Opioid and Substance Use Disorders

Opioid Use Disorder

Opioid use disorder is a chronic, lifelong disorder, with serious potential consequences including disability, relapse and death. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress. Doctors use a specific set of criteria to determine if a person has a substance use disorder. To be diagnosed with an opioid use disorder, a person must have two or more of the following symptoms within a 12-month period:

An opioid use disorder may be mild, moderate or severe: Mild = 2-3 symptoms; Moderate = 4-5 symptoms; Severe = 6+ symptoms
Loss of Control
1Substance taken in larger amounts or for a longer time than intended“I didn’t mean to use so much or take that many.”
2Persistent desire or unsuccessful efforts to cut down or control opioid use“I’ve tried to stop a few times before, but then I always start using again.”
3Spending a great deal of time obtaining, using or recovering from opioid use and its effects“Everything I do revolves around using opioids.”
4Craving or a strong desire/urge to use opioids “I wanted to use it so badly; I couldn’t think of anything else.”
Social Problems
5Problems fulfilling obligations at work, school or home“I keep having trouble at work and have lost the trust of friends and family because of using opioids.”
6Continued opioid use despite recurrent social or interpersonal problems“I can’t stop using even though it’s causing problems with my friends, family, boss, landlord, etc.”
7Giving up or reducing activities because of opioid use“I’ve stopped seeing my friends and family and have given up my favorite hobby because of opioids.”
Risky Use
8Recurrent opioid use in dangerous situations“I keep doing things that I know are risky.” OR “I buy/use illicit opioids even though it is dangerous.”
9Continued opioid use despite ongoing physical or psychological problems likely to have been caused or worsened by opioids“I know that using this drug causes me to feel badly/messes with my mind, but I still use it anyway.”
Pharmacological Problems
10Tolerance (i.e., need for increased amounts/higher dose to feel the same effects)“I have to take more and more of the drug to feel the same pain relief or high.”
11Withdrawal (the experience of uncomfortable symptoms in the absence of a drug) or taking opioids (or closely related substance) to relieve or avoid withdrawal symptoms“When I stop using the drug for a while, I’m in a lot of pain.” OR “I experience symptoms of anxiety, insomnia, sweating, dilated pupils, vomiting, etc.”

Visit the Washington Recovery Help Line website and/or talk to your health care provider about opioid use disorder symptoms that you or someone you know may be exhibiting.

Stimulant Use Disorder

Stimulant Use Disorder is a substance use disorder involving any of the class of drugs that include cocaine, methamphetamine, and prescription stimulants. Like other substance use disorders, a stimulant use disorder can affect a person’s body, mind, social connections and interferes with functioning.


According to the CDC, from 2013 to 2019 the psychostimulant-involved death rate increased 317%. These increases are taking place in the context of a national overdose crisis, in which stimulants are increasingly involved. In turn, it is important that community service providers and members of the public have access to information about stimulants to increase awareness of the risks stimulants may pose, how to identify a stimulant overdose, and what resources exist to provide further support or education.


Stimulant use disorder is recognized in the Diagnostic and Statistic Manual of Mental Disorders, 5th Edition (DSM-5) and can be diagnosed if at least 2 of the following symptoms are/were present in a 12-month period.


Loss of Control:

  • Stimulants are taken in larger amounts or over a longer period than was intended.
  • Persistent desire or unsuccessful attempts to cut down or control stimulant use.
  • Craving, or a strong desire or urge to use stimulants.
  • A great deal of time is spent in activities to obtain, use, or recover from the effects of stimulants.


Risky Use:

  • Recurrent stimulant use in situations in which it is physically hazardous.
  • Continued stimulant use despite physical (e.g., heart problems, abscesses, tooth loss) or psychological problem that is likely to have been caused or exacerbated by the substance.


Social Impairment:

  • Recurrent stimulant use resulting in a failure to fulfill major role obligations at work, school, or home.
  • Continued stimulant use despite having persistent or recurrent social or interpersonal problems (i.e., problems with friends, loved ones, coworkers, etc.) caused or exacerbated by the effects of stimulants.
  • Important social, occupational, or recreational activities are given up or reduced because of stimulant use.


Pharmacological Effects:

  • Tolerance (needing more of a drug to get the same effect)
  • Withdrawal (fatigue, depression, and sleep problems)


*Patients who are taking stimulant medications as directed by a medical professional can become physically dependent, meaning they can experience tolerance and if the medication is discontinued, they can experience withdrawal symptoms. However, this does not mean that they have a stimulant use disorder.


To learn more about the risks stimulants may pose, how to identify a stimulant overdose, and what resources exist to provide support and education, click here for more information.


If you or someone you know may be struggling with a stimulant use disorder, please seek help from your primary care provider.

Substance Use Disorder

Learn more about substance use disorders and specific types of addiction:

Substance use disorders are common, recurrent, and often serious, but they are treatable, and many people do recover.