Opioid use disorder is a medical diagnosis describing a problematic pattern of opioid use that leads to clinically significant impairment or distress, including cravings, loss of control, continued use despite harm, and withdrawal symptoms. It may develop from misuse of prescription pain medications or illicit opioids such as heroin and can range from moderate to severe. Treatment typically involves a combination of medication-assisted therapy, counseling, and support programs. Because opioid use disorder is associated with high rates of overdose, accidents, mental health issues, and coexisting medical conditions, it is a major adverse factor in life and disability underwriting. Carriers assess the duration of disorder, treatment history, relapse pattern, and length of sustained recovery.

In practice, advisors encounter opioid use disorder when clients disclose past addiction treatment, rehab stays, or medication-assisted therapies such as buprenorphine or methadone, or when medical records reveal such histories. Underwriters typically view active or recently treated opioid use disorder as uninsurable for fully underwritten products, often requiring several years of documented sobriety before reconsideration. Advisors can support clients by gathering comprehensive treatment summaries, urine drug screens, and physician statements that attest to stable recovery, employment, and absence of criminal or risky behaviors. For clients still early in recovery, producers may explore alternatives such as group coverage, guaranteed issue policies with limited benefits, or postponing applications until stronger stability is demonstrated. They must handle these cases with sensitivity and confidentiality, acknowledging both the seriousness of the risk and the client's progress. By understanding opioid use disorder and its underwriting implications, advisors can navigate challenging conversations respectfully while still searching for realistic coverage pathways.