Evaluating the Role of Social Connectedness in Recovery from Opioid Use Disorder during the Postpartum: A Supplement to Support Research Continuity - ABSTRACT The current proposal requests an administrative supplement via NOT-OD-23-032 to support research continuity on NIH/NIDA R21DA058364 during a period of parental leave for the study MPI (Linde-Krieger). The goal of the parent study is to understand the role of social connectedness in OUD-related recovery outcomes, specifically during the postpartum fourth trimester, an ideal inflection point with untapped potential. The prevalence of opioid use disorder (OUD) during pregnancy has increased by more than 500% over the past 15 years. While motivation for and compliance with OUD treatment during pregnancy is heightened, up to 80% of postpartum individuals with OUD relapse to illicit opioid use within six months of childbirth. A growing body of evidence suggests that positive social connectedness and strong social bonds are associated with improved OUD recovery outcomes (e.g., reduced craving, lower risk of relapse). Conversely, loneliness and social isolation are significant predictors of opioid misuse and relapse, particularly for women. Loneliness increases during transitional periods including from pregnancy to postpartum, signaling increased risk for adverse postpartum recovery outcomes. To achieve this goal, we are actively pursuing three aims in the parent study. First, we evaluate differing theoretical models of social connectedness in this population by testing the main and stress-buffering effects of social connectedness on recovery outcomes up to one year postpartum (Aim 1). Additionally, we characterize dynamic changes in social connectedness across the fourth trimester and how patterns/changes relate to mothers’ recovery outcomes (Aim 2). Lastly, we complete in-depth qualitative interviews with 30 participants from the target population to explore the feasibility, acceptability, and opportunities for intervention to enhance social connectedness to improve the treatment of OUD and prevent postpartum relapse (Aim 3). The results of this work will directly contribute to scientific knowledge on the role of social connectedness in postpartum OUD recovery. Moreover, findings will identify new intervention targets, which will contribute to the development of novel, high-impact relapse prevention treatments tailored to the fourth trimester. Supporting the progress and continuity of this work through an NIH administrative supplement will be directly impactful to the 80,000-120,000 women, infants, and families who suffer the consequences of perinatal OUD every year. The requested supplemental funds will be of high value during a pivotal time in Dr. Linde-Krieger’s early career and will ensure continued progress and momentum on the parent award. Further, this supplemental funding will support the preparation a new NIH R-series grant submission by Dr. Linde-Krieger upon her return from parental leave.
