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Updated on September 14, 2023
6 min read

What Happens When You Mix Hydromorphone and Alcohol?

Alyssa Hill
Dr P. E. Pancoast, MD
Written by 
6 Sources Cited
Alyssa Hill
Written by 
6 Sources Cited

What is Hydromorphone?

Hydromorphone hydrochloride is a prescription opioid pain medication that relieves severe pain by blocking pain signals in the central nervous system (CNS).1

Hydromorphone is available in tablet, oral liquid, and injection form. Brand names for hydromorphone include Dilaudid and Exalgo.

Hydromorphone is more potent than morphine and requires specialist medical care to prescribe. This also makes hydromorphone highly addictive, so you should always follow the directions on the prescription label.

Is Hydromorphone Safe to Use?

Like other drugs, hydromorphone is a prescription opioid pain medication with several side effects. Common side effects of hydromorphone include the following:2

  • Constipation
  • Dizziness and headaches
  • Drowsiness
  • Nausea and vomiting
  • Dry mouth

While the side effects listed above are not unusual, you should contact emergency services as quickly as possible under the following circumstances:

  • You’re experiencing severe allergic reactions such as skin rashes, hives, swelling, and throat blockages.
  • You’re experiencing signs of an opioid overdose, such as CNS depression.
  • You have low adrenal gland function.
  • You have low blood pressure.

Besides the severe reactions above, you should avoid combining hydromorphone and alcohol to prevent adverse drug reactions.


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Can You Drink Alcohol While Taking Hydromorphone?

You should avoid combining Dilaudid and alcohol, as the results can be fatal. Many people take the two substances together, often producing a euphoric high. However, people who are tolerant of both may require higher doses to achieve the same high.

If you’re taking a long-acting form of Dilaudid, mixing alcohol can cause a rapid release of the drug, increasing blood levels to a lethal dose.3

Hydromorphone and Alcohol Interactions

Mixing Dilaudid and alcohol often leads to short and long-term neurological and psychological consequences. This includes severe side effects to potential overdosing.

Listed below are the possible effects of mixing hydromorphone and alcohol:

Common Side Effects

  • Nausea and vomiting
  • Sweating
  • Insomnia
  • Body pains
  • Dry mouth
  • Loss of appetite
  • Headaches and dizziness
  • Itching
  • Anxiety
  • Depression

Severe Side Effects

  • Hives and rashes
  • Seizures
  • Chest pain
  • Difficulty breathing or swallowing (respiratory depression)
  • Extreme drowsiness
  • Fainting
  • Swelling of the eyes, tongue, and lips

Overdose Symptoms

  • Low blood pressure
  • Cold and clammy skin
  • Blue-colored lips and fingers
  • Weak pulse
  • Breathing problems 
  • Confusion
  • Pinpoint pupils
  • Stomach spasms
  • Fatigue and drowsiness
  • Muscle twitching
  • Coma and loss of consciousness

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How to Avoid the Adverse Effects of Hydromorphone’s Alcohol Interactions

The most effective way to avoid adverse effects from hydromorphone and alcohol is to abstain from drinking when you have taken (or will be taking) hydromorphone within 24 hours.

Mixing Dilaudid and alcohol leads to severe consequences to the central nervous system and occasionally leads to death, so taking precautions is essential.

Below are a few tips for avoiding serious side effects when taking prescription painkillers with alcohol.

Report Effects to Your Healthcare Provider

Let your healthcare provider know if:

  • The pain does not go away after taking your medication
  • The pain gets worse
  • You experience a different kind of pain

Concurrent opioid and alcohol abuse can lead to tolerance, which means you’ll require more of the same substances to feel pain relief.4 People misusing Dilaudid may continue taking it in higher doses, leading to physical dependence and potential hydromorphone overdose.

Disclose Your Medical History

Taking multiple narcotic medications can significantly increase side effects. To avoid drug interactions, you should always disclose a list of the medications and prescription drugs you use and at what dosages.

By sharing your medical history, your doctor will ensure that your treatment will avoid mixing Dilaudid with other drugs and substances that may compromise your health.

Seek Addiction Treatment for Substance Abuse

If you have a history of opioid abuse or develop addictive behaviors during the course of your medication, seek addiction treatment immediately.

Withdrawal symptoms from Dilaudid and alcohol dependence are often severe, requiring an immediate detox. Typical withdrawal symptoms last up to 72 hours and begin between 4 and 8 hours.5 These symptoms might include the following:

  • Nausea and vomiting
  • Irritability and restlessness
  • Fever and sweating
  • Depression and confusion
  • Muscle spasms
  • Cognitive issues
  • Suicide ideation
  • Appetite loss
  • Anxiety
  • Diarrhea
  • Chills
  • Impaired judgment
  • Cravings for the drug

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What to Do if You've Consumed Alcohol While on Hydromorphone

Mixing Dilaudid and alcohol has dangerous side effects, potentially leading to death. If you consume alcohol while taking Dilaudid, here’s what you should do:

  • Seek medical attention: Even if your symptoms appear mild, don’t wait for them to worsen. Call emergency services immediately and inform your healthcare provider regarding polysubstance abuse. They must know the specific alcohol and drugs in your system to provide the appropriate care.
  • Avoid operating machinery: Because combining alcohol and opioid drugs can significantly impair motor function, avoid driving yourself to the hospital.
  • Stop drinking alcohol: Avoid drinking more alcohol to prevent side effects from worsening. Instead, hydrate with water to combat dehydration and other lesser symptoms.

Common Questions on Hydromorphone and Alcohol

Can You Overdose on Hydromorphone and Alcohol?

Yes, you can overdose on hydromorphone and alcohol, especially if the dose taken leads to respiratory depression and shallow breathing.6

Opioid painkillers like Dilaudid can mask the usual signs of alcohol intoxication, potentially leading a person to consume more alcohol than usual. You may already be overdosing without knowing you’ve exceeded your limit.

What Special Precautions Should I Follow When Prescribed Hydromorphone?

When you’re prescribed Dilaudid, special precautions to follow include:

  • Understanding common side effects, including constipation, dryness in the mouth, nausea and vomiting, drowsiness, and other symptoms
  • Understanding potential interactions with other drugs, especially opioids (others include medications for sleep, anxiety, depression, and allergies)
  • Avoiding activities that require mental alertness, such as driving or operating heavy machinery
  • Monitoring side effects and how your pain changes

How Can I Stay Safe While Prescribed with Hydromorphone?

You can stay safe on a Dilaudid prescription by doing the following:

  • Disclosing other medications you’re taking to your healthcare provider, mainly if you’re already prescribed opioids
  • Detailing any history of substance abuse, as your healthcare provider may recommend alternative treatment options
  • Potentially storing naloxone, an emergency medication administered for opioid overdoses
  • Knowing when to call emergency services, especially when side effects last longer than anticipated

Keep note of your local area’s emergency responders to contact if you’re experiencing severe side effects from Dilaudid use.


Hydromorphone is an opioid pain reliever that provides significant pain relief after traumatic physical injuries or medical procedures. While on this medication, it’s crucial to avoid alcohol and substances not prescribed by your healthcare provider due to its adverse effects.

If you or someone you know has accidentally combined hydromorphone and alcohol or suspect an overdose, seek immediate medical attention.

Remember, engaging in drug abuse can put patients at risk of dependence and overdose. If you struggle with drug and alcohol dependence, seeking the appropriate help and support from community members is the first step in a fulfilling journey toward sobriety.

Updated on September 14, 2023
6 sources cited
Updated on September 14, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Murray et al. “Hydromorphone.” Journal of Pain and Symptom Management, 2005.
  2. Hong et al. “The Side Effects of Morphine and Hydromorphone Patient-Controlled Analgesia.” Anesthesia & Analgesia, 2008.
  3. Murray, S., and Woolterton, E. “Alcohol-associated rapid release of a long-acting opioid.” Canadian Medical Association Journal, 2005.
  4. Kosten T.R., and Geaorge, T.P. “The Neurobiology of Opioid Dependence: Implications for Treatment.” Addiction Science & Clinical Practice, 2002.
  5. Pergolizzi et al. “Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management.” 2020.
  6. White et al. “Mechanisms of fatal opioid overdose.” 1999.
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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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