Opioid-related disorders
Opioid-Related Disorders
The opioids include natural opioids (e.g., morphine), semisynthetics (e.g., heroin), and synthetics with morphine-like action (e.g., codeine, hydromorphone, methadone, oxycodone, meperidine, fentanyl). Medications such as pentazocine and buprenorphine that have both opiate agonist and antagonist effects are also included in this class because, especially at lower doses, their agonist properties produce similar physiological and behavioral effects as classic opioid agonists. Opioids are prescribed as analgesics, anesthetics, antidiarrheal agents, or cough suppressants. Heroin is one of the most commonly misused drugs of this class and is usually taken by injection, although it can be smoked or "snorted" when very pure heroin is available. Fentanyl is injected, whereas cough suppressants and antidiarrheal agents are taken orally. The other opioids are taken both by injection and orally.
This section contains discussions specific to the Opioid-Related Disorders. Texts and criteria sets have already been provided for the generic aspects of Substance Dependence (p. 192) and Substance Abuse (p. 198) that apply across all substances. The application of these general criteria to Opioid Dependence and Abuse is provided below. However, there are no unique criteria sets for Opioid Dependence and Opioid Abuse. Specific text and criteria sets for Opioid Intoxication and Opioid Withdrawal are also provided below. The Opioid-Induced Disorders (other than Opioid Intoxication and Withdrawal) are described in the sections of the manual with disorders with which they share phenomenology (e.g., Opioid-Induced Mood Disorder is included in the "Mood Disorders" section). Listed below are the Opioid Use Disorders and the Opioid-Induced Disorders.
Opioid Use Disorders
- 304.00 Opioid Dependence (see p. 270)
- 305.50 Opioid Abuse (see p. 271)
Opioid-Induced Disorders
- 292.89 Opioid Intoxication (see p. 271) Specify if: With Perceptual Disturbances
- 292.0 Opioid Withdrawal (see p. 272)
- 292.81 Opioid Intoxication Delirium (see p. 143)
- 292.11 Opioid-Induced Psychotic Disorder, With Delusions (see p. 338)
Specify if: With Onset During Intoxication - 292.12 Opioid-Induced Psychotic Disorder, With Hallucinations (see p. 338) Specify if: With Onset During Intoxication
- 292.84 Opioid-Induced Mood Disorder (see p. 405) Specify if: With Onset During Intoxication
- 292.89 Opioid-Induced Sexual Dysfunction (see p. 562)
Specify if: With Onset During Intoxication - 292.85 Opioid-Induced Sleep Disorder (see p. 655)
Specify if: With Onset During Intoxication/With Onset During Withdrawal - 292.9 Opioid-Related Disorder Not Otherwise Specified (see p. 277)