Heroin

Heroin and other opioid dependence

Case definition
Cases meet DSM-IV (304.00) or ICD-10 (F11.2) criteria for opioid dependence, excluding cases in remission.

Substance dependence
Presence of at least three of the following criteria at some time during the previous year:

Tolerance
Withdrawal
Discontinuation of important social activities and other pleasurable events and/or failure to meet occupational obligations
Increased dosage and/or duration of use
Significant amount of time spent obtaining, using or recovering from the substance
Persistent use despite significant associated problems
Compulsion to take the substance*
Desire to cut down use, or unsuccessful attempts to cut down**

*ICD-10 only
**DSM-IV only

Opioid dependence (specifically)

Craving, and drug seeking and drug use become central preoccupations.
Regular daily patterns of opioid use.
High tolerance with rapid withdrawal.
Withdrawal experienced as feeling sick, tired, agitated, experience cramps and nausea, and the desire to take more opioids can be perceived as overwhelming.

Discussion papers

Discussion papers will be made available and updated when appropriate.

Flowcharts

TBA