Theme: Epidemiology and Public Health Research Year: 2021
Background: History of child maltreatment is a common risk factor for opioid dependence and is associated with risk behaviours and mental disorders that adversely affect treatment outcomes. A better understanding of the prevalence of child maltreatment in people with opioid dependence is critical to provide comprehensive care to this population. Methods: We searched the peer-reviewed literature for studies of people with opioid dependence reporting one or more type of child maltreatment from 1990-2019. We identified 6,131 relevant studies for screening. Prevalence data for any child maltreatment, sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect were pooled using random-effects metaanalyses with exact method study-specific confidence intervals. Quantitative heterogeneity was explored by pre-defined subgroups for each type of maltreatment. Results: Among studies (n=104) of people with opioid dependence, the estimated prevalence rates were: 55% (95%CI 45-65%) for any form of child maltreatment, 27% (95%CI 22-32%) for sexual abuse, 39% (95%CI 28-49%) for physical abuse, 41% (95%CI 35-47%) for emotional abuse, 30% (95%CI 22-37%) for physical neglect and 42% (95%CI 24-40%) for emotional neglect. In stratified meta-analyses, females reported significantly higher rates of sexual abuse (44%; 95%CI 37-51%) compared to males (18%; 95%CI 10-24%). Study-level characteristics, such as recruitment methods, patterns of opioid use and definitions of child maltreatment, were associated with heterogeneity for several types of child maltreatment. Most studies reported only sexual and physical abuse, and few used validated scales or definitions. Conclusion: Child maltreatment is common among people with opioid dependence, reinforcing the need for the availability of comprehensive trauma and psychological care for this patient group. Future research should utilize validated definitions of child maltreatment and consider the impact of child maltreatment on opioid use and dependence. Disclosure of Interest Statement: LD has received investigator-initiated untied educational grants for studies of opioid medications in Australia from Indivior, Mundipharma and Seqirus.
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