According to the DSM-5 Opioid Use Disorder will be diagnosed if two or more of the following symptoms are present and recurring over a 12 month period.
- Opioids are often taken in higher quantities than intended.
- Unable to stop or reduce opioid use.
- Significant time is spent in obtaining, using or recovering from the effects of opioids
- An intense craving and desire for opioids.
- Recurrent opioid use resulting in failure to fulfill major role obligations at work, school or home.
- Continued opioid use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
- Important social, occupational or recreational activities are given up or reduced because of opioid use.
- Recurrent opioid use in situations in which it is physically hazardous.
- Continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by opioids.
- Tolerance, as defined by either of the following:
- Need for markedly increased amounts of opioids to achieve intoxication or desired effect
- Markedly diminished effect with continued use of the same amount of an opioid
- Withdrawal, as manifested by either of the following:
- The characteristic opioid withdrawal syndrome
- The same (or a closely related) substance are taken to relieve or avoid withdrawal symptoms
Opioid Use Disorder is not diagnosed when an individual is under medical care and opioids are prescribed (unless the prescription is being abused as described above). The DSM-5 also explains that proper diagnosis depends on the stage at which the individual is in along the continuum of withdrawal – early remission, sustained remission, or maintenance therapy – and if the individual is in an environment where access to opioids is restricted. As well, the diagnosis is mild if there are two or three symptoms, moderate with four or five symptoms and severe with six or more symptoms.