What is Opioid Dependence?

What is Opioid Dependence?

What is opioid dependence?

Opioid dependence occurs when there is a physical and/or psychological to use opioids despite a desire to stop.

The criteria for opioid dependence are:

Impaired control

  • 1 –  Taking the substance in a larger amount or over a longer period than originally intended
  • 2 – Persistent desire to cut down or regulate use and failure in attempting to do so
  • 3 – Spends a great deal of time procuring, using and recovering from the effects of intake
  • 4 – Craving – an intense desire to use especially when around triggers of use

Social impairment

  • 5 – Failure to fulfill major role obligations at work, school or home
  • 6 – Continued use despite these adverse consequences
  • 7 – Important social, occupational or recreational activities given up or reduced due to substance use

Risky use

  • 8 – Use in situations that could be physically hazardous
  • 9 – Failure to abstain despite knowledge of a physical or psychological problem likely caused or exacerbated by use


  • 10 – Tolerance – the need for more of the drug to have the same effects
  • 11 – Withdrawal or acute abstinence syndrome

*These 2 occur in normal medical use of opioids and alone do not define dependence when used appropriately.  #10 or #11 in combination with any the preceding 9 listed symptoms indicate opioid dependence.

Estimate of severity of dependence:

  • MILD – 2 or 3 symptoms
  • MODERATE – 4 or 5 symptoms
  • SEVERE – 6 or more symptoms