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Heroin Addiction and Related Clinical Problems: 2025, 27, 11

Dissociation, Childhood Trauma and Opioid Use: A Naturalistic Follow-Up Study in a Substance Use Treatment Inpatient Clinic

Sercan Karabulut, Hatice Genç, and Seyhan Uzar Uçkun

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2025-11

Summary: Objective Dissociative symptoms coexist in patients with other trauma-based disorders, such as complex post-traumatic stress disorder, borderline personality disorder and substance use disorders (SUD). Given the emerging data suggesting a relationship between opioid use disorder (OUD) and dissociation, we aimed to determine the prevalence of patients who had elevated Dissociative Experiences Scale (DES) scores among inpatients with OUD, its clinical correlates and cognitive impairments related to dissociation. Methods: A total of 167 inpatients with OUD or poly-substance use disorder that included opioid use as the main substance were included in the study. All patients underwent detoxification with oral buprenorphine/naloxone (2-32 mg/day flexible doses). Patients were followed up during the inpatient detoxification program. All participants were separated into two groups: patients with high dissociative experiences and low dissociative experiences by DES. Two groups were interviewed in terms of addiction, childhood trauma, depression, anxiety, withdrawal and personality traits. The Tower of London and the Go/No-go Test examined response inhibition and planning ability differences. Results: 40.7 % of the sample was in the low-DES group, and 59.3 % were in the high-DES group. Addiction severity (p=0.004), withdrawal (p< 0.001), depression (p<0.001), anxiety (p<0.001), craving (p = 0.008), all CATI subscales (p<0.05), impulsivity (p<0.001), ASRS (p<0.001) and CTQ scores (p<0.001) were higher in the high-DES group. Go/No-Go Test Commission Error total numbers were higher in the high-DES group (p=0.007). Conclusion The high rates of comorbid psychiatric symptoms and impulsivity highlight the need for clinicians to conduct detailed examinations of patients. Even if the optimum treatment for OUD patients is employed, it would be challenging to utilise treatment retention without screening, predicting and implementing effective strategies for dissociative symptoms. Interventions that enhance response inhibition with OUD patients can effectively improve the treatment outcomes.

Keywords: Childhood Trauma; Dissociation; Opioid Use; Substance Use Disorder