What is Opioid Use Disorder (OUD)?

What is OUD? 

Opiate abuse affects the brain’s normal reward system so much that normal activities are ignored and forgotten about in favor of the “high” the drugs give. Over time, other activities become less pleasurable, and a person has to take the drug just to feel “normal.”

An individual may also believe they can control their use. However, with continued use, a person’s self control can become seriously impaired. This loss of self-control is a hallmark of OUD.

Opioid use disorder involves using an opioid drug without self control and to be overwhelmingly occupied with finding, getting, and using that drug.

With continued opiate abuse, changes in the brain’s reward system cause a person to become physically dependent on the drug.

All substance use disorders, including opioid use disorder, are brain disorders.

They are brain disorders because they involve physical changes to areas in the brain that are involved in reward, stress, and self-control. These changes may last a long time after a person has stopped taking drugs.

Brain imaging studies of people with OUD show physical changes in areas of the brain that control judgment, decision-making, learning, memory, and behavior control. These changes help explain the uncontrollable, compulsive nature of Opioid Use Disorder.

OUD is similar to other diseases, like heart disease. Both disrupt the normal, healthy functioning of an organ in the body, have serious harmful effects, and both can, in many cases, be prevented and treated. If left untreated, they can both last a lifetime and may lead to death.

During OUD treatment and recovery, relapse is common and indicates that more or different treatments are needed.

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Opioid Use Disorder is NOT a result of having bad morals or not having any willpower.

Although the first time opioids are taken may be voluntary, Opioid Use Disorder is NOT done on purpose.

NOT everyone will begin to abuse opioids. A person’s risk factors, such as their environment and genetics, play a large role in which individuals will develop Opioid Use Disorder. 

Examples of environmental risk factors:

  • Aggressive behavior during childhood
  • Lack of parental supervision
  • Poor social skills
  • Availability of drugs at school
  • Community poverty

Most importantly, Opioid Use Disorder does NOT mean you are a
failure or that you can not live a healthy, opioid-free life.

Individuals with OUD CAN and DO recover!

Opioid Use Disorder Diagnosis 

To be diagnosed with OUD, a person must experience at least 2 symptoms within a 12-month period.

An opioid use disorder is diagnosed as mild, moderate, or severe:

  • Mild: 2-3 symptoms
  • Moderate: 4-5 symptoms
  • Severe: 6+ symptoms

The following are a list of symptoms that individuals with OUD may experience, according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

OUD Symptoms

  • Opioids are often taken in larger amounts or over a longer period of time than intended.
  • There is a persistent desire or unsuccessful efforts to cut down or control opioid use.
  • A great deal of time is spent in activities necessary to obtain the opioid, use the opioid, or recover from its effects.
  • Craving, or a strong desire to use opioids.
  • Recurrent opioid use resulting in failure to fulfill major role obligations at work, school, or home.
  • Continued opioid use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
  • Important social, occupational, or recreational activities are given up or reduced because of opioid use.
  • Recurrent opioid use in situations in which it is physically hazardous
  • Continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by opioids.
  • Tolerance, as defined by either of the following:
    1. A need for markedly increased amounts of opioids to achieve intoxication or desired effect
    2.  Markedly diminished effect with continued use of the same amount of an opioid
  • Withdrawal, as manifested by either of the following:
    1. The characteristic opioid withdrawal syndrome
    2. The same (or a closely related) substance are taken to relieve or avoid withdrawal symptoms

For more information on Opioid Use Disorder, check out the Recovery Tools and Substance Use sections on this website.