Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders

Abstract

Background: Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD. Whereas cortisol levels reflect

Higher perceived stress during admission is associated with shorter retention in short-term residential substance use disorder treatment

“…We found that higher perceived stress during admission predicted shorter treatment retention. These findings may be attributable to different factors, including the stressful nature of recovery and clients’ inability to use substances to cope with this stress ( Maddox-Rooper et al, 2022 ). This study also found that individuals being of another race/ethnicity compared to being Non-Hispanic Black predicted premature discharge in this sample.…”

“…Individuals in this sample with higher perceived stress may have left treatment prematurely in response to their discomfort. Further, abstaining from substances during treatment and recovery is itself inherently stressful ( Maddox-Rooper et al, 2022 ). Changing patterns related to substance use is also stressful as it may cause different interactions with an individual’s environment after treatment discharge.…”

“…We used a self-report measure of stress; repeated measures during treatment and physiological measures may provide a more complete picture of the role of stress in retention ( Kyriakou et al, 2019 , Ligabue et al, 2020 , Maddox-Rooper et al, 2022 ). However, the PSS at admission has clinical utility and is correlated with cortisol levels ( van Eck & Nicolson, 1994 ).…”

Cortisol as a risk biomarker to guide recovery from substance use disorders

“…To this end, a recent study (Maddox‐Rooper et al, 2022) investigated relationships between salivary cortisol levels, stress exposure, adverse childhood experiences (ACEs), and completion of an abstinence‐based residential recovery program. The researchers hypothesized that decreased cortisol levels, less stress, and fewer ACEs would be associated with increased stay in the recovery program or program completion.…”