Hydromorphone is a potent opioid pain medication used to relieve moderate to severe pain. However, during its manufacturing process, impurities can be introduced, which can affect its quality, safety, and efficacy. Impurities such as 3-hydroxymorphinan, 6-hydroxyhydromorphone, and norhydromorphone have been identified in hydromorphone products, and their presence can lead to adverse effects, including toxicity and decreased potency.