Opioid Use Disorder

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Description

Opioid use disorder (OUD) describes the persistent use of opioids in the setting of clinical dysfunction with or without the manifestations of tolerance and withdrawal to opioids. Diagnosis is made by a checklist of symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The criteria are not considered to be met for individuals taking opioids solely under appropriate medical supervision.

Epidemiology

Prevalence

In 2018, an estimated 10,250,000 people reported opioid misuse (3.7% of population ≥12 years old)

  • 2,028,000 of those met DSM-5 criteria for a diagnosis of OUD (0.7% of population ≥12 years old) (1).

Risk Factors

  • Prior history of substance use disorder
  • More severe reported pain
  • Co-occurring mental disorders (2)

General Prevention

  • Opioid prescriptions have been reduced by 29% between 2006 and 2018, which reduces access to prescription opioids.
  • Harm reduction practices can prevent complications from OUD such as clean needle exchanges and safe injection sites.
  • Access to intranasal naloxone can prevent opioid-related deaths.

Commonly Associated Conditions

  • Mood disorders
  • Personality disorders
  • Posttraumatic stress disorder (PTSD)
  • Other substance use disorders
  • Sexually transmitted infections
  • Hepatitis A, B, C
  • HIV

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