Opioid Addiction and Recovery: Examining Neurobiology, Attachment, and the Survival-Stress Response in Relation to Opioid Addiction

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Baker, Jennifer
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The severity of the opioid crisis in Vancouver has intensified over the last 10 years with increasing numbers of overdose-related deaths. Among people living with opioid use disorder, a disproportionate number are also living with post-traumatic stress disorder (PTSD) and have high rates of adverse childhood experiences compared to the general population. This paper will explore how attachment experiences, trauma, the survival-stress response and nervous system dysregulation intersects with the use of exogenous opioids to provide a conceptual understanding of opioid use disorder and to give context to the functional use of opioids. The probability of developing patterns of addiction is directly impacted by the experiences of and need for safety and attachment. Attachment exchanges, in which a caregiver is responsive and attuned to infant/child develops the child’s implicit sense of self and is the first step in developing their capacity for self-regulation. The experience of responsiveness, safety, and attunement by the caregiver primes the infant for optimal development, a felt sense of safety and worthiness, flexibility in the nervous system, and a greater capacity for social connection later in life. The opposite occurs when there is a lack of responsiveness, attunement and safety; the infant/child is primed to respond to an unsafe or unresponsive environment and forms adaptations to cope with a suboptimal environment. Early attachment exchanges directly impact the body's survival-stress response, the capacity for self-regulation, social connectedness, and the endogenous opioid system. Understanding how opioids interact with the body’s survival and social attachment systems and the relevant neurobiology can inform therapeutic interventions used in substance use recovery programs.
attachment , defence cascade , addiction recovery , neurobiology , addiction , opioid use disorder , endogenous opioid system , trauma , opioids , polyvagal theory
Attribution-NonCommercial-NoDerivs 3.0 United States , openAccess