- The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.
Coding note: The ICD-9-CM code is 292.0. The ICD-10-CM code for opioid withdrawal is F11.23. Note that the ICD-10-CM code indicates the comorbid presence of a moderate or severe opioid use disorder, reflecting the fact that opioid withdrawal can only occur in the presence of a moderate or severe opioid use disorder. It is not permissible to code a comorbid mild opioid use disorder with opioid withdrawal.
- Presence of either of the following:
- Cessation of (or reduction in) opioid use that has been heavy and prolonged (i.e., several weeks or longer).
- Administration of an opioid antagonist after a period of opioid use.
- Three (or more) of the following developing within minutes to several days after Criterion A:
 Dysphoric mood.
- Nausea or vomiting.
- Muscle aches.
- Lacrimation or rhinorrhea.
- Pupillary dilation, piloerection, or sweating.