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Familial Opioid Misuse and Family Cohesion

Impact on Family Communication and Well-being

Alhussain, Khalid Pharm D*,†; Shah, Drishti MS*; Thornton, James Douglas PhD; Kelly, Kimberly M. PhD*

Addictive Disorders & Their Treatment: December 2019 - Volume 18 - Issue 4 - p 194–204
doi: 10.1097/ADT.0000000000000165
Original Articles

Objectives: This study aimed to understand family communication and overall well-being of young adults in the context of familial opioid misuse using the family systems framework.

Methods: A cross-sectional, mixed-methods, online survey of young adults aged 18 to 30 years (n=137) was conducted. A cluster analysis was performed based on family organization and structural characteristics. MANCOVA was utilized to compare groups identified using the cluster analysis in terms of (1) family’s belief about opioid misuse, (2) worry regarding opioid misuse, (3) family communication, and (4) overall well-being of young adults.

Results: A cluster analysis resulted in three groups (group 1: no familial opioid misuse with high family cohesion; group 2: familial opioid misuse with moderate family cohesion; group 3: those with/without familial opioid misuse and low family cohesion). Group 3 had the lowest family communication compared to group 1 and group 2 (P<0.001 and P=0.001, respectively) and had lower overall well-being compared to group 1 (P=0.008). Group 2 had a higher worry score than group 1 (P<0.001). Qualitative analysis using Labov’s narrative analysis elucidated that having someone misusing opioids with other substances (eg, alcohol) in the family can negatively impact the emotions of family members.

Conclusions: Our findings indicated that family cohesion had a greater impact on family communication and overall well-being of young adults even in the presence of familial opioid misuse. This suggests that higher family cohesion may positively influence young adults to cope with issues related to familial opioid misuse.

*Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV

Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia

Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, TX

The views expressed in this academic research paper are those of the authors and do not reflect the official policy or position of West Virginia University (WVU) or any other affiliated organizations.

J.D.T. was supported by the National Institutes of Health, National Institute of General Medical Sciences (grant number 5T32GM081741-08). The remaining authors declare that they have nothing to disclose.

Reprints: Kimberly M. Kelly, PhD, Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center (North), P.O. Box 9510, Morgantown, WV 26506-9510 (e-mail:

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