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

Introduction: Daily rewarding experiences not involving drugs are complex and may differentially support recovery from addiction. Rarely has nondrug reward, and its multiple facets (i.e. anticipation, meaning etc.), been examined in daily life—this could uncover the acute benefits of different components of nondrug reward on daily recovery outcomes. Methods: 153 adults in recovery from OUD receiving opioid agonist treatment (M age=41.1, SD=9.5; 57 % women; 84 % white) completed daily diaries for three weeks (2067 person-days), answering 7 continuous items about appraisals of nondrug rewards (e.g., meaning, reward, and anticipation). Item responses were used as indicators in a latent profile analysis. Daily latent profiles of nondrug reward were tested for their association with recovery outcomes (quality of life, mood, craving and use) using robust standard errors to adjust for the multilevel data structure. Results: The selected model had four latent profiles (% of days): Highly Anticipated-Rewarding (35 %), Moderately Rewarding (31 %), Minimally Rewarding-Unplanned (22 %), and Highly Rewarding-Unplanned profile (12 %). Relative to the Moderately Rewarding profile, Highly Anticipated-Rewarding was associated with greater positive mood and quality of life and lower negative mood and low-arousal moods. People with more days in the Highly Anticipated-Rewarding Profile (vs. Moderately Rewarding) were less likely to use or crave opioids. Conclusion: Greater meaning, reward, and anticipation (including planning) across indicators within profiles were associated with the best recovery outcomes. Latent profile analysis applied to intensive longitudinal data offers an innovative methodological approach for simultaneously assessing multiple daily protective factors that together may differentially promote recovery.