Adapting substance use motives measures for a clinical population of opiate,alcohol, and stimulant users

Background: Understanding underlying mechanisms that lead to substance use can provide insight into targets for treatment. A wealth of research has evaluated substance use motives as one such mechanism. However, popular motive measures are substance-specific and developed within a younger, non-clinical population. The current study utilizes a mixed-method approach to modify existing measures for use with a clinical polysubstance-using population and evaluates relationships with measures of use and problems by substance of choice.

Methods: Participants (n?=?120) were recruited from a 28-day inpatient Veterans Affairs program. Fourteen patients participated in Phase 1 focus groups to discuss underlying reasons for use and changes in motives over time and progression into hazardous use. The motives scale was adapted based on participant responses. In Phase 2, 106 participants reported on motives and other indices of use.

Results: Results supported an 8-factor measure with the following subscales: to help with withdrawal symptoms, to counteract other substance use, to cope with loneliness, to deal with my pain/sleep, to be social/to enhance positive emotions, to cope with anxiety, to cope with depression, and to relieve boredom/get energy. Social/enhancement, withdrawal, coping with depression, and boredom/energy motives were associated with substance use disorder symptomatology. Multivariate analyzes of motive endorsement by substance of choice revealed that individuals who used opiates were more likely to endorse withdrawal and pain/sleep motives, and coping with anxiety was uncommon among stimulant users.

Conclusions: Findings highlight the progression of use motives over time and suggest further avenues of research and potential areas of earlier intervention.