DSM 5 Opioid Use Disorder Checklist
Date of Birth:
(Opioid Use Disorder requires at least 2 criteria be met within a 12 month period)
|1. Opioids are often taken in larger amounts or over a longer period of time than intended.|
|2. There is a persistent desire or unsuccessful efforts to cut down or control opioid use.|
|3. A great deal of time is spent in activities necessary to obtain the opioid, use the opioid, or recover from its effects.|
|4. Craving, or a strong desire to use opioids.|
|5. Recurrent opioid use resulting in failure to fulfill major role obligations at work, school or home.|
|6. Continued opioid use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.|
|7. Important social, occupational or recreational activities are given up or reduced because of opioid use.|
|8. Recurrent opioid use in situations in which it is physically hazardous|
|9. Continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by opioids.|
|10. *Tolerance, as defined by either of the following:
(a) a need for markedly increased amounts of opioids to achieve intoxication or desired effect
(b) markedly diminished effect with continued use of the same amount of an opioid
|11. *Withdrawal, as manifested by either of the following:
(a) the characteristic opioid withdrawal syndrome
(b) the same (or a closely related) substance are taken to relieve or avoid withdrawal symptoms
*This criterion is not considered to be met for those individuals taking opioids solely under appropriate medical supervision.
Severity: Mild: 2-3 symptoms, Moderate: 4-5 symptoms. Severe: 6 or more symptoms.
Criteria from American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC, American Psychiatric Association page 541.