Daily Associations Among Craving, Affect, and Social Interactions in the Lives of Patients During Residential Opioid Use Disorder Treatment

Objective: This study captured the interrelationships among craving, negative affect, and positive and negative social exchanges in the daily lives of patients in residential treatment for opioid use disorders (OUDs). Method: Participants were 73 patients (77% male), age 19 to 61 (M-age = 30.10, SDage = 10.13) in residential treatment for OUD. Participants completed a smartphone-based survey 4 times per day for 12 consecutive days that measured positive and negative social exchanges (Test of Negative Social Exchange), negative affect (PA-NA scales), and craving (frequency and intensity). Within-person, day-level associations among daily positive and negative social exchanges, negative affect, and craving were examined using multilevel modeling. Results: Daily negative social exchanges (M = 1.44, SD = 2.27) were much less frequent than positive social exchanges (M = 6.59, SD = 4.00) during residential treatment. Whereas negative social exchanges had a direct association with same-day craving (beta = 0.08; 95% CI = 0.01, 0.16, Delta R-2 = 0.01), positive social exchanges related to craving indirectly via moderation of the within-person negative affect-craving link (beta = -0.01; 95% CI =-0.01, -0.001, Delta R-2 = 0.002). Positive social exchanges decoupled the same-day linkage between negative affect and craving on days when individuals had at least four more positive social exchanges than usual. Conclusions: These results indicate that both negative affect and negative social exchanges are uniquely related to craving on a daily basis, and that extra positive social interactions can reduce the intraindividual coupling of negative affect and craving during residential treatment for OUD.

Automated summary

This study explored the daily relationships between craving, negative affect, and positive and negative social exchanges in residential treatment for opioid use disorders. Results showed that negative social exchanges were less frequent than positive social exchanges during treatment, and both negative affect and negative social exchanges were uniquely related to craving on a daily basis. Positive social exchanges also played a role in reducing the coupling between negative affect and craving.