Determinants of Opioid use disorder severity and relapse among the Egyptian population: findings from a cohort study

Abstract Background Opioid use disorder (OUD) is characterized by features that influence its progression, severity, and relapse risk. Clinical criteria classify Severity as mild, moderate, or severe. Relapse is common, highlighting the chronic nature of OUD. Limited studies on country-specific risk factors for relapse emphasize the need for further research. This study aimed to identify risk factors of OUD severity and relapse. Methods A Cohort study was conducted at Tanta University's Psychiatry, Neurology, and Neurosurgery Centre from June 2022 to May 2023, involving 50 Egyptian opioid users aged 18 and older. Data were collected through interviews and medical records. Results Most participants were males aged 20–30, initiating opioid use (OU) between ages 21–25, with heroin as the most common substance. Starting OU before age 20 increased the odds of severe OUD (AOR = 7.414) and frequent relapse (AOR = 5.210). Prior legal issues were linked to higher OUD severity (AOR = 4.039), while severe OUD raised relapse likelihood (AOR = 4.964). Conclusion Early onset of opioid use and prior legal issues significantly increase OUD severity. Younger initiation and severe OUD substantially heighten relapse risk, underscoring the need for targeted prevention and intervention strategies.