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).