Table I.

Diagnostic criteria for opioid dependence

Opioid dependence: a maladaptive pattern of opioid use leading to clinical impairment or distress manifested within a 12-month period by ≥3 of the following:

1. Tolerance: increased amounts of opioids to achieve intoxication or the desired effect or diminished effects with continued use of the same amount of opioid

2. Withdrawal: manifested by the characteristic withdrawal syndrome or use of opioids to relieve or avoid withdrawal symptoms

3. Use of opioids in larger amounts or over a longer period of time than intended

4. Persistent desire or unsuccessful attempts to cut down or control opioid use

5. Great deal of time spent obtaining opioids, using opioids or recovering from their effects

6. Loss of interest in social, occupational or recreational activities

7. Opioid use despite knowledge of physical or psychological problems