Psychotherapy High Wycombe Psychotherapy High Wycombe - Last updated 07 January 2026

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DSM-IV and DSM-IV-TR:

Opioid Withdrawal

The brain adapts to use of alcohol and some other drugs in such a way that symptoms may result when the substance is reduced or discontinued, leading to diagnosis of this Substance-Related Disorder. This varies in intensity from no detectable symptoms to extreme discomfort with withdrawal.

• Grade 0: craving, anxiety, drug-seeking behavior
• Grade 1: yawning, sweating, lacrimation, rhinorrhea
• Grade 2: mydriasis, goose-flesh, muscle twitching, anorexia
• Grade 3: Insomnia, increased pulse, respiratory rate and blood pressure, abdominal cramps, vomiting, diarrhea, weakness

Diagnostic criteria for 292.0 Opioid Withdrawal

A. Either of the following:

(1) cessation of (or reduction in) opioid use that has been heavy and prolonged (several weeks or longer)
(2) administration of an opioid antagonist after a period of opioid use

B. Three (or more) of the following, developing within minutes to several days after Criterion A:

(1) dysphoric mood
(2) nausea or vomiting
(3) muscle aches
(4) lacrimation or rhinorrhea
(5) pupillary dilation, piloerection, or sweating
(6) diarrhea
(7) yawning
(8) fever
(9) Insomnia

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.

Based on the Diagnostic & Statistical Manual of Mental Disorders, 4th edition APA

Research sources