As the opioid epidemic is ravaging lives across our nation, it is also gaining mainstream attention. Treatment options are becoming more available. But with all the attention being directed towards the opioid epidemic also comes a lot of questions and misinformation. Families across the country are wondering if their loved one is suffering from opioid use disorder. Properly identifying the signs and symptoms of opioid disorder is imperative in choosing the right treatment.
Opiates, while highly addictive and sometimes deadly, are a necessary medication for some people. Recovering from surgical procedures or treating chronic pain? Opiates can be a very useful and effective method of treatment. However, they must be careful with their management. They must be taken as prescribed or dependence on these substances can sneak up on the patient fast. Spotting the difference between safe and regulated opiate use for a necessary condition and an opioid use disorder requires education and awareness.
Opioid use disorder refers to a documented pattern of opioid use that has proven to be problematic for the patient. This disorder does not just refer to people who are using illicit opiates such as heroin. It may also apply to people who are using prescription painkillers.
Opioid Disorder: Meeting Diagnosis Criteria for Treatment
There are certain criteria that a patient must meet for a valid opioid use disorder diagnosis. Physicians and treatment centers use criteria from the Diagnostic and Statistical Manual of Mental Disorders. This is also referred to as the DSM. The DSM is a publication provided by The American Psychiatric Association. It lays out the standardized criteria for various mental health and substance use disorders. It ensures physicians across the country are using the same criteria when diagnosing and treating addiction disorders.
In the most recent edition of the DSM, opioid use disorder is designated as a specialized form of substance use disorder with its’ own criteria for diagnosis. To meet the criteria for a formal diagnosis the patient must show that they have experienced at least two of the following symptoms within the previous 12 months.
- Opioids in larger amounts than intended or over a longer period of time than intended
- Persistent desire or unsuccessful efforts to control or cut down on opioid use
- Spending a large amount of time in activities to get the drug, use the drug, or recover from effects of the drug
- Craving, characterized by a strong urge to use opioids
- Failure to fulfill major role obligations at home, work, or school because of recurrent opioid use
- Continuing to use opioids despite having recurrent social or interpersonal problems that result from the drug use (e.g., fights with family members, legal issues)
- Giving up or reducing the frequency of important social, recreational, or occupational activities (e.g., stopping attending family activities)
- Continuing to use opioids in situations in which it is physically hazardous (e.g., driving under the influence of opioids)
- Continuing to use opioids despite knowing that physical or psychological problems are worse because of opioids.
- Tolerance, defined as at least one of the following:
- A need for markedly higher amounts of opioids to achieve the same effects as previously
- A markedly lower effect of opioids with continued use of the same amounts of the drug
- Withdrawal, defined as at least one of the following:
- Opioid withdrawal syndrome, which includes mood changes, nausea, vomiting, muscle aches, watery nose or eyes, diarrhea, dilated pupils, sweating yawning, fever, and insomnia.
- Continued use of opioids to alleviate or avoid withdrawal symptoms
If you can spot two or more of these symptoms in yourself or a loved one then an opioid use disorder may be present.
Attaining a Diagnosis
You know the criteria that will be used to make a diagnosis, and you think you are spotting enough symptoms for a diagnosis, but how do you attain a valid opioid use disorder diagnosis? This is an important point because an accurate diagnosis can lead you to the most effective treatment. Fortunately, there are many ways to attain an opioid use disorder diagnosis if you need one.
Many people turn to their general physician for diagnosis and referral to substance use disorder treatment facilities. Your general physician knows your history, can see you in their office to discuss your symptoms and concerns, and most of them have a variety of treatment referral options handy for patients in need. However, it is also common that when it comes to abusing prescription painkillers, a patient’s general physician is the exact person prescribing the medications that are being abused. Because of this, it is common for people suffering from opioid use disorder to have difficulties sharing accurate information with their general physicians. In such a case, relying on your general physician to spot the problem may not be successful.
Many treatment centers across the nation can aid with diagnosis and have qualified professionals on staff to do phone and in-person diagnostic interviews. After a pre-screening phone call and answering some questions about your opiate use such as: which substance you are using, the frequency you are using it, how long you have been using, what method of use you are engaging in, and how you are attaining your opiates, you may be able to receive enough of a diagnosis to qualify for enrollment in treatment. Once enrolled, a physician at the treatment center will oversee your case and document your diagnosis and treatment progress. They will taper your level of care using the DSM criteria for your disorder.
There are various treatment options when it comes to opioid use disorder, and which one you or your loved one needs should be determined by a specialized physician, on a case by case basis. Although Rapid Detox offers a nearly 100% success rate in opioid detoxification, the process is not indicated for all patients and other medical protocols should be available. Rapid Detox is much more effective when followed by an inpatient recovery center. There is no one-size-fits-all treatment method when it comes to opioid use disorder. So, if you are seeking treatment make sure you find the option that will best fit your individual needs.