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?

Video Transcription

Video Summary

The panel discussion, "Rethinking DSM-5 Opioid Use Disorder: Is it Time for a New Definition?", primarily explored the complexities of diagnosing and treating individuals with long-term opioid therapy (LTOT) for chronic pain who may not fit neatly into current opioid use disorder (OUD) criteria. Dr. Will Becker, an expert in addiction and pain management, suggested a case study of "Ms. Morris", a woman with chronic pain, to illustrate the challenges in applying the DSM-5 criteria for OUD. He argued for a new diagnostic category, referred to as "Condition X", to better address patients like Ms. Morris who are physiologically dependent on opioids for pain management but do not exhibit the loss of control typical of OUD. Dr. Wilson Compton highlighted the interconnection between substance use and mental health, noting how DSM-5 combined abuse and dependence categories to better reflect the symptoms. He emphasized the difficulty of distinguishing between physiological dependence and substance use disorder, suggesting that research and clinical practice should better align with patient needs. Dr. Karen Drexler provided historical context, discussing how societal factors and past opioid epidemics influenced DSM revisions. She stressed the importance of not mischaracterizing patients who are on opioid therapy for pain as having OUD. The panel acknowledged the ongoing stigma and legal complexities involved in diagnosing and treating pain with opioids under current regulations and debated whether a separate diagnosis could alleviate these issues or if existing criteria could be adapted. Overall, the discussion prompted reflection on how best to support patients and practitioners under evolving guidelines and medical understandings.

Keywords

opioid therapy

chronic pain

DSM-5

opioid use disorder

diagnostic frameworks

dependence

tolerance

withdrawal symptoms

buprenorphine

treatment approaches

public health

high-dose prescriptions

patient-centered

addiction specialists

long-term opioid therapy

diagnostic criteria

addiction management

Condition X

physiological dependence

substance use disorder

mental health

stigma

regulations

	The content on this site is intended solely to inform and educate medical professionals. This site shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional.		400 Massasoit Avenue Suite 108 East Providence, RI 02914 cmecpd@aaap.org Privacy	About Advocacy Membership Fellowship Education and Resources Training Events