The potential role of social support in reducing risk of opioid misuse following traumatic injury

Abstract

Background

Social support appears to play a pivotal role in the prevention, development, and remission of substance use disorders. Previous research suggests that interpersonal relationships moderate treatment outcomes for opioid use disorder based on the nature and quality of the relationship. However, the role of social support in the initiation of prescription opioid misuse (POM) is unclear.

Methods

In a prospective cohort of 221 patients with traumatic injuries at a level 1 trauma center in Wisconsin, we used multiple linear regression analysis to examine the association between social support and POM at six months post-discharge. Covariates included morphine equivalent daily dose (MEDD) at baseline (24 h pre-discharge), opioid use at six months post-discharge, pre-injury depression and anxiety symptoms, and discharge pain intensity.

Results

In models adjusted for relevant demographic and clinical outcomes, social support scores (β = −3.898, p < 0.001; Bonferroni corrected) and depression and anxiety composite scores (β = 2.29, p < 0.023; uncorrected) significantly predict POM scores 6 months post-discharge. When controlling for pre-injury depression and anxiety, patients with positive POM scores had significantly lower baseline social support scores than patients with negative POM (M = 24.31 vs 30.05, p = 0.003).

Conclusions

Findings suggest that the perceived presence and quality of social support within an individual’s life may influence the initiation of POM and should be considered in screening for risks related to potential POM. Providers may consider the use of social support when stratifying patients for risk of possible misuse.

Keywords:

• Prescription opioid misuse
• traumatic injury
• social support

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

The authors would like to extend thanks to the Trauma and Orthopedic clinical teams at the University of Wisconsin Hospital, including Kelly Laishes APNP, Amy Stacy APNP, Tatum Curry APNP, Jen Yeager NP, Shea Lues APNP, and Kimberly Williams NP. Rebecca Turpin MA, Injury Prevention Coordinator at UW Hospital, assisted in clinical communications and study implementation. Additionally, we would like to express appreciation for each of the participants enrolled in the parent study who made this research possible.

Additional information

Funding

This work was supported by the University of Wisconsin School of Medicine and Public Health from the Wisconsin Partnership Program (Grant ID 3152).