.

Chapters

0:00 Introduction
0:32 How addiction happens
1:33 Symptoms of addictions
2:30 Treatment for Opioid Use Disorder




Opioid use disorder (OUD) is a substance use disorder relating to the use of an opioid. Any such disorder causes significant impairment or distress.[3] Signs of the disorder include a strong desire to use opioids, increased tolerance to opioids, difficulty fulfilling obligations, trouble reducing use, and withdrawal symptoms with discontinuation.[4][5] Opioid withdrawal symptoms may include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood.[5] Addiction and dependence are components of a substance use disorder.[13] Complications may include opioid overdose, suicide, HIV/AIDS, hepatitis C, and problems at school, work, or home.[4][5]

An article in The Lancet compared the harm and dependence liability of 20 drugs, using a scale from zero to three for physical dependence, psychological dependence, and pleasure to create a mean score for dependence. The 20 drugs were several opioids (morphine, heroin, methadone, hydromorphone, oxycodone), barbiturates (pentobarbital, secobarbital, amobarbital, phenobarbital), benzodiazepines (diazepam, temazepam, nitrazepam, lorazepam, triazolam), nicotine, cocaine, amphetamine, MDMA (ecstasy), alcohol, and cannabis. Selected results can be seen in the chart below. Diacetylmorphine and morphine both scored a 3.0 and ranked highest. Hydromorphone followed with a mean of 2.76, cocaine scoring 2.4, oxycodone 2.31, and methadone at 1.75. The mean benzodiazepine score was elevated to due to high scores exhibited by triazolam and temazepam for pleasure and psychological dependence.[1Opioids include substances such as heroin, morphine, fentanyl, codeine, dihydrocodeine, oxycodone, and hydrocodone.[5][6] In the United States, a majority of heroin users begin by using prescription opioids that may also be bought illegally.[15][16] Risk factors for misuse include a history of substance use, substance use among family and friends, mental illness, low socioeconomic status, and race.[17][18] Diagnosis may be based on criteria by the American Psychiatric Association in the DSM-5.[4] If more than two of eleven criteria are present during a year, the diagnosis is said to be present.[4]

Individuals with an opioid use disorder are often treated with opioid replacement therapy using methadone or buprenorphine.[7] Being on such treatment reduces the risk of death.[7] Additionally, individuals 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.[8] The medication naltrexone may also be useful to prevent relapse.[10] Naloxone is useful for treating an opioid overdose and giving those at risk naloxone to take home is beneficial.[9]

In 2013, opioid use disorders affected about 0.4% of people.[4] As of 2016, about 27 million people are affected.[11] Long term opioid use occurs in about 4% of people following their use for trauma or surgery-related pain.[19] Onset is often in young adulthood.[4] Males are affected more often than females.[4] It resulted in 122,000 deaths worldwide in 2015,[12] up from 18,000 deaths in 1990.[20] In the United States during 2020 alone, there were more than 65,000 deaths due to opioid overdose, of which more than 15,000 were the result of heroin use.[21]