Opioid and Substance Use Disorders
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 | ||
| 1 | Substance taken in larger amounts or for a longer time than intended | “I didn’t mean to use so much or take that many.” |
| 2 | Persistent 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.” |
| 3 | Spending a great deal of time obtaining, using or recovering from opioid use and its effects | “Everything I do revolves around using opioids.” |
| 4 | Craving or a strong desire/urge to use opioids | “I wanted to use it so badly; I couldn’t think of anything else.” |
| Social Problems | ||
| 5 | Problems 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.” |
| 6 | Continued 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.” |
| 7 | Giving 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 | ||
| 8 | Recurrent 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.” |
| 9 | Continued 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 | ||
| 10 | Tolerance (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.” |
| 11 | Withdrawal (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. 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.
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
The risk of addiction, how fast one becomes addicted, and symptoms of a substance use disorder varies by drug. Reaching a level that can be formally diagnosed often depends on a reduction in a person’s ability to function as a result of the disorder. Adverse effects of a substance use disorder may include health problems, disability, and failure to meet major responsibilities at work, school or home.
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.