The short answer.
Dilaudid (hydromorphone) and oxycodone are both prescription opioids. Hydromorphone is roughly 3 to 4 times stronger dose-for-dose.
Both are Schedule II controlled substances. Both carry significant risk of dependence.
Dilaudid
A strong opioid used mainly in clinical settings.
Hydromorphone is made by chemically modifying morphine. Dilaudid is the most common brand name. It is available in tablet and injectable forms.
Hydromorphone is most commonly used in hospitals — for acute pain, post-surgical care, and situations requiring a stronger opioid. It is prescribed at much lower milligram doses than oxycodone.
Oxycodone
The most commonly prescribed outpatient opioid.
Oxycodone is more widely prescribed in outpatient settings. Brand names include Percocet (oxycodone combined with acetaminophen), Roxicodone (oxycodone alone), and OxyContin (extended-release oxycodone).
Generic versions are widely available.
Key differences
How they compare.
Strength: Hydromorphone is roughly 3 to 4 times stronger than oxycodone per milligram.
Where used: Hydromorphone is used more in clinical and inpatient settings. Oxycodone is used more in outpatient settings.
Drug testing: Both can be missed on basic urine drug screens. More specific tests are used in treatment settings.
Available forms: Oxycodone has a wider range of oral products.
Dependence: Both produce physical dependence with regular use. Both are treatable with buprenorphine.
Treatment
Both are treatable with Suboxone.
At MyStreetHealth, Suboxone (buprenorphine) treatment works for dependence on any opioid, including hydromorphone and oxycodone. Your physician will determine timing and approach based on what you have been taking.
Common questions
Questions people usually have.
Is Dilaudid stronger than oxycodone?
Yes. Hydromorphone (Dilaudid) is roughly 3 to 4 times stronger than oxycodone on a milligram-for-milligram basis.
Do they show up the same on a drug test?
No. Each requires specific testing to be identified reliably. Basic urine drug screens may miss both.
What is Dilaudid?
Dilaudid is the most common brand name for hydromorphone. It is made by chemically modifying morphine and is used primarily in clinical settings for acute and severe pain.