Opioid use disorder

Opioid use disorder is a significant and rapidly evolving public health concern worldwide, with increasing use of synthetic opioids such as fentanyl driving increases in opioid use disorder and in overdose deaths.

Opioid use disorder is a problematic pattern of opioid use leading to clinically significant impairment or distress.

It is important to assess comorbid medical and psychiatric illnesses, as well as other substance use disorders.

Physicians should be aware of methods for screening and detection of opioid use in clinical settings.

Opioid use disorder is a treatable, chronic disease. Evidence-based treatments include medically supervised withdrawal, maintenance therapy with relapse prevention pharmacotherapy, and psychosocial treatment.

Treatment requires a multidisciplinary approach, is long term, and involves modifying deeply ingrained behaviors through the use of pharmacotherapy and psychosocial treatments.

An opioid is a synthetic or natural agent that stimulates opioid receptors and produces opium-like effects. Opiates are a type of opioid that are naturally derived from the opium poppy (e.g., codeine, morphine, opium). They are used to treat pain but may also be misused because of their euphoric effects. Naturally derived opiates are commonly misused alongside semisynthetic and synthetic opioids such as fentanyl, heroin (diamorphine), methadone, oxycodone, and hydrocodone. The Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR) defines opioid use disorder as a problematic pattern of opioid use leading to clinically significant impairment or distress, as manifested by at least 2 out of 11 criteria within a 12-month period.[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed, text revision (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022. https://ebooks.appi.org/product/diagnostic-statistical-manual-mental-disorders-fifth-edition-text-revision-dsm5tr