Opioid intoxication
292.89 Opioid Intoxication
Refer, in addition, to the text and criteria for Substance Intoxication (see p. 199). The essential feature of Opioid Intoxication is the presence of clinically significant maladaptive behavioral or psychological changes (e.g., initial euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, impaired judgment, or impaired social or occupational functioning) that develop during, or shortly after, opioid use (Criteria A and B). Intoxication is accompanied by pupillary constriction (unless there has been a severe overdose with consequent anoxia and pupillary dilation) and one or more of the following signs: drowsiness (described as being "on the nod") or even coma, slurred speech, and impairment in attention or memory (Criterion C). Individuals with Opioid Intoxication may demonstrate inattention to the environment, even to the point of ignoring potentially harmful events. The symptoms must not be due to a general medical condition and are not better accounted for by another mental disorder (Criterion D).
The magnitude of the behavioral and physiological changes that result from opioid use depends on the dose as well as characteristics of the individual using the substance (e.g., tolerance, rate of absorption, chronicity of use). Symptoms of Opioid Intoxication usually last for several hours, a time frame that is consistent with the half-life of most opioid drugs. Severe intoxication following an opioid overdose can lead to coma, respiratory depression, pupillary dilation, unconsciousness, and even death.
Specifier
The following specifier may be applied to a diagnosis of Opioid Intoxication:
With Perceptual Disturbances. This specifier may be noted in the rare instance in which hallucinations with intact reality testing or auditory, visual, or tactile illusions occur in the absence of a delirium. Intact reality testing means that the person knows that the hallucinations are induced by the substance and do not represent external reality. When hallucinations occur in the absence of intact reality testing, a diagnosis of Substance-Induced Psychotic Disorder, With Hallucinations, should be considered.
Diagnostic criteria for 292.89 Opioid Intoxication
- Recent use of an opioid.
- Clinically significant maladaptive behavioral or psychological changes (e.g., initial euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, impaired judgment, or impaired social or occupational functioning) that developed during, or shortly after, opioid use.
- Pupillary constriction (or pupillary dilation due to anoxia from severe overdose) and one (or more) of the following signs, developing during, or shortly after, opioid use:
- drowsiness or coma
- slurred speech
- impairment in attention or memory
- The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.
Specify if:
With Perceptual Disturbances