OUD recovery, social functioning, impulsivity, and trauma

Patients who are recovering from opioid use disorder (OUD) also have challenges in social functioning, and are more impulsive, a recent study (“Exploring social impairment in those with opioid use disorder: linking impulsivity, childhood trauma, and the prefrontal cortex”) has found. Patients with social impairment also have greater activation in the prefrontal cortex during the Go/No‐Go task (which measures impulsiveness). In addition, ACEs (Adverse Childhood Experiences) have an effect on the social impact of impulsivity: more ACEs correspond to a stronger negative relationship between impulsivity and social functioning — the higher the ACEs level, the more likely there will be higher impulsivity and lower social functioning. Neural correlates in the prefrontal cortex support this connection. The findings, published in the March 3 issue of BMC Psychiatry, have implications for looking at a more trauma‐informed approach to intervention in OUDs. In fact, challenges to social functioning are common in OUD, which complicates treatment. The researchers wanted to look at underlying reasons for the social impairment in OUD recovery. Childhood trauma can complicate recovery from OUD — and also contributes to OUD itself. The study was small: 16 participants with social impairment, and 16 without. Those with social impairment scored higher on the impulsivity scale and had more depressive symptoms than those without social impairment. Increased impulsivity corresponded to decreased social function. A moderator of the relationship — childhood trauma — was established only when controlling for the effects of depression. For the neural correlates, the socially impaired group had more activation in certain parts of the prefrontal cortex during the behavioral inhibition task.