Workshop: Rethinking DSM-5 Opioid Use Disorder: Is it time for a new definition?-Rethinking DSM-5 Opioid Use Disorder: Is it time for a new definition?

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Video Summary

In this workshop titled "Rethinking DSM-5 Opioid Use Disorder: Is it Time for a New Definition?", a group of experts delved into the complexities and challenges of diagnosing opioid use disorder (OUD) under the current DSM-5 criteria. Dr. Will Becker, Dr. Wilson Compton, Dr. Karen Drexler, and Dr. Ellen Edens highlighted the inadequacies of existing definitions, particularly for patients prescribed long-term opioid therapy for chronic pain who do not fit neatly into the typical OUD categories. They presented a complex case study—Ms. Morris, a 59-year-old woman on high-dose oxycodone for pain management—to illustrate the clinical uncertainty when diagnosing OUD in patients with chronic pain.<br /><br />Dr. Becker proposed the need for a new diagnostic category, "Condition X", to effectively treat such patients using high-dose buprenorphine, which is typically reserved for OUD. Dr. Compton highlighted the historical evolution of addiction diagnoses in DSM revisions, emphasizing the separation of tolerance and withdrawal in the current DSM-5 criteria and suggesting they might inadequately reflect the realities of prescription opioid use. Dr. Drexler focused on societal influences, questioning whether exceptions for tolerance and withdrawal should be revisited.<br /><br />Discussion revolved around whether DSM-5 sufficiently addresses nuances in chronic pain patients or whether a new category is needed to reduce stigma and align with treatment realities. Although the panel agreed on the complexity and need for patient-centered approaches, opinions varied on whether changes to DSM or additional guidelines are the best path forward for accurately diagnosing and treating prescription opioid dependence.

Keywords

long-term opioid therapy

chronic pain

DSM-5

opioid use disorder

diagnostic frameworks

addiction specialists

pain management

buprenorphine

tolerance

withdrawal symptoms

public health

treatment ethics

patient-centered approach

pharmaceutical interests

diagnosis

Dr. Will Becker

Dr. Wilson Compton

Dr. Karen Drexler

Dr. Ellen Edens

Condition X

tolerance and withdrawal

prescription opioid dependence

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