User:Kalij94/Opioid use disorder
Opioid use disorder (OUD) is a substance use disorder often characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids.[1] Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood.[2] Addiction and dependence are components of a substance use disorder. Risk factors for OUD include a history of opioid misuse, current opioid misuse, young age, untreated psychiatric disorders, and environments that promote misuse (social, family, professional, etc.).[3] Complications may include opioid overdose, suicide, HIV/AIDS, hepatitis C, and problems meeting social or professional responsibilities.[4]
Opioids include substances such as heroin, morphine, fentanyl, codeine, dihydrocodeine, oxycodone, and hydrocodone. A useful standard for the relative strength of different opioids is morphine milligram equivalents (MME).[5] It is recommended for clinicians to refer to daily MMEs when prescribing opioids to decrease the risk of misuse and adverse effects.[6]
People with an opioid use disorder are often treated with opioid replacement therapy using methadone or buprenorphine.[7] Such treatment reduces the risk of death. [7]Additionally, they may benefit from cognitive behavioral therapy, other forms of support from mental health professionals such as individual or group therapy, twelve-step programs, and other peer support programs.[8] The medication naltrexone may also be useful to prevent relapse. Naloxone is useful for treating an opioid overdose and giving those at risk naloxone to take home is beneficial.[9] In 2020, the CDC estimated that nearly 3 million people in the U.S. 12 or older live with OUD.[10] Recent estimates of the number of people living with OUD and annual opioid overdoses worldwide are 16 million and 120,000.[11]
A study compared the harm and dependence liability of 20 drugs, using a scale from zero to three for physical dependence, psychological dependence, and pleasure to create a mean score for dependence.[12] Selected results can be seen in the chart below. Diacetylmorphine and morphine both scored highest, at 3.0.
| Drug | Mean | Pleasure | Psychological dependence | Physical dependence |
|---|---|---|---|---|
| Heroin/Morphine | 3.00 | 3.0 | 3.0 | 3.0 |
| Cocaine | 2.39 | 3.0 | 2.8 | 1.3 |
| Alcohol | 1.93 | 2.3 | 1.9 | 1.6 |
| Benzodiazepines | 1.83 | 1.7 | 2.1 | 1.8 |
| Tobacco | 2.21 | 2.3 | 2.6 | 1.8 |
- ^ Diagnostic and statistical manual of mental disorders : DSM-5. Internet Archive. Arlington, VA : American Psychiatric Association. 2013. ISBN 978-0-89042-554-1.
{{cite book}}: CS1 maint: others (link) - ^ Shah, Mansi; Huecker, Martin R. (2022), "Opioid Withdrawal", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30252268, retrieved 2022-11-16
- ^ Webster, Lynn R. (2017-11). "Risk Factors for Opioid-Use Disorder and Overdose". Anesthesia and Analgesia. 125 (5): 1741–1748. doi:10.1213/ANE.0000000000002496. ISSN 1526-7598. PMID 29049118.
{{cite journal}}: Check date values in:|date=(help) - ^ Dydyk, Alexander M.; Jain, Nitesh K.; Gupta, Mohit (2022), "Opioid Use Disorder", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 31985959, retrieved 2022-11-16
- ^ Dowell, Deborah (2022). "CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022". MMWR. Recommendations and Reports. 71. doi:10.15585/mmwr.rr7103a1. ISSN 1057-5987.
- ^ "A Prescriber's Guide to Medicare Prescription Drug (Part D) Opioid Policies" (PDF).
- ^ a b "Trends in the Use of Methadone, Buprenorphine, and Extended-release Naltrexone at Substance Abuse Treatment Facilities: 2003-2015 (Update)". www.samhsa.gov. Retrieved 2022-11-16.
- ^ Donovan, Dennis M.; Ingalsbe, Michelle H.; Benbow, James; Daley, Dennis C. (2013). "12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview". Social work in public health. 28 (0): 313–332. doi:10.1080/19371918.2013.774663. ISSN 1937-1918. PMC 3753023. PMID 23731422.
- ^ "Opioid Overdose Prevention Programs Providing Naloxone to Laypersons — United States, 2014". www.cdc.gov. Retrieved 2022-11-16.
- ^ CDC (2022-08-30). "Disease of the Week - Opioid Use Disorder". Centers for Disease Control and Prevention. Retrieved 2022-11-16.
- ^ CDC (2022-08-30). "Disease of the Week - Opioid Use Disorder". Centers for Disease Control and Prevention. Retrieved 2022-11-16.
- ^ Nutt, David; King, Leslie A.; Saulsbury, William; Blakemore, Colin (2007-03-24). "Development of a rational scale to assess the harm of drugs of potential misuse". The Lancet. 369 (9566): 1047–1053. doi:10.1016/S0140-6736(07)60464-4. ISSN 0140-6736. PMID 17382831.