Opioid Withdrawal 547
use disorder is comorbid, the ICD-10-CM code is F11.229.  If there is no comorbid opi-
oid use disorder, then the ICD-10-CM code is F11.929.
For opioid intoxication wit h perceptual disturbances: If a mild opioid use disorder
is comorbid, the ICD-10-CM code is F11.122,  and if a moderate or severe opioid use
disorder is comorbid, the ICD-10-CM code is F11.222.  If there is no comorbid opioid
use disorder, then the ICD-10-CM code is F11.922.
Diagnostic Features
The essential feature of opioid intoxication is  the presence of clinically significant prob-
lematic behavioral or psychological changes (e .g., initial euphoria followed by apathy,
dysphoria, psychomotor agitation or retardat ion, impaired judgment) that develop dur-
ing, or shortly after, opioid use (Criteria A and B). Intoxication is accompanied by pupil-
lary constriction (unless ther e has been a severe overdose with consequent anoxia and
pupillary dilation) and one or more of the fo llowing signs: drowsiness (described as be-
ing “on the nod”), slurred speech, and impairme nt in attention or memory (Criterion C);
drowsiness may progress to co ma. Individuals with opioid intoxication may demonstrate
inattention to the environment, even to the point of ignoring potentially harmful events.
The signs or symptoms must not be attributab le to another medical condition and are not
better explained by another me ntal disorder (Criterion D).
Differential Diagnosis
Other substance intoxication. Alcohol intoxication and se dative-hypnotic intoxication