Opioid Misuse Counseling Might Not Work for People with Childhood Emotional Abuse

MARCH 14, 2017
Caitlyn Fitzpatrick
psychiatry, pediatrics, pain management, addiction medicine, emotional abuse, prescription drugs, opioids, misuse, posttraumatic stress disorder, PTSDAbuse during childhood—whether physical, mental, or sexual—commonly has a lifelong impact on a person’s life. It might not be a surprise that children who go through such an experience have a higher risk of drug abuse down the line. Researchers from the University of Vermont looked at how childhood emotional abuse affects recovery from opioid misuses.
 
“If a person is being physically or sexually abused, it’s easier to put the blame on the person doing the abuse,” senior author, Matthew Price, PhD, (picture) assistant professor in the Department of Psychological Science at the University of Vermont, explained in a news release. “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,” he said.
 
The researchers gathered data from 84 people with a history of opioid misuse and childhood trauma. The participants were asked about their childhood experiences and then given psychological tests.
 
Using structural equation modeling, the team found that emotional abuse had a stronger association with opioid misuse than physical or sexual abuse—or any other forms of maltreatment.
 
People who had been emotionally abused in their childhood were more likely to engage in risky behavior during adolescence as well as have posttraumatic stress disorder (PTSD) as adults. PTSD can cause patients to turn to opioids, which can end up causing other issues. This understanding was supported in this study as PTSD severity was directly linked to how severe a patient’s opioid-related problems were.
 
Price said that the study results shed light on why some people with opioid abuse don’t respond to counseling or PTSD treatment. Patients may try to protect themselves from feeling strong emotions due to their childhood experiences, so substance abuse counseling should not be the sole approach. In addition, drug addiction and mental health issues are often treated by different physicians who specialize in those areas.
 
“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,” Price continued, “it makes sense to address the emotional component and the drug problems at the same time.”
 
However, many mental health specialists will advise patients to work on the drug abuse issues first. Price said that more integrated treatment is needed.

The study, “The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems,” was published in the journal Addictive Behaviors. The news release was provided by the University of Vermont.
 
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