The difference is hydromorphone contin is extended release. Generally they will scrape the coating off the pill and then use it.
My AH is also addicted to pain killers albeit prescribed for chronic pain. We went through the ringer with this when we first moved in together as he hid his level of addiction and abuse from me. I called it the "Nods" - perfectly fine then as the drugs kicked in he would fall asleep in mid sentence. Sometimes with his hands and arms still in mid air as he was talking like someone pressed stop on a recording. Oh boy, I remember those days well.
We have experienced 2 overdoses - once intentional and once not. The first was when he was having a very, very bad day pain wise and he decided eating the goo out of a fentanyl patch was a good idea. He was laying on the floor barely alive after 45 minutes. 911 - me giving CPR till they got there - narcon - and then he was put in a psyche ward as they thought it a suicide attempt. That's the only thing that makes me smile when I think about that hee hee hee.
After that I left. Yes I came back obviously.....but with some boundaries regarding his pain management.
The second overdose he had taken his meds and was putzing around then just started going into a trance. He stood at the kitchen sink with his arm in the air, eyes closed and one hand in the sink splashing around in dish water. Weirdest thing I have ever seen. This time he didn't stop breathing but another 911 call and trip to ER for some narcon. This time though, his levels came back perfectly normal - and he said he didn't take more than prescribed. It wasn't an "overdose" per se. What we were told is that sometimes "that is just what happens". That scared the crap out of him, and I was at wits end dealing with it anyway and he knew it. So started the journey in getting off pills. Morphine for him. He didn't want to go into rehab and detox - too scared with his health issues and he had been through pill withdrawel before when he had tried to get off them himself. This is a very, very, very difficult detox as I have read and was told by the professionals we did contact. He instead opted to work with pain management and gradually reduce his amounts. That was almost 2 years ago. He is down to 25% of what he used to be prescribed that is how long it takes (well that way anyway). We hope for him to be completely off them in the next couple of months.
My AH is also addicted to xanax (a benzo) also prescribed. That drug he has been tapering off as well. I was surprised to be told by his Dr's that the addiction to Benzo's is far more severe than the addiction to pain killers far more difficult to detox. The tapering off of that drug as been much slower. It will be the end of the year next year before it will be down far enough to stop.
All I can tell you mkr86 is that when AH (was sober) and abusing his medications it was no quality of life for me. None. He slept constantly. Talked gibberish when he was high (if that's what its called I call it comatose) - had no memory. Once we went to a dinner party and he fell asleep at the dinner table. The pills disturb sleep patterns so even though they look asleep they aren't going into normal sleep mode - they are never rested. Of course I would have no idea when he took the pills if we were going out its not like you can smell them on their breath. No sex life either - it killed that. Mixing with alcohol is a killer - now mine is relapsing with alcohol and even he said that worries HIM so I have noticed he will not take pain meds or xanax when he drinks - thankfully he seems to be on hiatus from alcohol we will see how long that lasts..
Given that I have dealt with both I have to tell you - to me in MY experience pills are a dead f'ing end a much harder battle than alcohol (only for me can't say everyone). Wait until he can't get his hands on any you want to talk about scary whew.....I experienced that once when we were out of town and AH left without meds. Needless to say we had to go home.
Until AH feared them he wouldn't have stopped. They are SO SO DANGEROUS. Wishing you success with your counseling. If BF isn't willing to get himself help RUN LIKE THE WIND lest you end up near crazy like I did.