Opioid Use Disorder 541
Opioid Use Disorder
Diagnostic Criteria
A. A problematic pattern of opioid use leading to clinically significant impairment or distress,
as manifested by at least two of the fo llowing, occurring within a 12-month period:
1. Opioids are often taken in larger amounts or over a longer period than was in-
tended.
2. There is a persistent desire or unsuccessful efforts to cut down or control opioid use.
3. A great deal of time is spent in activities necessary to obtain the opioid, use the opi-
oid, or recover from its effects.
4. Craving, or a strong desire or urge to use opioids.
5. Recurrent opioid use resulting in a failure to fulfill major role obligations at work,
school, or home.
6. Continued opioid use despite having persisten t or recurrent social or interpersonal
problems caused or exacerbated by the effects of opioids.
7. Important social, occupational, or recreat ional activities are given up or reduced be-
cause of opioid use.
8. Recurrent opioid use in situations in which it is physically hazardous.
9. Continued opioid use despite knowledge of having a persistent or recurrent physi-
cal or psychological problem that is likely to have been caused or exacerbated by
the substance.
10. Tolerance, as defined by either of the following: 
a. A need for markedly increased amounts of opioids to achieve intoxication or de-
sired effect.
b. A markedly diminished effect with continued use of the same amount of an opioid.
Note:  This criterion is not considered to be met for those taking opioids solely under
appropriate medical supervision.
11. Withdrawal, as manifested by either of the following:
a. The characteristic opioid withdrawal syndr ome (refer to Criteria A and B of the