Anxiety and Opioid Use Disorder: Potential Targets for Treatment and Prevention

Anxiety is among the most common symptoms and disorders in people with opioid use disorder. Although anxiety disorders have been understudied in opioid use disorder, research supports an important role of anxious responding to distress (e.g., distress intolerance) in problem opioid use. In this review, we provide an overview of the literature on the role of anxious responding to distress in opioid misuse. Anxious responding to distress is elevated in people with problem opioid use, is associated with severity of misuse, and appears to amplify risk via an increase in motivation for seeking relief. Preliminary studies have suggested that these vulnerabilities can be reduced with treatment in people with opioid use disorder. Anxious responding to distress is associated with opioid misuse across the spectrum of severity. Anxiety-focused treatment may be a promising approach for the prevention and treatment of opioid use disorder.