Opioid Use Disorder definition
Posted by dkwinter

An Overview of OUD

The term “Opioid Use Disorder” (OUD) was previously referred to as opioid abuse and opioid dependence in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). These diagnoses were replaced by one diagnosis (OUD) in the DSM-5.

Diagnostic Criteria

According to DSM-5, Opioid Use Disorder is defined by: 

A problematic pattern of opioid use leading to clinically significant impairment or distress, manifested by at least 2 of the following 11 points, occurring within a 12-month period:

  1. Opioids are often taken in larger amounts or over a longer period than was intended.
  2. There is a persistent desire or unsuccessful efforts to cut down or control opioid use.
  3. A great deal of time is spent in activities necessary to obtain the opioid, use the opioid, or recover from its effects.
  4. Craving, or a strong desire or urge to use opioids.
  5. Recurrent opioid use resulting in a failure to fulfill major role obligations at work, school, or home.
  6. Continued opioid use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
  7. Important social, occupational, or recreational activities are given up or reduced because of opioid use.
  8. Recurrent opioid use in situations in which it is physically hazardous.
  9. Continued opioid use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
  10. Tolerance, defined by either of the following :
    a) A need for markedly increased amounts of opioids to achieve intoxication or desired effect.
    b) A markedly diminished effect with continued use of the same amount of an opioid.
  11. Withdrawal, manifested by either of the following :
    a) The characteristic opioid withdrawal syndrome (refer to Criteria A and B of the criteria set for opioid withdrawal).
    b) Opioids (or a closely related substance) are taken to relieve or avoid withdrawal symptoms.

Note : The criteria for #10 (Tolerance) and #11 (Withdrawal) are not considered to be met for those taking opioids solely under appropriate medical supervision.