Definition and Diagnosis
Opium use disorder is classified within the broader category of opioid use disorders and involves problematic use of raw or prepared opium, leading to impaired control, tolerance, and a withdrawal syndrome similar to that seen with other opioids.
Epidemiology
Opium use remains prevalent in parts of South and Southwest Asia and the Middle East, where it is sometimes used traditionally or as a perceived remedy before progressing to a diagnosable use disorder in a subset of users.
Risk Factors
Risk factors include cultural availability and normalization of use, use for self-treatment of pain or gastrointestinal symptoms, family history of substance use, and co-occurring psychiatric or chronic medical conditions.
Symptoms and Subtypes
Features mirror other opioid use disorders: craving, escalating use, tolerance, and withdrawal marked by myalgia, gastrointestinal upset, sweating, anxiety, and insomnia.
Diagnosis
Diagnosis follows the same DSM-5-TR opioid use disorder criteria applied to other opioids, based on pattern of use, tolerance, and withdrawal, supported by history and toxicology where available.
Treatment
Management follows the same principles as other opioid use disorders: supervised withdrawal management, medication-assisted treatment with methadone or buprenorphine where available, and psychosocial support.
Prognosis
Prognosis is similar to other opioid use disorders, with relapse risk highest in the period following withdrawal; sustained treatment engagement improves long-term outcomes.
Reference
New Oxford Textbook of Psychiatry (2nd ed.).