Opioid Use Disorder

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.AddictionThe following page includes discussions of addiction, including substance abuse. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.

**Opioid Use Disorder (OUD)** is the chronic use of opioids that causes clinically significant distress or impairment. Opioids is a generic term given in the DSM-5, but the diagnostic guidelines indicate that the actual opioid used should be specified in the diagnosis.

Opioids are a drug class that acts on opioid receptors in the brain. Examples of opioids include morphine, heroin, fentanyl, and methadone. Prescription opioids are used to treat acute pain, such as recovering from an injury or post-surgery, chronic pain, active-phase cancer treatment, palliative care and end-of-life care.

## Signs & Symptoms

* The inability to control opioid use.
* Uncontrollable cravings.
* Drowsiness.
* Changes in sleep habits.
* Weight loss.
* Frequent flu-like symptoms.
* Decreased libido.
* Lack of hygiene.
* Changes in exercise habits.
* Isolation from friends and family.
* Stealing from family, friends or businesses.
* New financial difficulties.

### Diagnosis

A diagnosis of OUD is made when an individual who regularly uses opioids has experienced at least two of the following signs and symptoms within the past 12-month period:

* Physical dependence:
	+ Developing tolerance to opioids.
	+ Experiencing withdrawal symptoms if stopping opioid use, or using opioids to alleviate symptoms of withdrawal.
* Loss of control:
	+ Taking opioids in greater quantities or for longer than planned.
	+ Inability to quit or reduce use of opioids despite wanting to do so.
	+ Devoting a lot of time acquiring, using or recovering from opioids.
	+ Feeling compelled to use opioids.
* Consequences:
	+ Opioid use repeatedly interferes with completing duties at home, work or school.
	+ Continuing to use opioids even when they cause problems interacting with others.
	+ Skipping important occasions and events at work, school, or in personal life.
	+ Repeatedly taking opioids in circumstances that could cause physical harm.
	+ Continuing to use opioids even when they cause and exacerbate mental or physical problems.

If someone is prescribed opioids for pain and using them as prescribed, the physical dependence criteria are not factored into the number of signs and symptoms. Not everyone who gets prescribed with opioids develops OUD, the reason why is still not well known.

## Treatments

Medication-assisted treatment (MAT) is an effective treatment from individuals with opioid use disorder, which involves use of medications along with counseling and behavioral therapies. Medications may be used to relieve cravings, withdrawal symptoms and block the euphoric effects of opioids.

Cognitive behavioral approaches include encouraging motivation to change, education about treatment and relapse prevention. It may include participation in self-help programs, such as Narcotics Anonymous.

Three FDA-approved medications are commonly used to treat opioid addiction:

* **Methadone**, pretends withdrawal symptoms and reduces cravings. It is available only in specially regulated clinics.
* **Buprenophine**, blocks the effects of other opioids, reduces or eliminates withdrawal symptoms and reduces cravings. Buprenophine treatment is provided by specially trained and qualified medical professionals in office-based settings.
* **Naltrexone**, blocks the effects of other opioids and prevents the feeling of euphoria.

Opioid use disorder often requires continuing care to be effective.

If one overdoses on opioids, Naloxone is a potentially life-saving medication that can quickly reverse an overdose. It is available as a prefilled auto-injection device, as a nasal spray and as an injectable.

## References

https://www.verywellmind.com/opioid-use-disorder-22046

Dydyk AM, Jain NK, Gupta M. Opioid Use Disorder. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553166/

https://www.yalemedicine.org/conditions/opioid-use-disorder

https://www.hopkinsmedicine.org/opioids/signs-of-opioid-abuse.html

https://psychiatry.org/patients-families/opioid-use-disorder