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Hydromorphone "Dilaudid"
Hydromorphone is widely known by the brand name Dilaudid. Dilaudid is one of the most powerful narcotics known to man. Dilaudid is probably the most powerful pharmaceutical narcotic in existence. Dilaudid is the pharmaceutical drug that is very similar to heroin in terms of the way it affects the body. These are the reasons it is often called "drug store heroin" on the streets. In some ways Dilaudid is preferable to heroin. This is true because with Dilaudid there are no harmful cutting agents. Heroin can contain cutting agents unknown to the user. Additionally, unlike heroin, with Dilaudid the exact dosage amount is known.
Although Dilaudid is very popular, Department of Health and Environmental Control (DHEC) and Drug Enforcement Administration (DEA) tightly monitor it. These controls cause the street price of Dilaudid to be extremely expensive relative to other narcotics. Dilaudid is most often seen on the streets in tablet form. The average street price of Dilaudid (known as K-4s because of the "K" on one side of the tablet and a "4" on the other) is between $40.00 to $60.00 each.

Dilaudid is often obtained in small quantities by theft from a relative for whom the medication was legally prescribed. In larger quantities, drug store break-ins and organized crime are the likely source.