The role of social isolation in opioid addiction

Abstract

Humans are social animals: social isolation hurts people both psychologically and physically. Strong, positive social bonds help people to live longer and healthier lives compared with their more isolated peers. Opioid use disorder is associated with feelings of social isolation, an increased risk of suicide, and, at the community level, lower social capital. I propose a psychobiological mechanistic explanation that contributes to the association between opioid use and social isolation. The endogenous opioid system plays a central role in in the formation and maintenance of social bonds across the lifespan, and has been investigated primarily through the framework of the brain opioid theory of social attachment (BOTSA). In primates, maternal-infant bonding and social play are both impaired by administration of naltrexone (an opioid antagonist), and in humans the chronic use of opioids appears to be particularly (relative to other drugs) corrosive to close relationships. Social isolation may play a role in the development and exacerbation of opioid use disorder. Taken together, work on the brain’s opioid system suggests a possible mechanistic basis for bidirectional causal links between social isolation and opioid use disorder. Evaluation of this hypothesis would benefit from longitudinal psychosocial and neuropsychopharmacological investigations.

A Demographic and Regional Comparison of Opioid-Related Hospital Visits within Community Type in the United States

“…An explanation as to why unemployed and population size variables have a higher risk of opioid-related hospital visits can be very complex and cannot be deduced from our data. However, it has been proposed that certain adverse events can lead to social isolation, increasing the risk of opioid abuse as a coping mechanism [34]. Conversely, the current study did not find age to be a significant factor, and there are no other reports with comparable demographic substratifications to provide further context.…”

Changes in Social, Romantic, and General Life Satisfaction Over the Course of a Substance Use Disorder

“…This disruption is somewhat more complex for romantic partners: individuals who engage in chronic opioid use -males in particular-tend to lose sexual in their partners, with impairments in both psychological and physiological arousal (40). Given the centrality of the endogenous opioid system in the experience of social connection (see BOTSA), it has been proposed that problem use of opioids may be more closely linked to social disconnection than problem use of other substances (13). The directionality of the relationship between social isolation and opioid use remains unclear.…”

“…The directionality of the relationship between social isolation and opioid use remains unclear. However, we posit that the relationship is likely bidirectional, such that preexisting feelings of social exclusion or isolation put a person at higher risk of developing problem opioid use, and that chronic problem opioid use exacerbates the lived experience of social isolation and blunts feelings of reward associated with social connection [see (13)].…”

“…Additionally, recent work has shown that community-level social capital is negatively correlated with per capita fatal drug overdoses (13). During the pandemic, adults in the United States who report higher levels of social isolation had (a) lower life satisfaction across domains, and (b) were more likely to use substances to cope with life stressors (14).…”

Stigmatization of people with alcohol and drug addiction among Turkish undergraduate students

“…Economically, drug and alcohol addiction has been reported to contribute to economic cost as a result of substance-related activities such as crime and to lost work productivity, and use of health care services ( Degenhardt et al, 2016 ). Socially, people with alcohol and drug addiction are often socially isolated as their use of these substances tend to erode social ties with their family and friends ( Christie, 2021 , Daley et al, 2018 ).…”