Examining how support persons' buprenorphine attitudes and their communication about substance use impacts patient well-being.

While social support benefits those in treatment for opioid use disorder, it is unclear how social support impacts patient outcomes. This study examines how support person attitudes toward buprenorphine and their communication about substance use are associated with the well-being of patients receiving buprenorphine treatment. We analyzed cross-sectional baseline data from 219 buprenorphine patients (40% female) and their support persons (72% female). Patients were recruited from five community health centers and asked to nominate a support person. Patient outcomes included symptoms of depression, anxiety, impairment due to substance use, and perceived social support. Support persons predictors included their attitudes toward buprenorphine from four statements (e.g. "Buprenorphine is just replacing one drug for another") and communication using two items (e.g. comfort and effectiveness discussing substance use). More stigmatizing attitudes, such as believing patients should quit on their own without medication, were associated with increased patient substance use-related impairment (F = 4.53,  = .01). Effective communication was associated with lower patient depression (F = 10.15,  < .001), anxiety (F = 4.73,  = .001), lower impairment (F = 6.46,  < .001), and higher perceived social support (F = 3.68,  = .007). This study highlights how support person attitudes and communication dynamics significantly affect the mental health and impairment of individuals receiving buprenorphine treatment. Interventions that reduce stigma and promote effective communication between patients and their loved ones could enhance treatment outcomes and overall well-being among patients with OUD.