What is Opiod Use Disorder (OUD)?
Opioid Use Disorder (OUD) is a medical condition characterized by the problematic use of opioid drugs, which includes both prescription pain relievers (such as oxycodone and hydrocodone) and illegal drugs like heroin. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, provides specific criteria for diagnosing this disorder.
According to the DSM-5, Opioid Use Disorder is diagnosed based on a pattern of opioid use leading to clinically significant impairment or distress, as manifested by at least two of the following criteria within a 12-month period:
1. Opioids are often taken in larger amounts or over a longer period than was 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 or urge to use opioids.
5. Recurrent opioid use resulting in a 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 of opioids despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance, as defined by either of the following: a need for markedly increased amounts of opioids to achieve intoxication or desired effect, or markedly diminished effect with continued use of the same amount of an opioid.
11. Withdrawal, as manifested by either of the following: the characteristic withdrawal syndrome for opioids, or opioids (or a closely related substance) are taken to relieve or avoid withdrawal symptoms.
The presence of tolerance and withdrawal alone does not constitute a disorder if opioids are taken under appropriate medical supervision.
Treatment:
The treatment of Opioid Use Disorder often involves a combination of medication-assisted treatment (MAT), behavioral therapies, and support from recovery groups. Medications commonly used in MAT include methadone, buprenorphine, and naltrexone, which help control cravings and withdrawal symptoms. Behavioral therapies can include cognitive-behavioral therapy (CBT) and contingency management, which are designed to help modify the patient's thinking and behaviors related to drug use.
Frequently Asked Questions
Services
What types of services do you provide?
We provide two main services: psychopharmacology evaluations and medication management. First, you’ll meet with a provider for an evaluation to determine your treatment plan, which may include medication, therapy, lifestyle changes, or other recommendations. Second, if medication is appropriate, our providers will help you manage and adjust your medication to make sure it works effectively.
What is the difference between therapy and medication management?
Therapy, sometimes called “talk therapy,” involves talking with a mental health professional to address mental health issues through dialogue and behavioral strategies. Medication management, on the other hand, is a medical approach where a mental health professional prescribes, monitors, and adjusts psychiatric medication to treat mental health conditions to address your physiological symptoms. Often, a combination of talk therapy and medication management is beneficial.
Does this replace my need for a therapist?
Our providers are here to address your concerns and offer support, but it’s important to note that they are not meant to replace a licensed therapist. Evidence suggests that for many mental health conditions, a combination of medication and psychotherapy is the most effective approach.
How does online psychiatry work?
Virtual psychiatry works just like in-person psychiatry, except instead of sitting in a doctor’s office, you’ll talk to your provider during live video appointments.
What to Expect
What should I expect during a mental health assessment or evaluation?
You’ll connect 1:1 with your new provider to discuss your needs. If appropriate, they’ll prescribe medication and send it to your pharmacy of choice. Regular check-ins will help you track how you’re feeling and any side effects, and your provider will make any needed adjustments.
How do I prepare for my first appointment? How long are typical appointments?
Before your scheduled appointment, you’ll receive new patient forms, which you’ll need to complete in advance. We will also ask for your insurance information, a valid form of identification, a list of any of your current medications, and any relevant medical records or previous psychiatric evaluations.
Typical appointment times vary depending on the nature of your visit and your treatment plan. Initial consultations usually last around 60 minutes, during which you'll have an in-depth discussion with your provider. Follow-up appointments are typically shorter, ranging from 15 to 30 minutes, but this may be adjusted based on your specific needs and progress.
What should I do in case of an emergency or crisis?
If you’re having a medical or mental health emergency, call 911.
Call or text 833-773-2445 for 24/7 Crisis and Mental Health Support from the Massachusetts Behavioral Health Help Line.
Appointments
How do I schedule an appointment?
To schedule an appointment, please fill out our Appointment Request Form. Someone from the Monomoy Health team will contact you for more information and to help schedule your first appointment. We look forward to working with you!
Do you offer virtual/online appointments?
Yes, we offer virtual appointments. That means you can meet with your provider from the comfort of your home. We recommend choosing a well-lit and quiet space for your meeting.
Are my appointments and information confidential?
Yes. We adhere to the highest standards of privacy and confidentiality to ensure that your personal and medical information is safe, and privacy is a top priority in our practice. For more information, please download our HIPAA policy.
Our providers specialize in…
For more information about each of these conditions, click on each word in the list.
- Addiction and Substance Use Disorder
- Dementia and Alzheimer’s Disease
- Anxiety Disorders
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorder
- Bipolar Disorder
- Depression
- Disruptive, Impulse-Control and Conduct Disorders
- Dissociative Disorders
- Eating Disorders
- Gender Dysphoria
- Hoarding Disorder
- Obsessive-Compulsive Disorder
- Opioid Use Disorder
- Perinatal Depression (formerly Postpartum)
- Personality Disorders
- Post-Traumatic Stress Disorder (PTSD)
- Prolonged Grief Disorder
- Schizophrenia
- Seasonal Affective Disorder (SAD)
- Sleep Disorders
- Somatic Symptom Disorder
