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What is the Difference Between Fentanyl and Dilaudid?

Medically Verified: 2/1/24

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All of the information on this page has been reviewed and verified by a certified addiction professional.

Fentanyl and Dilaudid are both potent opioid medications commonly used to manage severe pain. While they share similarities in their effects, they also have distinct characteristics that set them apart.

What is Fentanyl?

Fentanyl is a synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine. It is available as a prescription and may be prescribed in various forms, including:

  • Fentanyl citrate injection (Sublimaze)
  • Fentanyl transdermal patch (Duragesic)
  • Fentanyl lozenge (Actiq)
  • Fentanyl buccal tablets (Fentora and Abstral)
  • Fentanyl nasal spray (Lazanda)
  • Fentanyl sublingual spray (Subsys)

Illicitly manufactured fentanyl (IMF) may also be found on the streets and comes in the form of a white powder or clear liquid. Illicit fentanyl is responsible for the majority of opioid overdose deaths today.

What is Dilaudid?

Dilaudid is the brand name for the opioid medication hydromorphone. It is a potent analgesic that is commonly used to manage moderate to severe pain. Like other opioids, including fentanyl, Dilaudid works by binding to specific receptors in the brain and spinal cord, known as mu-opioid receptors, to alter the perception of pain.

Dilaudid is available in various formulations, including oral tablets, injectable solutions, and suppositories. When abused, Dilaudid can be highly addictive.

Understanding the Differences Between Fentanyl and Dilaudid

There are many areas in which fentanyl and Dialudid are different. These include:

Pharmacological Properties

Fentanyl is a synthetic opioid that belongs to the phenylpiperidine class of opioid drugs. It is chemically designed to be more potent than morphine, with about 50 to 100 times the potency. This high potency allows for smaller doses to achieve pain relief, making it a valuable option for managing severe pain, such as that experienced during surgical procedures or cancer-related pain. Fentanyl primarily acts on the mu-opioid receptors in the brain and spinal cord, altering the perception of pain and producing a sense of euphoria.

Dilaudid, also known as hydromorphone, is another synthetic opioid analgesic. It is derived from morphine and is approximately 5 to 7 times more potent than morphine. Like fentanyl, Dilaudid also acts on the mu-opioid receptors, but its effects are not as long-lasting as fentanyl, requiring more frequent dosing for sustained pain relief.

Medical Uses

Fentanyl is commonly used in medical settings for pain management in surgical procedures, especially those requiring anesthesia. It is also prescribed to cancer patients experiencing severe pain that is not effectively controlled by other opioids. Fentanyl is available in various formulations, including patches, lozenges, nasal sprays, and injectables.

Dilaudid is typically used for the management of moderate to severe pain, either in a hospital setting or as a prescription medication for acute or chronic pain. It may be administered orally, intravenously, or via intramuscular injection. In some cases, it can also be prescribed as an alternative to other opioids for pain relief in patients who are intolerant or allergic to morphine.

Side Effects

Fentanyl and Dilaudid are similar medications pharmacologically, so they share several common side effects due to their opioid nature, including:

  • Nausea and vomiting
  • Constipation
  • Dizziness or lightheadedness
  • Sedation or drowsiness
  • Itching or rash

Some side effects may be more pronounced in one medication compared to the other. For instance, Fentanyl patches can cause skin irritation or redness at the application site, while Dilaudid is known to cause more nausea in some individuals.

Duration of Effects

One huge difference between fentanyl and Dilaudid is their duration of action. Fentanyl, particularly in its transdermal patch form, provides a more extended period of pain relief compared to Dilaudid. Fentanyl patches can last up to 72 hours, making them suitable for patients who require continuous pain management over an extended period.

Dilaudid, on the other hand, has a shorter duration of action, typically lasting around 4 to 6 hours. This shorter effect duration may necessitate more frequent dosing to maintain pain relief for patients.

Abuse Potential

Both fentanyl and Dilaudid carry a significant risk of abuse and addiction due to their potent opioid properties. Both drugs are classified as Schedule II controlled substances under the controlled substances act, indicating a high potential for misuse and dependence, but approved medicinal use.

Recreational use or misuse of either of these medications can lead to life-threatening consequences, including overdose and respiratory depression. However, overdose is more likely with fentanyl due to its exceptional potency. Fentanyl, in particular, is notorious for its involvement in a rising number of overdose deaths, often when illicitly manufactured or combined with other drugs like heroin or counterfeit prescription opioid pills.

Find Help for Opioid Abuse and Addiction Today

Whether you are addicted to fentanyl, Dilaudid, or another opioid, it is critical to seek professional treatment. Treatment begins with medically-assisted detox, where medical professionals can help you detox safely and manage your withdrawal symptoms. After detox, you will be encouraged to attend a residential or outpatient program to reinforce positive lifestyle changes and valuable coping skills that will help you stay sober.

At South Carolina Addiction Treatment, we offer individualized, extended-term treatment in an intimate setting located in Greenville/Simpsonville, SC. We take a holistic approach to treating addiction, offering a variety of treatment modalities centered around identifying and resolving the underlying issues associated with the addiction. Each client enrolled in our program will receive individual attention from a therapist and psychiatrist as well as gaining exposure to a multitude of traditional and alternative therapies.

To learn more about our opioid addiction treatment programs, please contact us today. Our admissions team is available 24 hours a day.


  1. Centers for Disease Control and Prevention (CDC): Fentanyl Facts, Retrieved August 2023 from
  2. United States Drug Enforcement Administration (DEA): Fentanyl, Retrieved August 2023 from
  3. United States Drug Enforcement Administration (DEA): Hydromorphone, Retrieved August 2023 from
  4. Food and Drug Administration (FDA): Dilaudid Oral Liquid and Dilaudid Tablets, Retrieved August 2023 from