DSM-IV Criteria for Opioid Withdrawal

Opioid withdrawal occurs in opioid-dependent individuals who reduce or stop their opioid use or who take an opioid antagonist (precipitated withdrawal). Because of its high affinity but low activity at opioid receptors, buprenorphine can act as an antagonist in some patients.

DSM-IV Criteria for Opioid Withdrawal

A. Either of the following:

• cessation of (or reduction in) opioid use that has been heavy and prolonged (several weeks or longer)
• administration of an opioid antagonist after a period of opioid use

B. Three (or more) of the following, developing within minutes to several days after Criterion A:

• dysphoric moods
• nausea or vomiting
• muscle aches
• lacrimation or rhinorrhea
• pupillary dilation, piloerection, or sweating
• diarrhea
• yawning
• fever
• insomnia

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.

(Reprinted with permission from Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Text Revision. Copyright © 2000 American Psychiatric Association.)