According to the DSM-5, what characterizes opioid use disorder (OUD)?

Opioid use disorder (OUD) is characterized by a range of behaviors and symptoms related to the use of opioids that go beyond mere physical dependence or the presence of withdrawal symptoms. The DSM-5 describes OUD as involving a loss of control over opioid use and engaging in risky behaviors associated with its use. This aspect emphasizes the behavioral patterns seen in individuals with OUD, including cravings, unsuccessful efforts to cut down on use, and continuing to use opioids despite negative consequences.

While physical dependence and withdrawal can be components of OUD, as well as tolerance, the defining feature according to the DSM-5 is the impairment and distress caused by the problematic pattern of opioid use, manifested through loss of control and risk-taking behaviors. Thus, the most comprehensive choice that encapsulates these critical aspects of OUD is the one focused on loss of control and risky use.