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Dilaudid is used to relieve moderate to severe pain and severe, painful dry coughing. As explored in detail below, Dilaudid is becoming more popular in the treatment of chronic pain in many countries, and it is used as a substitute for heroin and morphine where one or both of these drugs are not marketed. Dilaudid is preferred even over morphine in many cases ranging from the emergency department to the operating suite to ongoing treatment of chronic pain syndromes on account of Dilaudid’s superior solubility and speed of onset and less troublesome side effect profile and lower dependence liability as compared to morphine and heroin. Dilaudid is thought to be 2-4 times stronger than morphine, but with a lower dependence liability. However other studies have suggested hydromorphone is less than twice as potent as hydrocodone or oxycodone and therefore just over twice as strong as morphine via oral administration.