Opioid-Related Disorders
DEFINITION
- Per the DSM 5-TR, opioid-use disorder (OUD) is diagnosed when the non-medical use of opioids leads to significant impairment or distress.[1]
- At least two of the following must occur within a 12-month period:
- Taking larger amounts of opioids or taking opioids over a longer period than intended
- Persistent desire or unsuccessful efforts to reduce or control opioid use
- Spending a great deal of time obtaining, using, or recovering from opioids
- Craving, or having a strong desire or urge to use opioids
- Problems fulfilling obligations at work, school, or home
- Continued use despite having recurring social or interpersonal problems
- Giving up or reducing activities because of opioid use
- Using opioids in physically hazardous situations such as driving while under the influence
- Continued use despite ongoing physical or psychological problems likely to have been caused or worsened by opioids
- Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount, excluding patients taking prescribed opioids)
- Withdrawal or taking opioids or related substances to relieve or avoid withdrawal symptoms (excluding patients taking prescribed opioids)
- Opioids include natural opioids that come from the poppy plant (morphine, codeine), semi-synthetic opioids (heroin, oxycodone, hydrocodone, hydromorphone), and synthetic opioids (fentanyl, tramadol, propoxyphene, methadone, buprenorphine).
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Last updated: August 23, 2025
Citation
Lee, Royce, et al. "Opioid-Related Disorders." Johns Hopkins Psychiatry Guide, The Johns Hopkins University, 2025. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787101/7/Opioid_Related_Disorders.
Lee R, Lenihan V, Hobelmann JG, Hsu J. Opioid-Related Disorders. Johns Hopkins Psychiatry Guide. The Johns Hopkins University; 2025. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787101/7/Opioid_Related_Disorders. Accessed October 8, 2025.
Lee, R., Lenihan, V., Hobelmann, J. G., & Hsu, J. (2025). Opioid-Related Disorders. In Johns Hopkins Psychiatry Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787101/7/Opioid_Related_Disorders
Lee R, Lenihan V, Hobelmann JG, Hsu J. Opioid-Related Disorders [Internet]. In: Johns Hopkins Psychiatry Guide. The Johns Hopkins University; 2025. [cited 2025 October 08]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787101/7/Opioid_Related_Disorders.
* Article titles in AMA citation format should be in sentence-case
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AU - Hobelmann,J.,M.D., M.P.H.
AU - Hsu,Jeffrey,M.D.
Y1 - 2025/08/23/
BT - Johns Hopkins Psychiatry Guide
UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787101/7/Opioid_Related_Disorders
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