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Publication Date


First Advisor

James Drisko

Second Advisor

Maria Torres

Third Advisor

Shelley Cohen Konrad

Document Type


Degree Name

Doctor of Philosophy


School for Social Work


Opoid use disorder (OUD), Rural, Adult substance use disorder (SUD), Treatment outcomes, Biopsychosocial factors in opiod use disorder (OUD), Social determinants of health, Addiction


The purpose of this study is to examine biopsychosocial characteristics influencing treatment outcomes of adults in Maine receiving treatment for opioid use disorder, in an effort to increase understanding of how best to shape policy responses and treatment practices supporting opioid- affected families. Accounting for individual, interpersonal, and societal factors – biopsychosocial characteristics – that might influence outcomes Treatment Duration and Change in Use addresses gaps in current literature. Initial hypotheses were that primary substance of use, gender, and rurality would be the most significant predictors of outcomes. Data analysis supported the primary substance and rurality hypotheses. Gender is not a significant predictor of outcomes in this study. In addition, the variables living with others, opioid replacement therapy, and responsibility for a dependent child emerged as significant predictors in at least some models. Findings suggest relationally-oriented approaches that increase human connectedness may achieve greater success in treatment duration and change in drug use.


2020 Alison Smith Mitchell Access limited to the Smith College community and other researchers while on campus. Smith College community members also may access from off-campus using a Smith College log-in. Other off-campus researchers may request a copy through Interlibrary Loan for personal use.




viii, 151 pages : color illustrations, map. Includes bibliographical references (pages 131-147)