Establishing the Contributions of Romantic Partners to Older Individuals’ Prescription Opioid Misuse

People tend to exhibit health behaviors similar to those around them, especially their romantic partners or spouses. Studies of the inter-spousal correlation in health status among married couples in later life found a tendency to share lifestyle behaviors such as diet, smoking, and exercise. To date, however, research had not examined the romantic relationship context of serious prescription behaviors at the time of the prescription of a new opioid medication, a key medical event that commonly precedes longer-term, problematic opioid use or misuse.

Dr. Lauren M. Papp, Jane Rafferty Thiele Professor in Human Ecology and Professor of Human Development & Family Studies at the University of Wisconsin- Madison, and her colleagues, used an MRI Grant to study this area of research. 94 couples, nearly all different gender, participated in the study.

In line with previous studies of other health behaviors, Dr Papp’s team expected to document reliable concordance in romantic partners’ factors pertaining to prescription drug misuse. They estimated concordance in continuous variables using Pearson correlations. Results indicated that known precipitating factors for opioid misuse were inter-related within romantic couples, including positive associations between partners’ background levels of opioid misuse risk, tendency to catastrophize pain, and knowledge of opioid harms. Results challenge the status quo (i.e., taking an individual approach to medication decisions) and encourage attention to romantic partner risk factors for opioid misuse at the time of a new opioid prescription for acute pain in the emergency department setting.

 

Similarly, they tested the romantic partners’ COVID-19 experiences at the time of a pain-related emergency department visit. Links between partners’ experiences of the COVID-19 pandemic at the time of an important medical event had been untested. The sample was drawn from an existing study of patients who received a new opioid prescription at an emergency department visit for acute pain. They assessed COVID-19 experiences of 97 patients and their romantic partners at the BerbeeWalsh Emergency Department between April 2021 and June 2022. Romantic partners reported similar ratings of COVID-19 impact and were likely to agree on their coping with the pandemic by engaging in more time on activities like puzzles or books, using marijuana, and drinking alcohol. Partners also demonstrated high concordance in their COVID-19 vaccination statuses. These findings extend a robust literature showing romantic partners’ concordance in a host of health-relevant behaviors to their COVID-19 experiences.

The results are significant because they will provide new opportunities for the development of targeted interventions and evidence-based policies. And knowledge of romantic partners’ similarity in opioid factors and partner contributions to serious prescription drug behavior among older adults will be valuable for effectively combating the opioid epidemic in this population and for improving vital aging outcomes.

Sophie Suberville