Opioid Use Disorder: Symptoms, Causes, Treatment

Assessment includes prescribed and illicit opioids and the circumstances of use without blame. Recovery needs continuing care; a return to use calls for adjusted treatment and support rather than a judgment of personal failure.

Related reading: Cocaine use disorder and differences in care.

Features include cravings, unsuccessful attempts to cut down, continued use despite harm and neglected responsibilities. Tolerance or withdrawal alone during appropriately prescribed treatment does not establish the disorder.

Drug effects on the brain interact with individual vulnerability and psychological and social circumstances. Taking doses or using medicines more often than prescribed increases risk but does not replace a full assessment.

Uncontrolled use, previous substance problems and some mental-health conditions increase risk. Combining opioids with alcohol or sedatives increases respiratory-depression risk; disclose all substances to the clinician.

Clinicians assess patterns of use, functioning, other medicines, mental health and pregnancy. Selected tests inform safety; a positive drug test alone does not measure the severity of the disorder.

Buprenorphine, methadone or naltrexone can reduce harm when selected and monitored appropriately. Starting requirements differ, and psychological support is individualized. Detoxification alone is insufficient; do not start naltrexone without specialist guidance.

Overdose, injuries and health or family problems can occur. Returning to use after a break and reduced tolerance increases overdose risk. Temporary improvement does not remove the need for follow-up.

Follow prescribed pain-treatment plans, never share medicines and store them away from children. Discuss overdose prevention, naloxone access and family training; local availability and prescription rules must be checked.