Other substance intoxication. Alcohol intoxication and se dative-hypnotic intoxication
can cause a clinical picture that resembles op ioid intoxication. A diagnosis of alcohol or
sedative-hypnotic intoxication can usually be made based on the absence of pupillary con-
striction or the lack of a response to a naloxo ne challenge. In some cases, intoxication may
be due both to opioids and to alcohol or other sedatives. In these cases, the naloxone chal-
lenge will not reverse all of  the sedative effects. 
Other opioid-related disorders. Opioid intoxication is distinguished from the other
opioid-induced disorders (e.g.,  opioid-induced depressive disorder, with onset during in-
toxication) because the symptoms  in the latter disorders predominate in the clinical pre-
sentation and meet full criteria  for the relevant disorder.
Opioid Withdrawal
Diagnostic Criteria 292.0 (F11.23)
A. Presence of either of the following:
1. Cessation of (or reduction in) opioid use that has been heavy and prolonged (i.e.,
several weeks or longer).
2. Administration of an opioid antagonist after a period of opioid use.
B. Three (or more) of the following developing within minutes to several days after Criterion A:
1. Dysphoric mood.
2. Nausea or vomiting.
3. Muscle aches.
4. Lacrimation or rhinorrhea.
5. Pupillary dilation, piloerection, or sweating.