Childhood Maltreatment and Adult Opioid Use: A Systematic Review of the Literature

This review fills an important gap in the literature by identifying studies linking childhood maltreatment to adult opioid misuse, assessing methodological rigor including study measures and analyses, and reviewing substantive findings to identify common relationships across studies. We included empirical articles published, in-press, or published online without setting start dates, but setting an end date through November 30, 2023, from key databases including CINAHL Plus, PsychINFO, and PubMed. Qualitative studies, reviews, animal studies, non-English studies, univariate studies, bivariate studies, and studies with individuals under 18 years old were excluded. After removing 278 duplicates, the initial screening yielded 392 articles with 11 meeting the criteria for the final qualitative synthesis. Across studies, the sample size ranged from 60 to 14,800 participants, with studies employing multivariate analyses (n = 11). Measures for child maltreatment varied widely, with studies setting different cutoffs for when child maltreatment ended and few studies establishing the frequency, intensity, duration, or perpetrators of child maltreatment. Despite the methodological issues with the studies included, child maltreatment was directly associated with opioid use disorder, prescription opioid use, or younger age of onset for opioid use in nine studies. Interventions and policies should address the enduring effects of child maltreatment on opioid use.