Family Emotional Support and Outcomes for People with Opioid Use Disorder: A Systematic Review
DOI:
https://doi.org/10.52152//RCR.V14.1Keywords:
Emotional Support, Family Communication, Opioid Use Disorder, Sobriety, Systematic ReviewAbstract
Millions of people worldwide live with opioid use disorder (OUD). Family members of people living with OUD may decide to provide or deny emotional support, and these choices have important implications for the well-being of individuals with OUD. This study investigated the impact of family emotional support, or lack thereof, on people’ s ability to reduce their drug use and pursue sobriety. This study uses systematic review, a method that allows for the systematic collection of articles about a particular topic, even when they have diverse disciplinary backgrounds and methodologies. Eighteen studies about the impact of emotional support from family members on drug use reduction were identified from MEDLINE and Sociology Abstracts primarily, as well as Directory of Open Access Journals, ProQuest Social Sciences, and Toxicology Abstracts. These articles were then synthesized into four outcome categories: treatment adherence and retention, sobriety and abstinence, treatment seeking, and recovery. Across the studies, family emotional support was generally beneficial for reducing drug use, although people living with OUD sometimes grappled with complex feelings of guilt or pressure in their supportive interactions with family members. Strengths, limitations, and future directions for studies about family emotional support in the context of OUD are discussed.
References
Aghakhani, N., Lopez, V., & Cleary, M. (2017). Experiences and perceived social support among Iranian men on methadone maintenance therapy: A qualitative study. Issues in Mental Health Nursing, 38(9), 692–699. https://doi.org/10.1080/01612840.2017.1341586
Akdağ, E. M., Kotan, V. O., Kose, S., Tıkır, B., Aydemir, M. Ç., Okay, İ. T., Göka, E., & Özkaya, G. (2018). The relationship between internalized stigma and treatment motivation, perceived social support, depression and anxiety levels in opioid use disorder. Psychiatry and Clinical Psychopharmacology, 28(4), 394–401. https://doi.org/10.1080/24750573.2018.1478190
American Addiction Centers. (2024, February 9). Opioid relapse rates, prevention and recovery. DrugAbuse.com. https://drugabuse.com/opioids/relapse/
Amini-Rarani, M., Khedmati Morasae, E., Pashaei, T., & Moeeni, M. (2020). Redemption from plight: A qualitative study on reasons behind treatment decisions among Iranian male opioid users. Substance Abuse Treatment, Prevention and Policy, 15(1), 1–17. https://doi.org/10.1186/s13011-020-00299-x
Anderson, C. (2014, December 12). Signs you’ve hit rock bottom in your addiction and what to do. American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/rock-bottom
Becker, D. (2024, January 2). This family didn't wait for “rock bottom” to help a loved one with their addiction. NPR. https://www.npr.org/2024/01/02/1222552137/this-family-didnt-wait-for-rock-bottom-to-help-a-loved-one-with-their-addiction
Bleasdale, J., Morse, D. S., Cerulli, C., Hordes, M., Wilson, K., Gabriel, S. J., & Przybyla, S. M. (2022). Women’s motivators to engage in opioid use disorder treatment while enrolled in an opioid intervention court. Substance Use & Misuse, 57(7), 1035–1042. https://doi.org/10.1080/10826084.2022.2058704
Brown, P. C. M., Dinh, T. T. T., Edsall, A., Nguyen, T. H., Mai, P. P., Hoffman, K., Bart, G., Korthuis, P. T., & Le, M. G. (2022). Familial support in integrated treatment with antiretroviral therapy and medications for opioid use disorder in Vietnam: A qualitative study. Substance Abuse, 43(1), 1004–1010. https://doi.org/10.1080/08897077.2022.2060435
Cavaiola, A. A., Fulmer, B. A., & Stout, D. (2015). The impact of social support and attachment style on quality of life and readiness to change in a sample of individuals receiving medication-assisted treatment for opioid dependence. Substance Abuse, 36(2), 183–191. https://doi.org/10.1080/08897077.2015.1019662
Chen, J. (2017, October 26). Three major myths about opioid addiction. Yale Medicine. https://www.yalemedicine.org/news/opioid-addiction-myths
Cheetham, A., Picco, L., Barnett, A., Lubman, D. I., & Nielsen, S. (2022). The impact of stigma on people with opioid use disorder, opioid treatment, and policy. Substance Abuse and Rehabilitation, 13, 1–12. https://doi.org/10.2147/SAR.S304566
Cigna Healthcare. (2020, October). Understanding and addressing mental health stigma in Asia. Cigna Singapore. https://www.cigna.com.sg/health-content-hub/thought-leadership/mental-health-stigma-in-Asia
Cleveland, L. M., McGlothen-Bell, K., Scott, L. A., & Recto, P. (2020). A life-course theory exploration of opioid-related maternal mortality in the United States. Addiction, 115(11), 2079–2088. https://doi.org/10.1111/add.15054
Cohen, S. (2004). Social relationships and health. American Psychologist, 59(8), 676–684. https://doi.org/10.1037/0003-066X.59.8.676
Cooper, S., Campbell, G., Larance, B., Murnion, B., & Nielsen, S. (2018). Perceived stigma and social support in treatment for pharmaceutical opioid dependence. Drug and Alcohol Review, 37(2), 262–272. https://doi.org/10.1111/dar.12601
Crowley, J. L., & High, A. C. (2020). Validating the support gaps framework: Longitudinal effects and moderators of experiencing deficits and surpluses during supportive interactions. Communication Quarterly, 68(1), 29–53. https://doi.org/10.1080/01463373.2019.1668447
Crowley, J. L., & Miller, L. E. (2020). How people with opioid use disorder communicatively experience family: A family systems approach. Journal of Family Communication, 20(4), 298–312. https://doi.org/10.1080/15267431.2020.1819283
Dydyk, A. M., Jain, N. K., & Gupta, M. (2024). Opioid use disorder. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK553166/
Fals-Stewart, W. (n.d.). Substance abuse and intimate relationships. American Association for Marriage and Family Therapy. https://www.aamft.org/AAMFT/Consumer_Updates/Substance_Abuse_and_Intimate_Relationships.aspx
Fine, D. R., Herzberg, D., & Wakeman, S. E. (2021). Societal biases, institutional discrimination, and trends in opioid use in the USA. Journal of General Internal Medicine, 36(3), 797–801. https://doi.org/10.1007/s11606-020-05974-0
Goldberg, Z. E., Chin, N. P., Alio, A., Williams, G., & Morse, D. S. (2019). A qualitative analysis of family dynamics and motivation in sessions with 15 women in drug treatment court. Substance Abuse: Research and Treatment, 13, 1–10. https://doi.org/10.1177/1178221818818846
Golden Gate Recovery. (2023, October 4). Accountability in recovery: What you should know. https://goldengaterecovery.com/accountability-in-recovery/
Hatoum, A. S., Colbert, S. M. C., Johnson, E. C., Huggett, S. B., Deak, J. D., Pathak, G. A., … Agrawal, A. (2023). Multivariate genome-wide association meta-analysis of over 1 million subjects identifies loci underlying multiple substance use disorders. Nature Mental Health, 1, 210–223. https://doi.org/10.1038/s44220-023-00034-y
Hiller, S. P., Syvertsen, J. L., Lozada, R., & Ojeda, V. D. (2013). Social support and recovery among Mexican female sex workers who inject drugs. Journal of Substance Abuse Treatment, 45(1), 44–54. https://doi.org/10.1016/j.jsat.2012.12.009
Johnson, K. J. (2024). Good friends have boundaries: Provider strategies for creating support boundaries in friendships. Communication Studies, 1–21. https://doi.org/10.1080/10510974.2024.2408047
Khan, K. S., Kunz, R., Kleijnen, J., & Antes, G. (2003). Five steps to conducting a systematic review. Journal of the Royal Society of Medicine, 96, 118–121. https://doi.org/10.1177/014107680309600304
Kresovich, A. (2023, December). Media influence of opioid stigma and policy support. NORC at the University of Chicago. https://www.norc.org/research/projects/media-influence-on-opioid-stigma-and-policy-support.html
Lin, H., Chen, K., Wang, P., Yen, C., Wu, H., Yen, C., Yeh, Y., Chung, K., & Chang, H. (2013). Predictors for dropping out from methadone maintenance therapy programs among heroin users in southern Taiwan. Substance Use & Misuse, 48(1–2), 181–191. https://doi.org/10.3109/10826084.2012.749411
Liu, L., Wang, H., Chui, W. H., & Cao, L. (2018). Chinese drug users’ abstinence intentions: The role of perceived social support. Journal of Drug Issues, 48(4), 519–535. https://doi.org/10.1177/0022042618779379
MacGeorge, E. L., Feng, B., & Burleson, B. R. (2011). Supportive communication. In M. L. Knapp & J. A. Daly (Eds.), The SAGE handbook of interpersonal communication (4th ed., pp. 317–354). Thousand Oaks, CA: SAGE.
Makarenko, I., Mazhnaya, A., Marcus, R., Bojko, M. J., Madden, L., Filippovich, S., Dvoriak, S., & Altice, F. L. (2017). Willingness to pay for opioid agonist treatment among opioid-dependent people who inject drugs in Ukraine. International Journal of Drug Policy, 45, 56–63. https://doi.org/10.1016/j.drugpo.2017.05.037
National Institute on Drug Abuse. (2021, November 29). Words matter: Terms to use and avoid when talking about addiction. https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction
Pati, D., & Lorusso, L. N. (2018). How to write a systematic review of the literature. Health Environments Research & Design Journal, 11(1), 15–30. https://doi.org/10.1177/1937586717747384
Ray, C. D., Manusov, V., & McLaren, R. M. (2018). “Emotional support won’t cure cancer”: Reasons people give for not providing emotional support. Western Journal of Communication, 83(1), 20–38. https://doi.org/10.1080/10570314.2018.1472800
Ritchie, H., & Roser, M. (2022, October 26). Opioids, cocaine, cannabis and illicit drugs. Our World in Data. https://ourworldindata.org/illicit-drug-use
Schuler, M. S., & Seney, V. (2024). “It’s my secret”: Shame as a barrier to care in individuals with opioid use disorder. Journal of the American Psychiatric Nurses Association, 30(3), 456–464. https://doi.org/10.1177/10783903241242748
Shourie, S., & Singh, L. (2018). A comparison of abstinent and relapsed opioid dependents on perceived social support. IAHRW International Journal of Social Sciences Review, 6(3), 313–316.
Skaggs, P., Bell, S. B., Scutchfield, F. D., & Robinson, L. E. (2023). Providers’ stigma and the effects on patients with opioid use disorder: A scoping review. Journal of Appalachian Health, 4(3), 87–102. https://doi.org/10.13023/jah.0403.06
Smith, R. (2007). Language of the lost: An explication of stigma communication. Communication Theory, 17, 462–485. https://doi.org/10.1111/j.1468-2885.2007.00307.x
Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive Behaviors, 120, 106954. https://doi.org/10.1016/j.addbeh.2021.106954
Sporer, K., & Toller, P. W. (2017). Family identity disrupted by mental illness and violence: An application of relational dialectics theory. Southern Communication Journal, 82(2), 85–101. https://doi.org/10.1080/1041794X.2017.1302503
Stuikyte, R. (2021). Perception of drugs in Central and Eastern Europe and Central Asia: Overhaul needed. https://ececacd.org/wp-content/uploads/2021/11/EN_%D0%A8%D1%82%D1%83%D0%BA%D0%B8%D0%B9%D1%82%D0%B5-Perception-Report_15.11.2021.pdf
Substance Abuse and Mental Health Services Administration. (2022). Harm reduction. U.S. Department of Health and Human Services. https://www.samhsa.gov/find-help/harm-reduction
Tomori, C., Go, V. F., Tuan, L. N., Huong, N. M., Binh, N. T., Zelaya, C. E., Celentano, D. D., Dat, T., & Quan, V. M. (2014). “In their perception we are addicts”: Social vulnerabilities and sources of support for men released from drug treatment centers in Vietnam. International Journal of Drug Policy, 25(5), 897–904. https://doi.org/10.1016/j.drugpo.2014.04.012
United Recovery Project. (2024, November 18). The importance of accountability in recovery. https://unitedrecoveryproject.com/rehab-blog/accountability-in-recovery/
Zhou, K., Li, H., Wei, X., Li, X., & Zhuang, G. (2017a). Relationships between perceived social support and retention among patients in methadone maintenance treatment in mainland China. Psychology, Health & Medicine, 22(4), 493–500. https://doi.org/10.1080/13548506.2016.1164873
Zhou, K., Li, H., Wei, X., Yin, J., Liang, P., Zhang, H., Kou, L., Hao, M., You, L., Li, X., & Zhuang, G. (2017b). Relationships between received and perceived social support and health-related quality of life among patients receiving methadone maintenance treatment in mainland China. Substance Abuse Treatment, Prevention and Policy, 12(1), 33. https://doi.org/10.1186/s13011-017-0116-3
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