudid was one of the most misused and diverted opioid products in the U.S. According to a 2011 national survey, about 1 million Americans had abused Dilaudid at least once in their lives. Oxycodone has since surpassed hydromorphone as a drug of abuse, largely due to its popularity and easy access to the drug.
Hydromorphone is stronger and starts working faster than oxycodone. As a result, it has a higher potential for abuse, but it is not as widely known or easily accessible.

Woman in Lab Coat examining pills with forceps

Oxycodone can have a range of physical side effects, including skin irritation and rashes. Dilaudid is less likely to produce these effects.
Both Dilaudid and oxycodone are narcotic analgesics that are under tight federal regulation. They are classified as Schedule II controlled substances with significant potential for abuse and addiction.

Recognizing Misuse

Both Dilaudid and oxycodone are prescription medications. Any use of them without a medical need and prescription from a doctor is misuse. Users must comply exactly with prescription instructions.
Examples of prescription drug abuse are:

  • Any use of a drug without a prescription
  • Taking higher doses at a time than prescribed
  • Taking the drug in between doses
  • Continuing to take the drug after a prescription runs out
  • Inventing or exaggerating symptoms to obtain a drug
  • Doctor shopping, or going to more than one doctor to get multiple prescriptions
  • Altering the drug or the method by which it is designed to be taken

Both Dilaudid and oxycodone can have similar side effects.
Signs of abuse can include:

  • Appetite and/or weight changes
  • Mood swings
  • Stomach upset
  • Constipation
  • Personality shifts
  • Increased secrecy and isolation
  • Lack of interest in things that were important before
  • Changes in social structure and activities
  • Sleep pattern changes
  • Disinterest in personal hygiene and physical appearance
  • Obsession with the drugs
  • Issues at work, home, or school
  • Inability to keep up with chores and daily life tasks

A high from recreational use of Dilaudid or oxycodone can have mellowing effects. A person will often appear relaxed. They will likely breathe slowly and be impaired, both physically and mentally.
The crash after an opioid wears off can lead to emotional lows, anxiety, insomnia, and physical flu-like symptoms in the case of opioid dependence and withdrawal.

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Dangers of Abuse

Regular use of a drug like oxycodone or Dilaudid can quickly lead to drug dependence, withdrawal symptoms when without it, and addiction.
It is easy to overdose on an opioid drug, which can lead to coma or death, the U.S. Drug Enforcement Administration (DEA) warns.
Dilaudid and oxycodone are powerful pain medications that should only be used under the careful direction of a medical professional.