In early remission: After full criteria for opioid use disorder were previously met, none of the criteria for opioid use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, "Craving, or a strong desire or urge to use opioids," may be met).
In sustained remission: After full criteria for opioid use disorder were previously met, none of the criteria for opioid use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong de- sire or urge to use opioids," may be met).
Specify it:
On maintenance therapy: This additional specifier is used if the individual is taking a prescribed agonist medication such as methadone or buprenorphine and none of the criteria for opioid use disorder have been met for that class of medication (except tol- erance to, or withdrawal from, the agonist). This category also applies to those individ- uals being maintained on a partial agonist, an agonist/antagonist, or a full antagonist such as oral naltrexone or depot naltrexone.
In a controlled environment: This additional specifier is used if the individual is in an environment where access to opioids is restricted.
Coding based on current severity: Note for |CD-10-CM codes: If an opioid intoxication, opioid withdrawal, or another opioid-induced mental disorder is also present, do not use the codes below for opioid use disorder. Instead, the comorbid opioid use disorder is indi- cated in the 4th character of the opioid-induced disorder code (see the coding note for opi- oid intoxication, opioid withdrawal, or a specific opioid-induced mental disorder). For example, if there is comorbid opioid-induced depressive disorder and opioid use disorder, only the opioid-induced depressive disorder code is given, with the 4th character indicating whether the comorbid opioid use disorder is mild, moderate, or severe: F1 1 .14 for mild opi- oid use disorder with opioid-induced depressive disorder or F11.24 for a moderate or se- vere opioid use disorder with opioid-induced depressive disorder.
Specify current severity: 305.50 (F11.10) Mild: Presence of 2—3 symptoms.
304.00 (F11.20) Moderate: Presence of 4—5 symptoms.
304.00 (F11.20) Severe: Presence of 6 or more symptoms.
The ”on maintenance therapy” specifier applies as a further specifier of remission if the in- dividual is both in remission and receiving maintenance therapy. "In a controlled environ— ment” applies as a further specifier of remission if the individual is both in remission and in a controlled environment (i.e., in early remission in a controlled environment or in sustained remission in a controlled environment). Examples of these environments are closely super- vised and substance-free jails, therapeutic communities, and locked hospital units.
Changing severity across time in an individual is also reﬂected by reductions in the fre- quency (e.g., days of use per month) and / or dose (e.g., injections or number of pills) of an opioid, as assessed by the individual’s self—report, report of knowledgeable others, clini— cian’s observations, and biological testing.