Opioid use disorder
Medical condition / From Wikipedia, the free encyclopedia
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Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids.[12] Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood.[5] Addiction and dependence are important components of opioid use disorder.[13]
Opioid use disorder | |
---|---|
Other names | Opioid addiction,[1] problematic opioid use,[1] opioid abuse,[2] opioid dependence[3] |
Molecular structure of morphine | |
Specialty | Addiction medicine, psychiatry |
Symptoms | Strong desire to use opioids, increased tolerance to opioids, failure to meet obligations, trouble with reducing use, withdrawal syndrome with discontinuation[4][5] |
Complications | Opioid overdose, hepatitis C, marriage problems, unemployment, poverty[4][5] |
Duration | Long term[6] |
Causes | Opioids[3] |
Diagnostic method | Based on criteria in the DSM-5[4] |
Differential diagnosis | Alcoholism |
Treatment | Opioid replacement therapy, behavioral therapy, twelve-step programs, take home naloxone[7][8][9] |
Medication | Buprenorphine, methadone, naltrexone[7][10] |
Frequency | 16 million[11] |
Deaths | 120,000[11] |
Risk factors include a history of opioid misuse, current opioid misuse, young age, socioeconomic status, race, untreated psychiatric disorders, and environments that promote misuse (social, family, professional, etc.).[14][15] Complications may include opioid overdose, suicide, HIV/AIDS, hepatitis C, and problems meeting social or professional responsibilities.[5][4] Diagnosis may be based on criteria by the American Psychiatric Association in the DSM-5.[4]
Opioids include substances such as heroin, morphine, fentanyl, codeine, dihydrocodeine, oxycodone, and hydrocodone.[5][6] A useful standard for the relative strength of different opioids is morphine milligram equivalents (MME).[16] It is recommended for clinicians to refer to daily MMEs when prescribing opioids to decrease the risk of misuse and adverse effects.[17]
Long-term opioid use occurs in about 4% of people following their use for trauma or surgery-related pain.[18] In the United States, most heroin users begin by using prescription opioids that may also be bought illegally.[19][20]
People with an opioid use disorder are often treated with opioid replacement therapy using methadone or buprenorphine.[21] Such treatment reduces the risk of death.[21] Additionally, they may benefit from cognitive behavioral therapy, other forms of support from mental health professionals such as individual or group therapy, twelve-step programs, and other peer support programs.[22] The medication naltrexone may also be useful to prevent relapse.[10][8] Naloxone is useful for treating an opioid overdose and giving those at risk naloxone to take home is beneficial.[23] In 2020, the CDC estimated that nearly 3 million people in the U.S. were living with OUD and more than 65,000 people died by opioid overdose, of whom more than 15,000 were heroin overdoses.[24][25]