Dilaudid® and morphine are both opioids, but these drugs have different chemical formulations, are not equal in strength when taken in the same milligram dose, and may show slight differences in their side effects profiles. These medications do have many similarities, however, such as a tendency to be addictive, the ability to cause respiratory depression, their extreme strength, their chemical relationship, and their side effects, as well as their price. Both drugs are first line treatments for extreme pain and are available in a variety of formulations and forms; they each come in pills, liquid suspensions, and injectable solutions.
Morphine is a direct derivative of the opium poppy and was first developed in the early 19th century. About 100 years later, scientists developed Dilaudid® — also known as hydromorphone — deriving the drug from morphine. In this sense, the difference between the two is like the difference between parent and child: both are individuals, but they have a relationship and one is derived from the other.
To state that these drugs don’t have the same strength takes some explanation. If patients were given the same milligram amount, they would not get the same relief. In other words, a smaller milligram dose of hydromorphone may be equivalent to a larger dose of morphine.
Scientists believe Dilaudid® is about four times as strong as morphine. If patients are switching from morphine to hydromorphone, they need to bear in mind they will take lower doses, but that these should be adequate for pain. In the appropriate dosage strength, both drugs are found to be equally effective for pain.
There is considerable debate on how Dilaudid® and morphine differ in creating side effects. Both drugs can cause side effects like sleepiness, constipation, dizziness, cognitive distortion, and nausea/vomiting. Some reports suggest that Dilaudid® is less likely to create nausea or vomiting, and morphine is also linked to a higher level of cognitive distortion and mood depression.
Conclusions about side effects are based on trials and they may not always represent how individuals will respond to either of these drugs, which is why many people who have chronic pain issues prefer one drug to the other. Frequently, patients who are having significant side effects with one of these medicines switch to the other medication and find it preferable.
Ultimately, the differences in Dilaudid® and morphine may be fewer than the similarities. Both of these drugs and the related opioid, fentanyl, are designed for treatment of high amounts of pain that are either chronic or that result from injury or surgery. None of these medications are appropriate for casual use or for less profound pain issues that can be addressed with lower strength opioids like hydrocodone, codeine, or oxycodone, or over-the-counter pain relievers.