What Is Opioid Use Disorder?
 

Opioid use disorder (OUD) is a medical condition characterized by a problematic pattern of opioid use (e.g., fentanyl, heroin, oxycodone) that leads to significant impairment or distress.

OUD involves changes in brain pathways responsible for reward, motivation, and stress regulation. 

Symptoms may include:
 

• Taking opioids in larger amounts or longer than intended

• Difficulty reducing or stopping use

• Strong cravings

• Spending significant time obtaining, using, or recovering from opioids

• Failure to meet responsibilities due to opioid use

• Continued use despite physical, psychological, or social problems

• Giving up important activities because of opioid use

• Using opioids in unsafe situations

• Continued use despite knowing it causes harm

• Development of tolerance

• Withdrawal symptoms when stopping opioids

What Causes Opioid Use Disorder?
 

Opioid use disorder develops from one's polygenetic biological baseline and a combination of general factors including:​​
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• Environmental and social factors

Secondary, or more specific, factors include:
 

• prolonged, high-dose prescription opioid therapy for chronic pain causing severe physical dependence and subsequent behavioral OUD

• unmanaged chronic pain

• unmanaged co-occurring psychiatric disorder
   

How Is Opioid Use Disorder Diagnosed?

Diagnosis includes:

• History and physical

• Screening tools

Treatments
 

• Medications

• Behavioral therapies

• Rehabilitation programs

• Group support programs

• Addressing secondary causes

                                                        
                                                           Common Medications
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Buprenorphine - partial mu-opioid receptor agonist (which makes it less likely to cause overdose) and positive effects on other opioid receptors. It blocks the effects of other opioids due to its high receptor binding affinity. It also reduces cravings and withdrawal symptoms. It is commonly used as a first-line treatment option.

Naltrexone — strong full mu-opioid receptor antagonist that blocks the effects of opioids and helps reduce cravings. Patient must be off opioids for a certain number of days (based on either short or long-acting opioid use) so that it does not cause withdrawal symptoms.

Naloxone - emergency medicine used to temporarily reverse opioid overdose. Sometimes it is also found in certain buprenorphine formulations to prevent misuse. 

Methadone - full mu-opioid agonist that blocks the effects of other opioids and reduces cravings and withdrawal symptoms. It is only offered by federally regulated opioid treatment programs due to safety.

How Loria Mobile Medicine Can Help
 

Private, Stigma-Free Care at Home - Receive discreet, personalized evaluations in the comfort of your own environment, eliminating travel and public office visits.

Medication Management - I prescribe FDA-approved medications to help eliminate cravings, stabilize brain chemistry, and support long-term recovery.

Integrated Mental Health & Primary Care - I can assess and manage secondary causes and co-existing, related health disorders that may be associated with opioid use including hepatitis C and HIV. 

Patient Safety & Education - I discuss potential side effects and adverse risks, so you can make informed decisions by weighing the benefits against the risks. I also perform rigorous assessments to ensure there are no relative or absolute contraindications to these medications—carefully evaluating factors like substance type, time of last use, co-occurring health conditions, and potential drug interactions to keep your treatment safe.