As an opiate narcotic, Palladone alters how your central nervous system responds to pain signals. It is a brand name for an extended release form of hydromorphone hydrochloride that was created for the management of continuous, moderate to severe pain in patients who need a potent opioid around-the-clock, for weeks, months, or longer.
Although many forms of hydromorphone are still on the market, Palladone was voluntarily discontinued by Purdue Pharma in July 2005 due to a potentially fatal interaction with alcohol.
Understanding Palladone Abuse
Like other opiate medications, hydromorphone relieves pain, and causes feelings of calm and well-being. This is due to the way the drug works in the brain. Hydromorphone binds itself to opioid receptors, blocking pain signals and causing your brain to release more of the neurotransmitter dopamine. When hydromorphone is abused by taking high doses, or by snorting or injecting the drug, the brain is induced to release excessive amounts of dopamine, leading to extreme relaxation and a rush of euphoria.
Dopamine is associated with movement, pleasure, and motivation. Our brains release this neurotransmitter to reward us for engaging in life-sustaining activities such as eating and exercising. According to the National Institute on Drug Abuse, not only does abusing drugs release 2 to 10 times as much dopamine as with natural rewards, the drug rewards occur incredibly quickly and the effects last much longer. “The resulting effects on the brain’s pleasure circuit dwarf those produced by naturally rewarding behaviors. The effect of such a powerful reward strongly motivates people to take drugs again and again. This is why scientists sometimes say that drug abuse is something we learn to do very, very well.”
Signs and Symptoms of Palladone Abuse
When a person is addicted to a prescription medication like Palladone, they usually try to pretend to themselves and their loved ones that their drug use is nothing to worry about. Sooner or later, though, the problem will become unmanageable, and the addict will begin to show evidence of what they’ve been trying to hide.
Some signs and symptoms of hydromorphone addiction may include:
- running out of a prescription earlier than scheduled
- visiting multiple doctors and pharmacies to obtain pills
- a preoccupation with maintaining a supply of drugs
- seeming intoxicated without drinking alcohol
- changes in appearance or hygiene
- changes in eating habits
- inability to focus
- isolation from family and friends
- nervousness and restlessness
- unexplained mood swings
- lack of interest in activities the former hobbies and activities
Dangers of Palladone Abuse
Abusing hydromorphone is dangerous in a wide variety of ways, but abuse of Palladone in particular carries additional risks. Purdue Pharma discontinued Palladone (hydromorphone) after the company discovered that taking the drug with alcohol (something that people with a substance abuse problem often do) harms the extended release mechanism, leading to dose-dumping.
According to the FDA news release, “dose-dumping is a term that describes the rapid release of the active ingredient from an extended release product into the blood stream. The consequences of dose dumping at the lowest marketed dose (12 mg) of Palladone could lead to serious, or even fatal, adverse events in some patients and the risk is even greater for the higher strengths of the product.”
Opiate medications like hydromorphone are never meant to be taken with alcohol due to the risk of adverse interactions, but the risk with this particular medication was much higher than usual, especially considering it only takes one drink to impair the extended release mechanism. The FDA and Purdue Pharma determined that too many patients would be likely to ignore or overlook prescribing instructions, and suffer fatal overdoses after assuming that “just one drink” would be harmless.
Who Abuses Palladone?
The Drug Enforcement Agency explains that hydromorphone is a Schedule II narcotic, with a high potential for abuse and dependence. Recently, hydrocodone and oxycodone became the most popular opiates of abuse among drug users, but before then, immediate release hydromorphone products such as Dilaudid were the leading opiods for abuse and criminal diversion.
Most hydromorphone abusers can be found among rural and suburban populations, and use is on the rise. Emergency room visits associated with recreational use of hydromorphone increased by 50% from 2008 to 2011.
One aspect of addiction is tolerance—needing to take more and more of a drug to experience the same effects. High doses of an opiate like Palladone carry a number of risks, including the possibility that you may die due to respiratory depression. All opiates suppress respiratory function. If you have a cold and only take a little hydromorphone, it can make you stop coughing, while a high dose of the medication can make you stop breathing altogether.
MedlinePlus lists the following signs of hydromorphone overdose:
- coma (loss of consciousness for a period of time)
- muscle weakness
- cold, clammy skin
- narrowing or widening of the pupils (dark circles in the middle of the eyes)
- slowed or stopped breathing
- slowed or stopped heartbeat
Am I Addicted to Palladone?
What if you aren’t sure that you are an addict? Read the following list of questions. Consider each one carefully and respond honestly.
- Have you used drugs other than those required for medicinal reasons?
- Have you used prescription drugs at higher doses than recommended or needed to obtain a new prescription before the due date?
- Do you use more than one drug at a time?
- Do you have a hard time getting through the week or the day without using drugs?
- Do you find yourself unable to stop using drugs when you want to?
- Have you had “blackouts” or “flashbacks” as a result of drug use?
- Do you ever feel bad or guilty about your drug use?
- Does your spouse (or parents) ever complain about your involvement with drugs?
- Has drug use created problems between you and your spouse or your parents?
- Have you lost friends because of your use of drugs?
- Have you neglected your family because of your use of drugs?
- Have you been in trouble at work or school because of drug use?
- Have you lost a job because of drug use?
- Have you gotten into fights when under the influence of drugs?
- Have you engaged in illegal activities in order to obtain drugs?
- Have you been arrested for possession of illegal drugs?
- Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
- Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding, etc.)?
- Do you feel incapable of quitting drugs on your own?
If you answered yes to one or more of these questions, you may be addicted to hydromorphone and in need of professional substance abuse treatment.
Palladone Addiction Treatment
Although the programs you find at drug and alcohol rehabilitation centers may vary in several ways, there are certain phases of substance abuse treatment that you will encounter everywhere.
When you first arrive at a treatment facility, you will meet with doctors and staff to determine who you are and what kind of addiction you’re suffering. You may be given tests to diagnose any co-occurring conditions or mental health issues that should be addressed as a part of your recovery. Once your treatment team has all the information they need, they will work with you to create a customized recovery plan suited to your unique needs and goals.
The first component of your recovery plan will be detoxification. Quitting hydromorphone “cold turkey” is not advisable, as a sudden stop will result in much more severe withdrawal symptoms that will not only cause you to suffer, but will likely taint your perception of the recovery process.
The medical staff at a drug and alcohol treatment facility have the training and tools to help you through this phase of the process. They may slowly taper off your dosage of hydromorphone, or else give you a medication designed to ease withdrawal symptoms and suppress drug cravings.
Treatments you may encounter in recovery include:
- Counseling/Talk Therapy
- 12 Step Meetings such as Narcotics Anonymous.
- Cognitive Behavioral Therapy
- Relapse Prevention