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Hydromorphone (Dilaudid) is much more potent than hydrocodone (Vicodin). Potency wise, hydromorphone is roughly 7-8 times stronger than hydrocodone when administered IV, and almost as much stronger when taken orally. Hydromorphone comes in short acting preparations (Dilaudid) only. For a brief time there was a long acting preparation on the market that was pulled back when it was learned that, when taken with alcohol, the long-acting mechanism broke down causing all the med to be released into the bloodstream at once. In some cases the results were fatal.

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