Opioid use disorder can develop as a result of self-medication, though this is controversial. Scoring systems have been derived to assess the likelihood of opiate addiction in chronic pain patients.
According to position papers on the treatment of opioid dependence published by the United Nations Office on Drugs and Crime and the World Health Organization, care providers should not treat opioid use disorder as the result of a weak character or will. Additionally, detoxification alone does not constitute adequate treatment.
The DSM-5 guidelines for diagnosis of opioid use disorder require that the individual has significant impairment or distress related to opioid uses. In order to make the diagnosed two or more of eleven criteria must be present in a given year:
- More opioids are taken than intended
- The individual is unable to decrease the amount of opioids used
- Large amounts of time are spent trying to obtain opioids, use opioids, or recover from taking them
- The individual has cravings for opioids
- Difficulty fulfilling professional duties at work or school
- Continued use of opioids leading to social and interpersonal consequences
- Decreased social or recreational activities
- Using opioids despite it being physically dangerous settings
- Continued use despite opioids worsening physical or psychological health (i.e. Depression, constipation)
- Tolerance
- Withdrawa.
Signs and symptoms include:
- Drug seeking behavior
- Multiple prescriptions from different providers
- Increased use over time
- Opioid cravings
- Multiple medical complications from drug use (HIV/AIDS, hospitalizations, abscesses)
- Legal or social ramifications secondary to drug use
- Withdrawal symptom.
Withdrawal => Symptoms of withdrawal from opioids include:
- Early symptoms => Altered perception of temperature (hot/cold flashes)
- Agitation
- Anxiety
- Change in libido (abnormally high or low)
- Dehydration
- Fatigue
- Muscle aches
- Mental fog or confusion
- Lack of motivation
- Increased tearing
- Insomnia
- Restless legs
- Runny nose
- Sweating
- Yawning
- Skin-crawlin.
- Late symptoms => Abdominal cramping
- Sneezing
- Diarrhea
- Dilated pupils
- Goose bumps
- Nausea
- Vomitin.
Opioid intoxication => Signs and symptoms of opioid intoxication include:
- Decreased perception of pain
- Euphoria
- Confusion
- Desire to sleep
- Nausea
- Constipation
- Miosi.
Signs and symptoms of opioid overdose include, but are not limited to:
- Pin-point pupils may occur. Patient presenting with dilated pupils may still be suffering an opioid overdose.
- Decreased heart rate
- Decreased body temperature
- Decreased breathing
- Altered level of consciousness. People may be unresponsive or unconscious.
- Pulmonary edema (fluid accumulation in the lungs)
- Shock
- Deat