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How Personality Factors May Impact Treatment for Opiate Dependence

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Man in different position in a room with a chair showing various personality factors

Medical professionals who treat opiate dependence have long recognized the relationship between drug addiction and mental health.  In fact, according to the Substance Abuse and Mental Health Services Administration, 8.9 million Americans currently suffer from a substance use disorder and a co-occurring mental health problem.  Much of the research and clinical focus in this area has surrounded psychological issues such as depression, anxiety, post traumatic stress disorder, and bipolar disorder.  However, disorders related to personality characteristics — often called “Axis II disorders” because of their classification in the Diagnostic and Statistical Manual of Mental Disorders — may also impact opiate dependence.

What Is A Personality Disorder?

Personality refers to the differences in the way we think, feel, and behave.  Unlike moods, which may change relatively rapidly, personality is believed to reflect a more stable, long-term approach to interacting with the world.  These interactions might include qualities such as extroversion, neuroticism, conscientiousness, optimism, or agreeableness.
For some people, their patterns of interacting with the self or others may be problematic.  People with pervasive, problematic personality problems are often diagnosed with a personality disorder.  Although many people think, “my personality is just the way I am,” personality factors can actually go through changes.  Therapy helps many people recognize problematic patterns of interacting with oneself or others.  Learning a new style of thinking, feeling, or behaving can help people with personality disorders.

The relationship between Personality Disorder and Opiate Dependence

The Substance Abuse and Mental Health Services Administration reports that rates of Axis II disorders are higher among people who struggle with opiate dependence.  In particular, three personality disorders are particularly likely to co-occur with opiate abuse: narcissistic personality disorder, antisocial personality disorder, and borderline personality disorder.  All three of these conditions are considered “Cluster B” disorders, meaning that are characterized by poor impulse control, difficulties with emotional regulation, and problems of self-esteem.
In a recent study, researchers at the McGill University Health Center sought to identify factors associated with poor treatment outcome among those with opiate dependence.  For those wondering what does opiate means, this study defined people with opiate dependence as having difficulty controlling their use of either illicit or prescription opioids.  Thus, people who abused heroin, oxycodone, morphine, and hydrocodone were all included in the sample.
All of the participants in the study were at an inpatient detoxification facility.  Compared to a control group struggling with sedative-hypnotic drug dependence, the opiate dependent individuals were significantly less likely to complete detoxification and successfully undergo opiate withdrawal.  Additionally, they had considerably higher rates of the Cluster B personality disorders than the comparison group.  The researchers found that a diagnosis of Cluster B personality disorder resulted in lower treatment compliance and poorer overall outcomes.  This suggests that personality factors such as poor impulse control and difficulty controlling emotions may contribute to difficulty completing treatment.

Seeking Treatment for Opiate Dependence

Although the research indicates that specific personality characteristics may have an association with poorer treatment outcomes, this is not to say that people with personality disorders should not seek treatment. Instead, the critical message is that it is imperative for treatment providers to assess mental health conditions.  Knowing about personality factors before treatment can help a team of professionals help you through the treatment process.
For example, a patient who has difficulty with emotional control may find the opiate withdrawal process particularly challenging.  For patients wondering what does opiate mean and how can I successfully overcome opiate dependence, an approach such as rapid opiate detoxification may be appropriate.  Rapid detox protocols wash the opioids out of the system more quickly than going “cold turkey.” This may help impulsive or emotionally reactive patients make it through the opiate withdrawal period without dropping out of treatment.  Getting a personalized assessment at the Waismann Center is a significant first step in understanding what does opiate mean as well as overcoming opiate dependence.


Center for Substance Abuse Treatment. Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 43.) Chapter 12. Treatment of Co-Occurring Disorders. Retrieved on April 9, 2015.
Illicit and Prescription Opiate Dependence: The Impact of Axis II Psychiatric Comorbidity on Detoxification Outcome. Addiction Research & Therapy. Retrieved on April 9, 2015.

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