Authors
Stull SW, Marsch LA, Lanza ST
Purpose
This study examined real-world aspects of available nondrug rewards in individuals recovering from opioid use disorder (OUD). Previous research has shown that nondrug rewards have multiple components and dynamic impacts on recovery in people with OUD. This study aims to understand the association with and implications of daily patterns of nondrug reward on acute same-day recovery outcomes.
Methods
This study had three aims: (1) Identify profiles of the most rewarding daily nondrug experiences using latent profile analysis (LPA), (2) examine how these profiles relate to individual factors like anhedonia and time in recovery, and (3) assess links between reward profiles and same-day recovery outcomes. Adults (N = 153) in opioid agonist treatment (M age = 41.1, SD = 9.5; 57% women; 84% white) completed daily diaries for three weeks (2,067 person-days) and rated seven types of nondrug rewards experienced each day. Rewards were rated 1-5 based on how much an individual looked forward to it (anticipatory), enjoyed it (consummatory), how meaningful/purposeful it was, how immersive it was (engagement), if it was intended to feel good (hedonic). Participants also indicated if a reward was planned or unplanned and reported their overall enjoyment. These responses informed LPA; resulting profiles were tested for associations with recovery outcomes (quality of life, positive/negative mood, and opioid craving or use).
Findings
- The most common type of nondrug reward based on daily diary reports was a Highly Rewarding-Planned day (35% of days); the least common was a Highly Rewarding-Unplanned day (12% of days).
- Greater anticipation and planning for a nondrug reward combined with high ratings on the other measures of the reward (Highly Rewarding-Planned) was associated with better individual outcomes (e.g., better mood, higher quality of life).
- Individuals with lower opioid craving tended to have more highly-rewarding planned days compared to other day types (Moderately Rewarding days or Minimally Rewarding-Unplanned day).
- Daily non-drug reward profiles may provide insights into daily risk or protective factors while in long-term OUD recovery.
Relevance
- Understanding an individual’s daily nondrug reward profile may help identify risky or protective factors for recovery offering a potential foundation for personalized interventions to support recovery outcomes.
- Development of moment-to-moment assessments of nondrug reward may be aided by the findings that daily non-drug experiences vary between-persons and within-persons from day-to-day.
- Future research should aim to develop measures of nondrug reward suited to within-person changes from moment to moment.
- Access to nondrug rewards is not equal; differences in the types of non-drug rewards (e.g., food vs. exercise/nature) requires further research.
Read More
Stull SW, Marsch LA, Lanza ST. (2025). Daily profiles of nondrug reward and their association with daily outcomes for people in recovery from opioid use disorder: An application of latent profile analysis applied to intensive longitudinal data. Drug Alcohol Depend. 271:112646. doi:10.1016/j.drugalcdep.2025.112646