Emotional urgency and lack of perseverance are linked to anxiety sensitivity and improve during early recovery from opioid use disorder

Few studies have identified how facets of impulsivity relate to recovery in opioid use disorder (OUD). Treatment-enrolled individuals with OUD (n = 167) and healthy controls (CTL; n = 46) completed the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency (UPPS-P) Impulsive Behavior Scale along with demographic and clinical measures at visit 1. Over the next three months, abstinence and return to use were documented for participants with OUD (via self-report, alcohol breathalyzer, urine drug screen, and secondary contact communication). Participants with OUD who returned to use (n = 59) did not complete further study visits, whereas those who remained abstinent (n = 43) and CTL (n = 36) completed the UPPS-P at three additional visits. Group analyses compared: (1) OUD (including the two subgroups) and CTL on visit 1 UPPS-P scores; and (2) abstinent OUD and CTL groups on UPPS-P scores across four visits. Regressions examined associations between visit 1 UPPS-P scores and OUD demographic and clinical characteristics. Results indicated that: (1) participants with OUD reported higher visit 1 scores than CTL on all five UPPS-P facets (none of which differentiated OUD subgroups); (2) within the OUD group, greater anxiety sensitivity severity was associated with higher Positive and Negative Urgency and Lack of Perseverance scores (argued to reflect heightened arousal in common); and (3) Positive and Negative Urgency and Lack of Perseverance scores decreased for participants with OUD who remained abstinent (but not CTL) over time. While heightened impulsivity may not be associated with return to substance use, individuals report decreased emotional urgency and increased perseverance during early addiction recovery.