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Study shows indirect link between child abuse, opioid addiction

Recent findings indicated that childhood maltreatment was associated with PTSD, which in turn was associated opioid abuse.

“With emotional abuse, the abuser is saying ‘you are the problem.’ Being called names, being told you're not good enough, being told no one cares about you undermines your ability to cope with difficult emotions,” study researcher Matthew Price, PhD, of University of Vermont, said in a press release. “To protect themselves from strong emotions and from trauma cues that can bring on PTSD symptoms, people with this kind of childhood experience frequently adopt a strategy of avoidance, which can include opioid use.”

To assess associations between childhood maltreatment, PTSD and substance use disorders, researchers used structural equation modeling among 84 individuals with a history of opioid use who met lifetime DSM-IV criteria for opioid abuse and identified opioids as their substance of choice. Opioid use was defined as use of heroin or misused prescription opioids for more than 1 year. Study participants had a mean age of 35.27 years.

Overall, 67.9% of the cohort met criteria for PTSD.

An initial model that included paths for each type of childhood abuse, positive and negative urgency, PTSD and substance abuse did not fit the data well, according to researchers.

A pruned model fit the data and suggested a direct association between emotional abuse, positive urgency and negative urgency and PTSD symptoms, while only PTSD symptoms were directly associated with substance abuse.

Researchers found that significant indirect effects indicated emotional abuse and negative urgency were related to substance abuse due to PTSD symptom severity.

“We should really start to explore more integrated treatment,” Price said in the release. “If a patient has had severe emotional abuse and they have a tendency to act out when they're feeling upset, and then they turn to opioids to deal with the resulting PTSD, it makes sense to address the emotional component and the drug problems at the same time.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.