Testing a Neuro-Evolutionary Theory of Social Bonds and Addiction: Methadone Associated With Lower Attachment Anxiety, Comfort With Closeness, and Proximity Maintenance

Model of Family Caregiver Resilience and Burden in Opioid Use Disorder

This theory synthesis provides a theoretical model for nursing researchers to examine factors that influence resilience and burden in family caregivers of individuals with opioid use disorder. Two frameworks, the Resiliency Model and the Conceptual Framework for Family Involvement with Adults with Co-occurring Substance and Mental Disorders, were synthesized and modified by incorporating concepts and conceptual relationships from recent research studies and experiential knowledge from clinical practice to develop a new model. The model predicts the impact of caregiver characteristics, caregiver support, stressors, and caregiver-care recipient dyad characteristics on caregiver well-being.

Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement

This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.