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Opioid Use Disorder

Chronic relapsing condition treated with medications and behavioral therapies that save lives.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Psikiyatri department. Book Appointment →

What is Opioid Use Disorder?

Opioid use disorder (OUD) is a chronic, relapsing brain disorder characterized by compulsive use of opioids despite harmful consequences. DSM-5-TR diagnostic criteria include using more than intended, unsuccessful efforts to cut down, time spent obtaining or recovering, craving, failure to fulfill obligations, social/interpersonal problems, giving up activities, hazardous use, continued use despite physical/psychological problems, tolerance, and withdrawal.

Opioids include heroin, prescription analgesics (oxycodone, hydrocodone, morphine, fentanyl), and synthetic opioids. Fentanyl and its analogues now drive most overdose deaths in many regions due to high potency, contamination of other substances, and unpredictability. Repeated use causes neuroadaptive changes in reward, motivation, and stress circuitry, sustaining the disorder beyond initial choice.

Effective evidence-based treatment combines medications for opioid use disorder (MOUD): full agonist methadone, partial agonist buprenorphine (sublingual film/tablet, monthly extended-release injection), and antagonist extended-release naltrexone, plus psychosocial therapies (CBT, contingency management, mutual help). Harm reduction (naloxone access, sterile injection equipment, fentanyl test strips, safe consumption sites where legal) reduces mortality. Stigma and access barriers must be addressed.

Symptoms

Compulsive opioid use despite harms
Tolerance (need higher doses for same effect)
Withdrawal symptoms (anxiety, sweating, yawning, lacrimation, diarrhea, muscle aches)
Craving
Failure at work, school, or home
Social and relationship problems
Continued use despite physical or mental harm
Hazardous use (driving, IV use)
Loss of interest in hobbies
Time spent obtaining or recovering from opioids
Pinpoint pupils, sedation, slowed breathing on use
Overdose with respiratory depression and unconsciousness
Track marks, abscesses (IV use)
Physical and mental health decline

Risk Factors

Personal or family history of substance use
Mental health conditions (depression, anxiety, PTSD, ADHD)
Chronic pain and prescription opioid exposure
Adverse childhood experiences and trauma
Social determinants: housing instability, poverty, unemployment
Adolescent age of first opioid use
Polysubstance use
Stigma reducing care-seeking
Limited access to evidence-based treatment
Recent release from incarceration (high overdose risk)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Loss of control over opioid use
  • Withdrawal symptoms when not using
  • Recent overdose or near-overdose
  • Family or self concern about use
  • Need for rescue with naloxone
  • Mental health symptoms with use
  • Pregnancy and opioid use
  • Wish to stop or reduce use
  • Chronic pain and rising opioid needs

Treatment Methods

01
Universal screening with single-question screen and SBIRT
02
DSM-5-TR diagnostic interview to confirm OUD severity
03
Comprehensive medical, psychiatric, and social assessment
04
Methadone (full agonist) at licensed opioid treatment programs, individualized dosing
05
Buprenorphine (partial agonist): sublingual film/tablet 4-24 mg/day, with home induction or office induction
06
Buprenorphine extended-release monthly injection (Sublocade) for stabilized patients
07
Naltrexone extended-release monthly injection (Vivitrol) after 7-10 days opioid abstinence
08
Choice individualized: methadone retention often higher; buprenorphine more flexible; naltrexone if antagonist preferred
09
Long-term medication: continue MOUD as long as benefit, often indefinite
10
Psychosocial therapies: CBT, motivational interviewing, contingency management, 12-step facilitation
11
Mutual help: NA, SMART Recovery
12
Treat co-occurring mental health and pain
13
Naloxone prescription and education for patient and family
14
Fentanyl test strip access where appropriate
15
Harm reduction: sterile injection equipment, infectious disease testing (HIV, HCV, HBV)
16
Treat HCV with direct-acting antivirals (DAA)
17
Pregnancy: methadone or buprenorphine, monitor neonatal abstinence syndrome
18
Care coordination across primary care, psychiatry, addiction medicine, social services
19
Recovery housing, peer support specialists
20
Reentry planning post-incarceration with MOUD continuity
21
Reduce stigma in clinical settings; person-first language

Which Department to Visit?

You can visit our Psikiyatri department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.