What is Opioid Use Disorder?

Opioid Use Disorder (OUD) is the clinical term used to describe the condition commonly referred to as opioid addiction. OUD is defined as a problematic pattern of opioid use leading to clinically significant impairment or distress. This pertains to prescription opioids, such as OxyContin, Vicodin, codeine, morphine, and others, as well as illicit drugs such as heroin and synthetic opioids such as fentanyl.

OUD is a spectrum condition, meaning that it ranges in severity from mild, moderate, or severe.

The severity is based on the number of clinical criteria a person meets. In order to confirm a diagnosis of OUD, a person must meet at least two of the following criteria in the last 12-month period. Additional criteria indicates a more severe OUD:

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. Exhibits tolerance, meaning a need for higher amounts of opioids to achieve intoxication or desired effect, OR a lower effect with continued use of the same amount of an opioid.
11. Exhibits withdrawal. This is classified as three (or more) of the following symptoms developing within minutes to several days after stopping or reducing opioid use that has been heavy or prolonged: mood changes that result in sadness, heaviness, irritability, or numbness; nausea or vomiting; muscle aches; watery eyes or runny nose; dilation of the pupils, hairs standing up, or sweating; diarrhea; yawning; fever; or inability to sleep.

If you or someone you love match this criteria, the term “diagnosed with an opioid use disorder” may sound scary. It’s okay to feel this way but it’s important to know that this diagnosis is used to get people the help they need. Opioid use disorder is also a known complication of taking opioids, even if taken as prescribed. All kinds of people have problems with opioids and opioid use disorder is an extremely treatable condition.

Treatments for OUD range based not only on the severity of OUD, but the presence of other conditions (for example depression, schizophrenia, or limited mobility), diseases (such as HIV or hepatitis C), and risk factors (such as housing or the concurrent use of other drugs or medications). Given this, a clinical assessment that determines the best treatment approach will not only cover the criteria listed above and drug use history, but will also include a medical and psychiatric history and an evaluation of family and social supports.