a million people suffer from a severe or high-risk drug dependency in the UK.
Opioids are the most common drug and account for 40% of drug treatment requests
as well as most overdoses (European Monitoring Centre for Drugs and Drug
Addiction, 2016). Opioid use has also been linked to social factors such as
social distress, anxiety, ability to trust and feelings of disconnection.
Carlyle (2017) is currently investigating the link
between empathy and social pain in chronic opioid users using questionnaires on
attachment, loneliness, trauma, and personal history, cortisol salivary
measures, a multi-faceted empathy test and a social pain paradigm. Participants
included are intoxicated users ( hours ago) and a control group.
As expected the control group showed an increase in cortisol after the social
pain paradigm with a natural decay due to the body’s endogenous opioid system.
The intoxicated users showed a suppression of the social pain system due to the
opioids in their systems. The non-intoxicated users are expected to show a
natural increase in cortisol from the stress of social pain but no decay due to
the chronic opioid use damaging the participants’ endogenous opioid systems
(Carlyle, 2017; Compton et al., 2001).
A second study was conducted examining the ability to
foster self-compassion in chronic opioid users who are high on self-criticism
and low on self-esteem. Three two-hour sessions were given to recovered users
over three consecutive weeks. Participants were randomized into three groups: a
compassion group, a compassion-relaxation group and a waitlist control.
Participants were measured on craving, depression, anxiety, and stress,
self-criticism and opinions about their prescriptions. Retention was high at
81% and a decline in depression and stress were found between the compassion
and waitlist groups. Reported measures of craving and resistance to use
increased between baseline and follow-up for the same groups (Carlyle, 2017).
A third study is being proposed to examine the link
between childhood trauma and later opioid use. The groups being compared will
consist either of those who have experienced childhood trauma or those who have
not. Both groups will be given 10 mg of morphine and asked to complete a button
pressing task to look at reward-seeking, a pain threshold task and a social
pain task. It is predicted that those in the life trauma group will have lower
pain thresholds, a higher sensitivity to social pain and more positive
responses to morphine (Carlyle, 2017).
During study number one the results depended heavily on 4
samples of cortisol taken from each participant before the social pain paradigm
and then at 15-minute intervals afterwards. These samples however, were not
taken under ideal conditions and the results could be influenced by factors
such as additional stress not associated with the paradigm. Participants were
required to answer questionnaires about stress, mental health and life-events
such as trauma following the paradigm during which one or two samples of saliva
were taken. It is suggested that the participants been allowed to rest completely,
and the questionnaires taken either before the baseline measure of cortisol or
after the 3 post-test samples were collected.
Secondly, the second study examining the effects of
fostering self-compassion in recovered opioid users showed high retention rates
and moderate effects. Since compassion is known to be a protective factor for patients
suffering drug addiction a follow-up is suggested looking at whether participants
are still following and using the information and skills learned during the
intervention (de Cordova et al., 2014; Vettese et al., 2011). The exercises
given to one of the experimental groups included mindful walks and eating
tasks, compassionate body scans and compassionate self-letter writing. These
tasks are easy to continue un-aided and it would be interesting and helpful to
know if participants were able to continue using these techniques which they
rated helpful and easy to use, independently. All participants could be
contacted 3-6 months post-intervention and given the same measures, as well as
a new measure assessing whether participants continued with the techniques