The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse

Abstract

The association between interpersonal trauma (IPT) and opioid misuse is well established. There are important gaps, however, in our understanding of this relationship. Studies often do not account for the co-occurrence of IPT across time (i.e., multiple experiences of the same type of IPT) and contexts (i.e., experiences of different types of IPT). In addition, few studies have examined the relationship between IPT and prescription opioid use or gender differences. To address these gaps, this study examines the impact of IPT co-occurrence and gender on prescription opioid use and opioid misuse. Data were collected through a cross-sectional online survey of 235 adults with a self-reported history of IPT (i.e., intimate partner violence, sexual assault, adverse childhood experiences). IPT co-occurrence and interactions between IPT, as continuous scales, were assessed as correlates of opioid use and misuse using multinomial regression models. IPT was associated with opioid misuse, but not use, adjusting for gender. The relationship between sexual assault and opioid misuse was confounded by exposure to other types of IPT. Intimate partner violence was associated with opioid misuse among men. Adverse childhood experiences were associated with misuse among women. The interaction between intimate partner violence and sexual assault increased odds of opioid use among women. This study highlights the importance of accounting for IPT co-occurrence and examining gender differences in clinical practice and research related to opioid use/misuse. These approaches are important for understanding the relationship between IPT and opioid use/misuse by more accurately representing the complexity of the lives of survivors.

COVID-19, mental health, and opioid use disorder: Old and new public health crises intertwine.

“…People with opioid use disorders also have disproportionately high rates of psychological trauma and mental health problems (Williams, Girdler, Williams, & Cromeens, 2020), the effects of which can be compounded by social isolation. Exposure to large-scale disasters has also been associated with increases in domestic violence, child abuse, posttraumatic stress disorder, depression, and substance use disorder (Galea, Merchant, & Lurie, 2020; Tracy, Norris, & Galea, 2011).…”

Sexual Violence, Mental Health, and Prescription Opioid Use and Misuse

“…Results from previous studies show an association of childhood sexual abuse 6−8 and adolescent sexual assault 6,9−11 with prescription opioid misuse. In addition, a few studies demonstrate associations of childhood sexual abuse 12 and adolescent sexual assault 10,13 with prescription opioid use. Although some studies show these associations among both women and men, 7,9,11 other studies observe associations only among women 13,14 or do not present sex-specific results.…”

“…In addition, a few studies demonstrate associations of childhood sexual abuse 12 and adolescent sexual assault 10,13 with prescription opioid use. Although some studies show these associations among both women and men, 7,9,11 other studies observe associations only among women 13,14 or do not present sex-specific results. 6,8,10,15 Importantly, many existing studies were unable to establish temporality between measures of sexual violence and prescription opioid outcomes, [9][10][11]13,15 which is central to understanding potential causal pathways.…”

Relationships Between Opioid-Related Hospitalizations and Intimate Partner Violence and Child Maltreatment Hospitalizations in Pennsylvania Across Space and Time

“…Jessell et al (2015) found a connection between nonmedical use of prescription opioids and heroin and increased sexual violence victimization among young adults; this association was stronger for women but was present for men as well. Conversely, Williams et al (2020) found a stronger association between opioid use and IPV victimization among males than females after accounting for sexual assault and childhood trauma. Another study found that opioid-dependent fathers exhibited more physical, psychological, and sexual aggression toward the mothers of their youngest children than a control group (Moore et al, 2011).…”