MedicalResearch.com Interview with:
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Krisha S. Patel[/caption]
Krisha S. Patel
Center For Pharmacy Innovation and Outcomes
Geisinger College Health Sciences
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Hydromorphone is a powerful opioid medication approved for treating moderate to severe acute pain, as well as chronic pain that doesn’t respond to other treatments. One brand name is Dilaudid. It is much more potent than morphine, about 5 to 10 times stronger, and crosses the blood-brain barrier more efficiently. Hydromorphone comes in several forms, including oral powders, solutions, immediate- and extended-release tablets, and injectable options like intravenous, intramuscular, and subcutaneous.
Like morphine, hydromorphone primarily targets the mu-opioid receptors, with some activity at delta receptors. Its higher fat solubility gives it a faster onset of action than morphine, though not as rapid as fentanyl. Due to its potency and risk for misuse and overdose, hydromorphone is typically prescribed only when other pain management options have failed. According to the RADARS StreetRx Program, in 2023, the black-market value of a 1 mg immediate-release tablet was about $15,000 annually, with extended-release tablets reaching $62,000 for a full-years supply.
While previous studies have explored regional differences in the use of opioids like morphine, oxycodone, and codeine, hydromorphone has not been examined. This study aims to fill that gap by analyzing state-level and temporal trends in hydromorphone use across the US from 2010 to 2023. It draws on data from three major sources: the Drug Enforcement Administration’s Automated Reports and Consolidated Orders System (ARCOS), Medicaid, and Medicare Part D. By comparing these datasets, this report also explores how hydromorphone distribution and prescribing patterns have evolved over time.