What is opioid use disorder?

Opioid use disorder means that a person uses opioids even though it causes harm to themselves or others. It can range from mild to severe. The more signs of this disorder you have, the more severe it may be. Moderate to severe opioid use disorder is sometimes called addiction. People who have it may find it hard to control their use.

This disorder can develop from the use of any type of opioid. Prescription ones include hydrocodone, oxycodone, fentanyl, and morphine. Heroin is an example of an illegal opioid.

With this disorder, you may get strong cravings for opioids. You may need more and more of the opioid to get the same effect. This is called tolerance. Your body may also get used to opioids. This is called physical dependence. If you stop using opioids, you may have uncomfortable symptoms (withdrawal).

You may have opioid use disorder if two or more of the following are true. The more signs you have, the more severe the disorder may be.

• You use larger amounts of the opioid than you ever meant to. Or you've been using it for a longer time than you ever meant to.
• You can't cut down or control your use. Or you constantly wish you could cut down.
• You spend a lot of time getting or using the opioid or recovering from the effects.
• You have strong cravings for the opioid. You can no longer do your main jobs at work, at school, or at home.
• You keep using, even though your opioid use hurts your relationships.
• You have stopped doing important activities because of your opioid use.
• You use the opioid in situations where doing so is dangerous.
• You keep using the opioid even though you know it's causing health problems.
• You need more and more of the opioid to get the same effect, or you get less effect from the same amount over time. This is called tolerance.
• You have uncomfortable symptoms when you stop using the opioid or use less. This is called withdrawal.

If you're taking opioids as part of a supervised care plan, the signs of tolerance and withdrawal may not mean that you have opioid use disorder.

Opioid use disorder may be diagnosed at a routine doctor visit or during a visit for a condition linked to substance use, such as anxiety or depression. Your doctor will ask questions about your symptoms and history of opioid use and do a physical exam. The doctor may also do a mental health assessment.

Treatment for opioid use disorder most often includes medicines, group therapy, counseling, and education.

Sometimes medicines are used to help you quit. They may help control cravings, ease withdrawal symptoms, and prevent relapse. This treatment is called medication-assisted treatment, or MAT. During MAT, you take a medicine in place of the opioid you were using. (It's usually methadone or buprenorphine.) This can help you focus on getting healthy. Most people take the medicine for months or years as part of the treatment, along with therapy or counseling.

Treatment focuses on more than opioid use. It helps you cope with the anger, frustration, sadness, and disappointment that often happen when a person tries to stop using opioids.

Many people with this disorder—and sometimes their families—feel embarrassed or ashamed. Don't let these feelings stand in the way of getting treatment. Remember that the disorder can happen to anyone who takes opioids, no matter the reason.

It can be really hard to be in severe pain and at the same time be afraid to take medicine for it because you could have a relapse.

It's important to see a doctor when you're in severe pain. If you try to manage the pain yourself, you could fall back into your old habits with opioids.

An important part of preventing a relapse is to make sure the doctor knows about your history of opioid use disorder. Make sure the doctor knows, even when your visit is for some other reason than pain.

You may feel embarrassed or ashamed to talk about it. But don't let these feelings stand in your way. Your doctor is there to help you. To get you the right treatment, your doctor needs to know about your history.

It may be easier to bring it up if you write down a sentence or two about it ahead of time. For example, you could write what you were taking and for how long. You could say how long you have been in recovery. And you could say how important it is to you to avoid using opioids.

You may also take someone with you who could help you explain your history. This could be a friend, a family member, or your Narcotics Anonymous sponsor.