Trauma, Dissociation, and Opiate Use Disorder

Purpose of Review: The objective of this article is to identify the role of opioid use among survivors of trauma and to characterize the dissociative functions associated with this class of substances. More precisely, this paper will evaluate if the biochemical impact of opioid substances, such as heroin, has particular psychological effects on traumatized users, pertinent to their emotional needs. Recent Findings: Reviewed studies demonstrated not only that the vast majority of opioid use disorder (OUD) patients reported a history of childhood trauma but that dissociation played an important role in both the experience of opioid use and abstinence. Summary: Traumatized individuals were more likely to report dissociative experiences during their opioid use (chemical dissociation) and were more likely to report dissociative experiences during abstinence. The small body of literature on the inter-relationship between opioid use disorder (OUD) and dissociation suggests that heroin produces powerful sensations that mimic psychogenic dissociation. It might therefore be employed when posttraumatic distress can no longer be regulated by psychogenic mechanisms and when it is available. Future research should explore if OUD treatment can be more efficient following effective resolution of trauma-related dissociation and underlying posttraumatic psychopathology.