Patient presents with features suggestive of Opioid Use Disorder (OUD).  Presenting concerns include opioid cravings, opioid withdrawal symptoms, and escalating opioid use despite adverse consequences.  Patient reports a history of prescription opioid use for chronic back pain that has progressed to daily use exceeding prescribed dosage.  Symptoms consistent with opioid dependence include tolerance, withdrawal, and unsuccessful attempts to cut down or quit.  Patient acknowledges a preoccupation with obtaining and using opioids, neglecting social and occupational responsibilities.  Physical examination reveals mild pupillary constriction and evidence of intravenous drug use with track marks on the arms.  Patient denies current suicidal or homicidal ideation.  Assessment includes review of past medical history, mental health history, substance use history, and family history of addiction.  Urine drug screen is positive for opioids.  Diagnosis of Opioid Use Disorder (OUD) is made based on DSM-5 criteria.  Differential diagnosis includes chronic pain syndrome, anxiety disorders, and other substance use disorders.  Treatment plan includes referral to addiction specialist for medication-assisted treatment (MAT) with buprenorphine naloxone.  Patient education provided on opioid overdose prevention, naloxone administration, and community resources for addiction support.  Patient agrees to follow-up appointments for monitoring of treatment progress and ongoing support.  ICD-10 code F11.20 is assigned for Opioid Use Disorder, uncomplicated.  CPT codes for evaluation and management services will be billed accordingly.  Prognosis is guarded but hopeful with adherence to treatment recommendations.  Continued monitoring and support are crucial for long-term recovery.