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172. What’s Love Got to do With it: Examining the Role of Social Supports in Promoting Recovery and Building Resilience for Young People Who Inject Drugs

      Purpose

      Locally, one out of every ten hospitalized young people (ages 18-30) who inject opioids (YPWID) die within a year of discharge. Ongoing substance use is the primary driver of high morbidity and mortality in this group. Social connectedness and peer support are critical during this developmental stage. Research suggests contact with parents and/or peers who have substance use disorders (SUD) may serve as a risk factor for ongoing substance use. Our study aims to examine how hospitalized YPWID conceptualize social supports (both family and peers) and how these relationships influence abstinence and treatment seeking-behaviors.

      Methods

      As part of an ongoing study, we identified and recruited hospitalized patients ages 18-29 admitted with infectious complications of injection opioid use. We conducted 30-60 minute semi-structured qualitative interviews informed by the Capacity-Opportunity-Motivation-Behavior (COM-B) framework, which were audio-recorded and transcribed verbatim. Interviews were analyzed iteratively using rapid analytic methods. Transcribed interviews were placed in a summary matrix based on interview guides used to identify broad domains using the COM-B model. We then identified themes, sub-themes and concepts related to each domain, including exemplar quotes. We represent findings from the first six interviews.

      Results

      There were 6 participants (mean age 26.0 years). 85% were white and half were female. The overarching themes show that parents and peers serve as important sources of support. These positive impacts span all three COM-B domains of capability, motivation, and opportunity. A recurrent theme suggests parents and peers foster resilience and build self-efficacy. Another common theme focused on the importance of parents and peer relationships as motivation for change. All youth described having parents and/or peers with SUD with whom they initiated or endorsed ongoing substance use, but they also discussed the positive ways in which even loved ones who use substances were able to support their recovery. For example, youth perceived parents and peers in recovery to have greater insight into their struggles. One 26-year-old woman expressed: “ [Both my parents] also have addiction problems…So they know what I'm going through, and I know what they're going through.” Having parents and peers with SUD helped reduce the shame and stigma around initial disclosure. Additionally, young people viewed the lived experiences of parents and peers as important to show change was attainable. Youth also commonly described defining themselves in opposition to the tragic outcomes of loved ones with SUD. One 29-year-old woman voiced, “I've lost a lot of friends, lots of people I've known for a long time, due to overdoses… Watching people go through the struggle… definitely helps, I mean it helps me want to get better.”

      Conclusions

      Parents and peers, even those with SUD, can be assets in engaging YPWID into recovery. YPWID describe rich, complex interpersonal connections that may be leveraged to support recovery. Providers should look for ways to partner with these individuals to support youth recovery and abstinence, enhance youth capability, augment youth motivation, and create social opportunities for recovery.

      Sources of Support

      Funded by NIDA grant K23DA04898.