Comorbidity of Lifetime History of Abuse and Trauma With Opioid Use Disorder: Implications for Nursing Assessment and Care

• Published in: Journal of the American Psychiatric Nurses Association Vol. 30; no. 1; p. 149
• Main Authors: Driscoll Powers, Linda, Cook, Paul F, Weber, Mary, Techau, Aimee, Sorrell, Tanya
• Format: Journal Article
• Language: English
• Published: United States 01.01.2024
• Subjects: Adult; Chronic Pain - epidemiology; Comorbidity; Humans; Nursing Assessment; Opioid-Related Disorders - epidemiology; Sex Offenses; trauma; pain; physical abuse; medication-assisted treatment; opioid use
• ISSN: 1532-5725
• DOI: 10.1177/10783903221083260

Opioid use disorder (OUD) is a public health crisis and is challenging to treat. Previous research has shown correlations between OUD, abuse/trauma, and chronic pain. The purpose of this study was to investigate history of lifetime sexual, physical, and/or emotional abuse among participants in a medication-assisted treatment (MAT) program for OUD, and to investigate associations between abuse history and chronic pain. This is a secondary analysis of intake data from a 2-year, nonexperimental cohort treatment program of patients with OUD in rural Colorado. De-identified data were provided by 476 adult MAT patients using the Adult Addiction Severity Index (ASI-6). The ASI-6 includes three yes/no questions about history of abuse (emotional, physical, and sexual), with separate scoring for "past 30 days" and "lifetime" abuse. Lifetime history among MAT program for OUD patients was 23% for sexual abuse, 43% for physical abuse, and 58% for emotional abuse. History of physical abuse was significantly associated with having a chronic pain diagnosis, χ = 4.49, = .03, and also with higher reported pain levels, (460) = 2.71, = .007. Lifetime history of physical abuse was associated with OUD and chronic pain, yet standard pain assessments do not assess these factors. In health care settings, the implementation of standardized trauma-informed screening tools, prompt recognition of abuse/trauma history, and adjunct psychological interventions may reduce stigma, reduce opioid use escalation, and help patients overcome OUD.