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Comparing Dilaudid vs Oxycodone, Which One is Better For Pain?

Both Dilaudid and Oxycodone are opioid drugs that are commonly prescribed to treat moderate to severe acute pain. Initially, their widespread and sometimes reckless prescription practices significantly contributed to the ongoing opioid epidemic.


According to the National Institute on Drug Abuse, more than 100 million Americans suffer from chronic pain, which often serves as a trigger for drug addiction in many people. Chronic pain patients frequently develop a dependence on their pain medications, which can lead to addiction.

Dilaudid and Oxycodone, two of the most potent pain relievers, have contributed significantly to America’s ongoing opioid crisis. However, with so many painkillers on the market these days, it can be difficult to distinguish the relative potency of Dilaudid vs Oxycodone.

If you or someone you know is suffering from Oxycodone substance abuse or withdrawals, the We Level Up Treatment Centers can help. Speak with our hotline specialists and discover the support and professional-accredited addiction treatment programs we offer.


Comparing Oxycodone vs Dilaudid

Both Dilaudid and Oxycodone fall within the opioid drug category and are commonly prescribed to alleviate moderate to severe acute pain. Initially, their widespread and sometimes reckless prescription practices contributed significantly to the persistent opioid epidemic. However, distinguishing between Dilaudid and Oxycodone reveals apparent disparities in their properties.

What is Oxycodone?

Oxycodone, a semi-synthetic opioid, is derived from the opium poppy plant and is available in various pill forms under brand names like Roxicodone, OxyContin, or Percocet. At times, it might be combined with acetaminophen, an over-the-counter drug.

What is Dilaudid?

Dilaudid, a brand-name medication, contains the semi-synthetic opioid hydromorphone derived from morphine. It is formulated as an immediate-release medication and can be administered orally or through injection. Generally, patients are advised against combining Dilaudid with other pain-relieving medications.

While both Dilaudid and Oxycodone serve the purpose of pain management, due to their potential for addiction and habit-forming nature, they are typically considered the last resort for treatment only after non-opioid methods have proven ineffective.

Similarities and Differences

Hydromorphone hydrochloride (Dilaudid) and oxycodone share some similarities. Both can be administered in tablet form and are available in liquid formulations. Additionally, both medications offer extended-release versions tailored for individuals who have been on opioid therapy for an extended duration and require a carefully controlled, higher dosage to manage discomfort effectively.

However, Dilaudid and other formulations of hydromorphone are considered more potent than oxycodone. These medications are frequently employed to address severe pain resulting from surgical procedures, fractures, or cancer. According to the World Health Organization (WHO), they advocate a three-step approach for managing cancer-related pain. The initial step involves non-opioid analgesics, which can be obtained without a prescription and encompass medications like aspirin, ibuprofen, and acetaminophen (Tylenol).

When over-the-counter medications fail to provide adequate relief, the second phase introduces mild opioids such as codeine. Subsequently, the third stage incorporates robust opioids like oxycodone and hydromorphone. Additionally, WHO recommends scheduled dosing rather than administering these medications solely on an as-needed basis for effectively managing severe pain.

Which is Better For Pain?

Dilaudid is typically more potent than equivalent doses of oxycodone. According to the World Health Organization’s three-step cancer treatment protocol, the first phase includes non-opioid medication, followed by a mild opioid like codeine, and the final step includes a potent opioid like oxycodone or hydromorphone.

Some important distinctions between Dilaudid and oxycodone, as well as general aspects of these two drugs:

  • Hydromorphone surpasses morphine in strength and acts more rapidly than other pain medications, contributing to a higher potential for abuse compared to oxycodone.
  • Dilaudid tends to elicit fewer physical side effects, like rashes, in comparison to morphine.
  • Oxycodone is effective for breakthrough pain or as-needed use, while its extended-release formulations offer continuous pain relief over an extended period.
  • Both Dilaudid and oxycodone can induce constipation, occasionally severe.
  • Dizziness and drowsiness are common side effects associated with both Dilaudid and oxycodone.
  • Prolonged usage of Dilaudid and oxycodone can lead to addiction and dependence.

Potential Warnings on Oxycodone and Dilaudid

Warnings for Oxycodone:

  1. Addiction and Abuse Potential: Oxycodone, being an opioid medication, carries a high potential for addiction and abuse. Misuse, overdose, or sharing of this medication can lead to severe consequences, including death.
  2. Respiratory Depression: Oxycodone can cause slowed or shallow breathing, especially in the initial stages of use or when dosage increases. This effect can be life-threatening, particularly in individuals with respiratory conditions.
  3. Withdrawal Symptoms: Abruptly stopping Oxycodone after prolonged use may lead to withdrawal symptoms, such as restlessness, muscle aches, anxiety, insomnia, and more severe reactions.
  4. Interaction with Other Substances: Combining Oxycodone with alcohol, other opioids, sedatives, or certain medications can intensify sedation and respiratory depression, leading to a higher risk of overdose.

Warnings for Dilaudid:

  1. Addiction and Abuse Risk: Similar to Oxycodone, Dilaudid also carries a significant risk of addiction, misuse, and abuse. It should be used precisely as prescribed by a healthcare professional.
  2. Respiratory Depression: Hydromorphone, like other opioids, can cause breathing problems, particularly at the commencement of therapy or with dosage escalation.
  3. Potential for Dependency: Long-term use of Dilaudid can result in physical and psychological dependence. Abruptly ceasing or reducing the dosage can lead to withdrawal symptoms.
  4. Caution in Specific Populations: Special care should be exercised in older adults, individuals with respiratory issues, and those prone to gastrointestinal issues, as Dilaudid can exacerbate these conditions.

Gradual tapering is advisable for individuals who have used Dilaudid or oxycodone for more than two weeks to mitigate withdrawal symptoms. This approach can help manage discontinuation effectively.

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Oxycodone, a potent pain relief medication, lingers in the system for varying durations, influenced by factors such as dosage and duration of use.
Oxycodone, a potent pain relief medication, lingers in the system for varying durations, influenced by factors such as dosage and duration of use.

Is Dilaudid Stronger Than Oxycodone?

Users of oxycodone commonly encounter various sleep disorders, including:

  1. Insomnia: A prevalent side effect of opioid painkillers like oxycodone, causing challenges in falling or staying asleep. Research indicates that the occurrence of insomnia among opioid users surpasses that of non-opioid users by more than 40%.
  2. Parasomnia: Oxycodone use can trigger parasomnia, a sleep disorder characterized by atypical behaviors and occurrences (e.g., sleep paralysis, sleepwalking) during sleep, alongside inducing insomnia.
  3. Hypersomnia: Oxycodone’s tendency to disrupt adequate sleep can lead to hypersomnia, resulting in excessive daytime sleepiness. This heightened sleepiness during the day can negatively impact various aspects of life, such as work performance, relationships, and mental well-being.
  4. Sleep-Disordered Breathing: Oxycodone may instigate sleep-disordered breathing, encompassing conditions like sleep apnea and hypopnea, involving irregular breathing patterns during sleep.
  5. Mixed Sleep Disorders: Some oxycodone users may experience a combination of sleep disorders. For instance, individuals facing night terrors (parasomnia) might also develop excessive daytime sleepiness.

Sleep disorders can significantly disrupt personal and professional aspects of life. If you are using oxycodone and encountering sleep difficulties or experiencing daytime drowsiness, disturbed sleep, or similar symptoms, it is advisable to seek guidance from a healthcare professional.

Dosing of Dilaudid Vs Oxycodone

Dosage instructions for Oxycodone and Hydromorphone (Dilaudid) depend on various factors, including the patient’s specific needs and formulation—whether in liquid or tablet form, immediate or delayed release.

Both drugs are typically administered every four to six hours in immediate-release form. If an individual develops a tolerance or the severity of pain increases, the strength of Oxycodone or Hydromorphone may be gradually increased.

Your doctor will determine the appropriate dosage based on the nature and severity of your pain. In long-term use, your doctor may prescribe an extended-release medication when dosage adjustments are required.

Selecting the Right Drug For Your Pain


Selecting the appropriate medication The choice between oxycodone and hydromorphone as pain management solutions primarily relies on the nature of the pain you are enduring.

Dilaudid is recognized as the more potent medication. Typically, your physician will determine the type of pain relief required and might initially prescribe a short-acting medication. In cases where the pain remains inadequately controlled, there might be a need to switch to an extended-release variant or opt for a more potent medication like hydromorphone.

Severe pain can significantly impact your overall quality of life. These medications can offer crucial relief when utilized as directed and for short durations.

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Even if you have failed previously and relapsed, or are in the middle of a difficult crisis, we stand ready to support you. Our trusted behavioral health specialists will not give up on you. When you feel ready or just want someone to speak to about therapy alternatives to change your life call us. Even if we cannot assist you, we will lead you to wherever you can get support. There is no obligation. Call our network hotline today.

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Side Effect Comparison Between Dilaudid vs Oxycodone

Understanding the potential side effects of pain medications is crucial for informed decision-making in healthcare. Dilaudid (hydromorphone) and Oxycodone are both potent opioid analgesics prescribed to manage severe pain. Here’s a comparison of the side effects commonly associated with these medications:

DilaudidOxycodoneOxycodone CR
Common Side EffectsNausea, Vomiting, Constipation, Dizziness, Drowsiness, Headache, Itching, Lack of energy, Sweating, Dry mouth, Nervousness, IndigestionNausea, Vomiting, Constipation, Dizziness, Drowsiness, Headache, Itching, Lack of energy, Trouble sleepingNausea, Vomiting, Constipation, Dizziness, Drowsiness, Headache, Itching, Weakness, Sweating, Dry mouth
Serious Side EffectsNausea, Vomiting, Constipation, Dizziness, Drowsiness, Headache, Itching, Lack of energy, Sweating, Dry mouth, Nervousness, and Indigestion.Slowed breathing, Shock, Low blood pressure, Breathlessness, Cardiac arrest, Allergic reaction (itching, hives, breathlessness, facial swelling)Slowed breathing, Shock, Low blood pressure, Breathlessness, Disrupted breathing during sleep
Comparison of Common and Serious Side Effects of Tramadol, Oxycodone, and Oxycodone CR

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Long-term Effects of Oxycodone Use

  • Development of a severe tolerance.
  • Emergence of withdrawal symptoms (indicative of physical dependence).
  • Potential development of an opiate use disorder.
  • Occasional cases of liver and kidney failure after extended use.
  • Brain changes lead to issues with attention, memory, and problem-solving.

When used as prescribed and monitored by a physician, the risk of detrimental long-term effects related to medicinal use is significantly minimized. Prolonged misuse raises the likelihood of these adverse long-term effects.

Precautions on Oxycodone and Dilaudid

Inform your healthcare provider or pharmacist about any allergic reactions to oxycodone, other opioid pain relievers, or any other allergies you may have. The inactive ingredients present in this product could trigger allergic reactions or other complications. Consult your pharmacist for more information.

Before commencing this medication, disclose your medical history to your healthcare provider or pharmacist. This includes any brain disorders, breathing problems like asthma or sleep apnea, kidney or liver disease, mental or mood disorders, history of substance use disorder, gastrointestinal issues, urinary difficulties, gallbladder or pancreatic disease.

Oxycodone carries a potential risk of abuse and addiction, increasing the possibility of overdose and fatal outcomes.
Oxycodone carries a potential risk of abuse and addiction, increasing the possibility of overdose and fatal outcomes.

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Identifying Misuse of Prescription Painkillers

Dilaudid and Oxycodone Misuse Statistics

According to the Drug Enforcement Agency (DEA), in 2012, nearly four million prescriptions for hydromorphone drugs, such as Dilaudid, were dispensed in the United States. Concurrently, over a million individuals admitted to recreational Dilaudid use in 2011. However, the United States Department of Justice reports that Oxycodone abuse surpassed Dilaudid, with almost four million cases of Oxycodone misuse in 2016. Shockingly, over 13 million Americans, including minors as young as 12, have abused Oxycodone.

Abuse and Similarities Between Dilaudid and Oxycodone

Although Dilaudid is less frequently abused compared to Oxycodone due to its lower prescription rates, their abuse reasons align. Both opioids produce an intense, euphoric high akin to heroin, fostering rapid tolerance development within just weeks.

Risks and Dependency

Dilaudid misuse poses severe risks due to its high potency, leading to respiratory suppression and extreme sedation, even under medical supervision. Physical and psychological dependence can develop irrespective of adherence to prescription guidelines. Gradual dosage reduction is crucial to mitigate severe withdrawal symptoms, including insomnia, nausea, muscle shaking, and intense cravings.

Abusers typically exhibit a relaxed demeanor, slow breathing, and impaired faculties while under the drug’s influence. However, post-drug effects can induce emotional lows and flu-like symptoms. Prolonged use fosters physical dependence, compelling individuals to avoid distressing opioid withdrawal, fostering continual relapses, and perpetuating addiction.

Treatment for Dilaudid and Oxycodone Addiction

Recovery from oxycodone or Dilaudid addiction is possible with the proper support and treatment. At Level Up Treatment Center, we specialize in comprehensive addiction treatment programs tailored to your unique needs.

Our evidence-based treatments include:

  • Medically Supervised Detoxification: Safely manage the withdrawal process under medical supervision to ease discomfort.
  • Individualized Therapy: Engage in one-on-one counseling to address underlying issues contributing to addiction.
  • Group Therapy: Participate in supportive group sessions to gain insights, share experiences, and build a strong support network.
  • Holistic Approach: Incorporate holistic therapies like yoga, meditation, and mindfulness to promote overall well-being.

Why Choose Level Up Treatment Center?

At Level Up Treatment Center, our dedicated team of professionals is committed to guiding you through every step of your recovery journey. We prioritize your well-being and provide a nurturing environment conducive to healing and growth.

Take the first step towards recovery today. Contact us to begin your journey to a drug-free life. You don’t have to face addiction alone—we are here to help you reclaim control and achieve lasting sobriety.

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Begin with a free call to an addiction & behavioral health treatment advisor. Learn more about our dual-diagnosis programs. The We Level Up treatment center network delivers recovery programs that vary by each treatment facility. Call to learn more.

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How Long Do Opiates Stay in Your System?

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