Family ties: Maternal-offspring attachment and young adult nonmedical prescription opioid use

Abstract

Background Nonmedical prescription drug use is prevalent among young adults, yet little is known about modifiable determinants of use. We examined whether maternal-offspring attachment reported at mean age 21 was associated with nonmedical prescription opioid use at mean age 26, and investigated whether a history of depressive symptoms and substance use played a role in associations between maternal-offspring attachment and nonmedical prescription opioid use. Methods We used data from the Growing Up Today Study, a longitudinal cohort of United States adolescents followed into young adulthood. Maternal-offspring attachment was reported by young adults and their mothers, and defined as mutual low, mutual medium or high, and dissonant. Analyses were carried out in the full sample using generalized estimating equation models, and in a sibling subsample, using conditional fixed effects models to control for stable aspects of the family environment. Results Analyses with the full sample and the sibling subsample both showed that mutual medium/high maternal-offspring attachment at age 21 was associated with lower odds of nonmedical prescription opioid use at age 26 (RR=0.74; 95% CI=0.57-0.97 in full sample). The association was partly mediated by mean age 23 offspring smoking, heavy episodic drinking, and illicit drug use. Conclusions Promoting reciprocal attachment in the maternal-offspring dyad should be investigated as a strategy to prevent nonmedical prescription opioid use by young adulthood. Even in young adulthood, programs that target both parents and offspring may have greater impact on offspring substance use than programs that target offspring alone.

Non-medical use of prescription drugs by young men: impact of potentially traumatic events and of social-environmental stressors

“…These findings are in line with studies indicating that adolescents with strong bonds to their family or school are less likely to engage in NMUPD (Cerda et al, 2014; Ford, 2009). Intense conflicts with parents have been shown to be significantly correlated with the NMU of psychostimulants by adolescents (Herman-Stahl et al, 2006).…”

Nonmedical use of prescription drugs in emerging adulthood: differentiating sex from gender

“…Consistent with previous research, NMUPD is associated with depression: specifically, as rates of NMUPD increase so does depression (Cerdá et al 2014; Schepis & McCabe 2012; Teter et al, 2010; Zullig & Divin, 2012), however the directionality of the relationship is unclear. Age also had a robust association with NMUPD.…”

Adult attachment style is associated with cerebral μ‐opioid receptor availability in humans

“…Disruption of the endogenous opioid system by opiate addiction is associated with antisocial behavior [Ross et al, 2005]. Importantly, insecure maternal-offspring attachment is associated with higher likelihood of opioid use [Cerd a et al, 2014;Schindler et al, 2005], while, critically, abuse of heroin (but not drugs that do not influence the opioidergic system, such as ecstasy or cannabis) is associated with avoidant adult attachment [Schindler et al, 2009]. Importantly, insecure maternal-offspring attachment is associated with higher likelihood of opioid use [Cerd a et al, 2014;Schindler et al, 2005], while, critically, abuse of heroin (but not drugs that do not influence the opioidergic system, such as ecstasy or cannabis) is associated with avoidant adult attachment [Schindler et al, 2009].…”

“…Chronic opiate addiction leading to opioid tolerance [Koch and Hollt, 2008] may thus render MOR-dependent attachment circuitries unresponsive to social interaction. Importantly, insecure maternal-offspring attachment is associated with higher likelihood of opioid use [Cerd a et al, 2014;Schindler et al, 2005], while, critically, abuse of heroin (but not drugs that do not influence the opioidergic system, such as ecstasy or cannabis) is associated with avoidant adult attachment [Schindler et al, 2009]. Together with animal work showing how opioid agonists alleviate separation distress [Panksepp et al, 1978], these data suggest that exogenous opiates may be used as a chemical substitutes of secure attachment in avoidantly attached human individuals, further highlighting the specific role of the opioid system in governing human avoidant attachment behavior.…”