Opioid Use Disorder

A 32-year-old male with a 6-year history of heroin use disorder presents to the de-addiction centre in Delhi. He reports daily use of 2–3 grams of heroin, multiple failed quit attempts, and significant functional impairment. He is motivated for treatment and has no active medical comorbidities. What is the most appropriate next step in management?

Which opioid receptor subtype mediates the analgesic and euphoric effects of opioids in opioid use disorder?

Which of the following is the gold standard medication for maintenance treatment and relapse prevention in opioid use disorder in India?

A 32-year-old man from Delhi presents to the emergency department with severe anxiety, body aches, sweating, and insomnia for the past 36 hours. He reports last using heroin 2 days ago and is now requesting immediate relief. Vital signs show: HR 110/min, BP 145/92 mmHg, RR 20/min, temperature 37.8°C. Pupil size is 4 mm bilaterally. Which of the following is the most appropriate immediate pharmacological intervention?

A 28-year-old woman is brought to the psychiatry outpatient clinic by her mother. She has been on buprenorphine 16 mg/day for opioid use disorder for 6 months and reports good adherence. However, she now complains of persistent low mood, anhedonia, and fatigue despite stable opioid abstinence. She denies active opioid use on urine drug screening. Her psychiatrist suspects that her depressive symptoms may be related to the buprenorphine itself. Which of the following is the most accurate explanation for opioid-induced depression in this context?