Do you know the signs of opioid use disorder? The Centers for Disease Control and Prevention offers a Continuing Medical Education Module on this topic, as part of its effort to reduce the harms from use of opioids and other drugs. You can get started by going to https://www.cdc.gov/drugoverdose/training/online-training.html and selecting module 5, “Assessing and Addressing Opioid Use Disorder.”

As discussed in the module, opioid use disorder (OUD) is defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as “a problematic pattern of opioid use leading to clinically significant impairment or distress.” Confirming the diagnosis requires observing 2 or more of the following 11 behaviors over a 21-month period.

1. Opioids are often taken in larger amounts or over a longer period than was intended.
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 opioid, 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 persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
7. Important social, occupational, or recreational activities are given up or reduced because 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 physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Exhibits tolerance.
11. Exhibits withdrawal.

The CME module includes sample patient charts and dialogs to test your understanding of the criteria, and suggested communication strategies, including approaching with compassion, building a relationship, and explaining treatment options. Decision-making for use of medical-assisted therapy is also discussed within the module.

“Module 5: Assessing and Addressing Opioid Use Disorder (OUD).” Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/training/oud/accessible/index.html