Overdose, personality correlates and treatment utilization in opioid use disorder

Abstract

Opioid use disorder (OUD) and fatal opioid overdose are significant public health problems. As part of this PhD, I have used mixed methods to investigate multiple aspects of OUD. The investigations described in this thesis include a literature review of personality traits associated with OUD; routine linked-data analysis to identify the sociodemographic and service use characteristics of high-risk opioid users; an interview study to identify factors which facilitate help seeking for OUD; and a literature review and survey study to identify obstacles to adherence for treatment for OUD. The findings from this program of study suggest that there is an enduring personality trait configuration associated with OUD; that high-risk opioid users use health services often but infrequently use substance use treatment services; that help seeking is a values-based behaviour based on rejection of the addiction lifestyle; and that barriers to treatment adherence include comorbid mental health and substance use problems but that more needs to be done to understand obstacles to treatment adherence in this population. It is hoped that the findings of the studies reported in this thesis will be used to inform and develop further studies to help improve outcomes for people with opioid use disorder.