Opioid use disorder

Opioid use disorder is a problematic pattern of opioid use that causes significant impairment or distress. Symptoms of the disorder include a strong desire to use opioids, increased tolerance to opioids, failure to fulfill obligations, trouble reducing use, and withdrawal syndrome with discontinuation. Opioid withdrawal symptoms may include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are components of a substance use disorder. Complications may include opioid overdose, suicide, HIV/AIDS, hepatitis C, marriage problems, or unemployment. Opioids include substances such as heroin, morphine, fentanyl, codeine, oxycodone, and hydrocodone. In the United States, a majority of heroin users begin by using prescription opioids. These can be bought illegally or prescribed. Diagnosis may be based on criteria by the American Psychiatric Association in the DSM-5. If more than two of eleven criteria are present during a year the diagnosis is said to be present. If a person is appropriately taking opioids for a medical condition, issues of tolerance and withdrawal do not apply. Individuals with an opioid use disorder are often treated with opioid replacement therapy using methadone or buprenorphine. Being on such treatment reduces the risk of death. 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. The medication naltrexone may also be useful to prevent relapse. Naloxone is useful for treating an opioid overdose and giving those at risk naloxone to take home is beneficial. In 2013, opioid use disorders affected about 0.4% of people. As of 2016, about 27 million people are affected. Long term opioid use occurs in about 4% of people following their use for trauma or surgery related pain. Onset is often in young adulthood. Males are affected more often than females. It resulted in 122,000 deaths worldwide in 2015, up from 18,000 deaths in 1990. In the United States during 2016, there were more than 42,000 deaths due to opioid overdose, of which more than 15,000 were the result of heroin use. Signs and symptoms include: Addiction and dependence are components of a substance use disorder and addiction represents the more severe form. Opioid dependence can occur as physical dependence, psychological dependence, or both. Onset of withdrawal from opioids depends on which opioid was used last. With heroin this typically occurs 5 hours after use, while with methadone it might not occur until 2 days later. The length of time that major symptoms occur also depends on the opioid used. For heroin withdrawal, symptoms are typically greatest at two to four days after cessation and can last for up to two weeks. Less significant symptoms may remain for an even longer period, in which case it is known as a protracted abstinence syndrome. Signs and symptoms of opioid intoxication include: