Hydromorphone is a semi-synthetic opioid agonist and a hydrogenated ketone of morphine(9). It is about 8 times more potent than morphine and since it was first introduced into clinical practice it has been used to treat cancer pain and post-operative pain. It is a useful alternative to morphine in patients who have adverse side effects with morphine such as nausea, sedation and myoclonus(10). Hydromorphone hydrochloride is five times more water soluble than morphine sulphate which is important when concentrated preparations or small delivery volumes are required(10). It is much sought after by narcotic addicts and is usually obtained by the abuser through fraudulent prescriptions and theft.
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