Empathy and Love as Protective Factors in Opioid Use Disorder Recovery

Opioid use disorder (OUD) is a debilitating condition that impacts multiple domains of life, including social attachment systems, which makes recovery and relapse prevention challenging. The Brain Opioid Theory of Social Attachment suggests opioids hijack mechanisms involved in love and bonding. Previous studies show that social interaction can help reduce opioid use in both animals and humans, but little is known about whether prosocial emotions like love and empathy can protect against opioid use among people treated with medications for OUD. In this cross-sectional study, data were analyzed from 189 adults receiving methadone treatment for OUD at community-based programs in New Jersey and Utah. Surveys measured opioid use, empathy, love, along with covariates including pain, anxiety, depression, social support, and stigma. Participants reported lower levels of love and empathy compared to normative samples. In zero-inflated Poisson, higher love and empathy scores were significantly associated with fewer episodes of opioid use, even after adjusting for covariates. Anxiety, pain, and social support were significant predictors, with social support unexpectedly linked to greater opioid use. Findings suggest that love and empathy can buffer against opioid use, consistent with theories that support the use of prosocial emotions that target the same pathways as opioids.