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Fentanyl vs. Dilaudid

Many Americans deal with chronic pain conditions daily. According to the Centers for Disease Control and Prevention (CDC), nearly 11% of U.S. adults took prescription pain medications between 2015 to 2018.[1]

The primary type of medication used to treat chronic pain is opioid substances. While opioids are effective in managing pain symptoms, using them long-term can result in addiction. Opioid addiction can be hazardous, putting you at risk of experiencing life-threatening overdoses.

According to the National Institute of Drug Abuse (NIDA), “In 2021, the number of reported deaths involving prescription opioids totaled 16,706.”[2]

Two of the most dangerous prescription opioids include fentanyl and Dilaudid. 

What is Fentanyl? 

Fentanyl is a potent prescription opioid medication that is primarily used to treat pain among adults who have a tolerance for lesser opioids. It is one of the most potent opioids, estimated to be 50 times stronger than heroin and 100 times stronger than morphine. While the pharmaceutical version of this substance is safe to take as prescribed, there is an illicit form of fentanyl on the streets. 

Illicitly manufactured fentanyl (IMF) is incredibly dangerous to abuse. Many people who come across fentanyl experience life-threatening overdoses that require immediate medical attention. According to NIDA, synthetic opioids like fentanyl were responsible for 70,601 overdose deaths in 2021.[2]

Side Effects of Fentanyl

Like any medication, fentanyl can cause a range of side effects. People often abuse fentanyl because it can cause a rush of euphoria and drowsiness or dizziness.

The common side effects of fentanyl include:[3]

  • A rush of euphoria 
  • Drowsiness and dizziness 
  • Nausea
  • Confusion
  • Constipation
  • Sedation
  • Breathing issues 
  • Unconsciousness

If someone takes too much fentanyl at once or has a bad reaction to the medication, they may experience:

  • Hypotension
  • Respiratory depression
  • Seizures 
  • Confusion
  • Hallucinations 

What is Dilaudid 

Dilaudid is the brand name for a prescription opioid medication called hydromorphone.[4] Hydromorphone is provided to individuals with severe pain that cannot be treated with lesser opioids. While this substance is potent, it is not as strong as fentanyl. 

Because Dilaudid is an opioid, many people abuse the substance to experience a euphoric and drowsy high. Even individuals who are taking the drug as prescribed can develop an addiction if they are taking it long-term. As a result, doctors usually prescribe this substance with caution to ensure that their patients do not develop a substance use disorder.

Side Effects of Dilaudid 

Dilaudid is an opioid like fentanyl, so it causes similar side effects. 

Common side effects of Dilaudid include:[4]

  • Drowsiness 
  • Nausea or vomiting 
  • Constipation 
  • Dry mouth 
  • Euphoria 
  • Excessive sweating 
  • Lightheadedness 
  • Itching 

If you take too much hydromorphone or have a bad reaction to the substance, you might experience these severe side effects:

  • Hypotension
  • Respiratory depression
  • Seizures 
  • Confusion
  • Hallucinations

What are the Main Differences Between Fentanyl and Dilaudid?

Fentanyl and Dilaudid are both powerful opioids used to treat severe pain. However, they do have their differences that you should be aware of. 

First, these drugs vary in chemical composition and classification. Fentanyl is a synthetic opioid that is chemically distinct from naturally derived opioids like morphine. It is highly potent and acts on the body’s opioid receptors to provide pain relief. Dilaudid, or hydromorphone, is a semi-synthetic opioid derived from morphine. It also acts on opioid receptors and is known for its effectiveness in managing severe pain.

Other differences between fentanyl and hydromorphone include:

  • Potency – Fentanyl is considered to be more potent than Dilaudid. Dilaudid is also highly potent, but it is generally considered to be less potent than fentanyl. It is roughly 5 to 7 times more potent than morphine while fentanyl is up to 100 times stronger than morphine.
  • Medical Uses – Fentanyl is often used to treat pain after surgery, among cancer patients, and among opioid-tolerant patients. It is available in various forms, such as intravenous formulations, transdermal patches, and lozenges. On the other hand, Dilaudid is used for acute and chronic pain as well as during labor and delivery among pregnant people. It can be administered through various routes, including intravenous, intramuscular, oral, and rectal. 
  • The Onset of Action – Fentanyl takes effect faster than Dilaudid, providing relief almost instantly.
  • Duration of Action – Dilaudid provides relief for a longer period, meaning fentanyl is a more short-term medication
  • Side Effects – While fentanyl and Dilaudid share similar side effects, fentanyl poses a higher risk of experiencing respiratory depression. Due to their potency, both fentanyl and Dilaudid require careful dosing and monitoring to avoid adverse effects.

In addition to these differences, fentanyl is found on the street more often than Dilaudid. However, street fentanyl is illicitly manufactured, meaning there is no way to tell the potency or purity of the substance. Fentanyl currently plays a larger role in the opioid overdose epidemic in America. 

Find Help for Opioid Addiction 

At Mandala Healing Center, our opioid addiction treatment program inspires healing through compassionate care. Going beyond the conventional approach of detoxification, patients at our facility are inspired to fully heal in an environment designed to nourish their entire being.

Clients are taken on a journey of healing through complete immersion into evidence-based clinical modalities, multifaceted alternative therapies, and expert medical management, allowing them to fully detox and recover from drug and alcohol addictions. Through a program of care designed to encourage change, a foundation is created that allows clients to find their higher purpose and reclaim their lives.

If you or a loved one are suffering from opioid addiction or would like to learn more about your treatment options, please reach out to our dedicated admissions counselors today.


  1. The Centers for Disease Control and Prevention (CDC): Prevalence of Prescription Pain Medication Use Among Adults, Retrieved August 2023 From
  2. The National Institute of Drug Abuse (NIDA): Drug Overdose Death Rates, Retrieved August 2023 From
  3. The National Institute of Drug Abuse (NIDA): Fentanyl DrugFacts, Retrieved August 2023 From
  4. Medline Plus: Hydromorphone, Retrieved August 2023 From