Clinically meaningful individual differences in opioid withdrawal expression.

Opioid use disorder (OUD) is a significant public health concern. An individual with an OUD may experience withdrawal after stopping opioid use. There has been limited exploration of the individual differences in withdrawal expression. This study expands understanding of this issue by examining the presence and frequency at which persons who have ever had opioid withdrawal have experienced different opioid withdrawal symptoms. Using cross-sectional data captured online from Amazon Mechanical Turk, 124 adults with a lifetime experience of opioid withdrawal were included. Respondents were able to indicate ever experiencing 31 individual opioid withdrawal symptoms. If a symptom was ever experienced, respondents would indicate if it was common and whether it bothered them. A cluster analysis was used to explore variability between the withdrawal symptoms. The sample was primarily men ( n = 76, 61.3%) with an average age of 34.7 ( SD = 11.6). The typical withdrawal syndrome lasted 6.5 days ( SD = 4.9) and was most severe at 5.7 ( SD = 4.9) days. Lifetime endorsement of individual symptoms ranged from a high of 73.4% (anxious) to a low of 43.5% (nausea). The cluster analysis was significant, F (1, 122) = 215.6, p < .001, with good Bayesian information criteria (0.7). The two clusters are conceptualized here as HIGH ( N = 73; 59%) and LOW ( N = 51; 41%) endorsing, with a mean of 21.9 and 8.5 items endorsed. These data add to prior studies by suggesting high variability in the individual expression of opioid withdrawal symptoms. It may be time for the field to develop a consensus regarding opioid withdrawal symptom expression and measurement to enhance clinical care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).