a. The characteristic opioid withdrawal syndr ome (refer to Criteria A and B of the
criteria set for opioid withdrawal, pp. 547–548).
b. Opioids (or a closely related substance) are taken to relieve or avoid withdrawal
symptoms.
Note:  This criterion is not considered to be met for those individuals taking opioids
solely under appropriate medical supervision.
Specify if:
In early remission: After full criteria for opioid use disorder were previously met, none
of the criteria for opioid use disorder have been met for at least 3 months but for less
than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or
urge to use opioids,” may be met).
In sustained remission:  After full criteria for opioid us e disorder were previously met,
none of the criteria for opioid use disorder have been met at any time during a period
of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong de-
sire or urge to use opioids,” may be met). 
Specify if:
On maintenance therapy:  This additional specifier is used if the individual is taking a
prescribed agonist medication such as  methadone or buprenorphine and none of the
criteria for opioid use disorder have been met for that class of medication (except tol-
erance to, or withdrawal from, the agonist). This category also applies to those individ-