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Mixing Hydromorphone (Dilaudid) and Alcohol

Many substances, both licit and illicit, can cause serious side effects when used simultaneously with alcohol. Specifically, alcohol combined with opioids like hydromorphone can create effects that can quickly turn deadly.

In this article, we will discuss hydromorphone, what the side effects of combining it with alcohol are, and overdose potential. Additionally, we will talk about treatment methods and options, as well as provide you with information on how we can help you or a loved one get help for a hydromorphone addiction.

What is Hydromorphone (Dilaudid)?

Hydromorphone (brand names: Dilaudid or Exalgo) is a prescription opioid pain medication used to treat severe and persistent pain.1 It is a derivative of morphine and has similar effects, and it is commonly administered in hospitals.

When used as prescribed, it has low overdose potential, however, when hydromorphone is taken recreationally, and especially when it is combined with other drugs and alcohol, the results can be dangerous and sometimes fatal.1

When taken in higher doses and mixed with alcohol and other drugs, the high is often more intense and, thus, more dangerous. With continued use, the user develops tolerance and requires more of the drug to experience the same high.2 This significantly increases the risk of experiencing side effects and overdosing.

Side Effects Hydromorphone and Alcohol

When you are prescribed hydromorphone, you are advised not to drink alcohol since the combination of the two may increase the risk of dangerous side effects and overdose.1

Hydromorphone overdose can occur when you accidentally or intentionally take more than the prescribed dose, but may be even more likely when you combine it with alcohol or other drugs. Because tolerance builds, if you become addicted to the substance, you may begin to use increasingly higher doses to achieve the initial euphoria—raising your risk of overdose in the process.

Due to the risks of interaction, hydromorphone should never be combined with alcohol or other central nervous system (CNS) depressants, such as benzodiazepines (e.g., Xanax, Ativan).1

Opioid misuse, particularly when combined with alcohol or other CNS depressants, can result in long-term brain damage.1,2 Depressed respiration results in hypoxia, which lowers the amount of oxygen able to reach to the brain.2 This can induce coma, permanent brain damage, and death.2

Hydromorphone Overdose

Someone who is experiencing a hydromorphone overdose will experience symptoms and exhibit signs, some of which can include:1,3

  • Breathing problems (shallow breathing, slow breathing or no breathing).
  • Cold and clammy skin.
  • Pinpoint pupils.
  • Low blood pressure.
  • Somnolence progressing to stupor or coma.
  • Blue or purple colored fingernails and/or lips.
  • Limp body.
  • Vomiting or making gurgling noises.

If you or someone else is overdosing on hydromorphone or other opioids, or if you are unsure if an overdose is occurring, call 911 immediately. If available and able, administer naloxone and stay with the person until emergency medical services arrive. 

Concerns of Mixing Alcohol with Other Opiates

Treatment for Polysubstance Use

Treatment is available for those suffering from addiction to hydromorphone and alcohol. In cases of polysubstance misuse, individual recovery programs may vary. Because withdrawal from hydromorphone and alcohol can be severe and in many cases, dangerous, detox is the first step toward recovery.

With hydromorphone, withdrawal may be complicated in the case of an individual with an additional history of alcohol misuse, as the symptoms of acute alcohol withdrawal can be quite dangerous and require close medical care and supervision. Medically-assisted detox is available at most treatment facilities, which can be a safe option for someone wanting to end their hydromorphone use.

Pharmacological treatments are available for the treatment of opiate addiction and withdrawal. These include medications such as buprenorphine and methadone, which can reduce cravings and minimize withdrawal symptoms. Since some of these are also CNS depressants, alcohol should also be avoided with these medications as well. Extra caution must be taken when people addicted to alcohol are prescribed these medications.

Behavioral therapies are also an important part of recovery. These include:4

There are many rehabilitation programs available that offer a combination of behavioral and pharmacological therapies in both inpatient and outpatient settings. Inpatient rehabs are more intensive and thus are more effective for relapse prevention, especially in cases of severe addiction. Outpatient rehabilitation is a good choice for those who do not require the intensity of an inpatient program, but still need some structure in their recovery.

If you’re concerned that your polysubstance misuse of alcohol and hydromorphone is impacting your health, or that of someone close to you, addiction treatment programs can help. Call us at to speak with a treatment support advisor about your recovery options.

Find Polysubstance Misuse Rehab

If you or someone you love is in need of treatment for polysubstance misuse, know that there is help available. Finding polysubstance treatment near you is simple when using our rehab directory, which can connect you to the nation’s best rehab centers, including our very own American Addiction Centers facilities.

So, do not wait any longer – get started on your recovery right now by searching our rehab directory or calling us at to be connected with a compassionate, experienced admissions navigator.

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