Opioid use disorder is diagnosed if the pattern of use causes clinically significant impairment or distress and if ≥ 2 of the following are observed over a 12-month period: Taking opioids in larger amounts or for a longer time than intended Persistently desiring or unsuccessfully attempting to decrease or control opioid use Spending a great deal of time trying to obtain or use the opioid or recover from its effects Craving or having a strong desire or urge to use opioids Using opioids repeatedly resulting in failing to meet obligations at work, home, or school Continuing to use opioids despite having persistent or recurrent social or interpersonal problems caused or exacerbated by opioid use Giving up or reducing important social, work, or recreational activities because of opioids Continuing to use opioids in physically hazardous situations Continuing to use opioids despite having a persistent or recurrent physical or psychologic disorder caused or worsened by opioids Having tolerance to opioids Having opioid withdrawal symptoms Tolerance and withdrawal (secondary to the development of physical dependence) are expected in patients who take opioids under appropriate medical supervision Thus, these findings in a patient being medically managed with opioid therapy do not count as part of the criteria of opioid use disorder.