Opioid use disorder (OUD) can affect nearly every part of a person’s life, including relationships with family, friends, and loved ones. Over time, substance use can strain trust, disrupt communication, and create distance between people. Families may struggle with how best to respond, and some may turn to approaches centered on detachment or “tough love” in hopes of encouraging change. But growing research suggests that healthy social connection may also have an important role in recovery. 

A new study involving RARC/BHI researcher Nina Cooperman of the Division of Addiction Psychiatry at Rutgers Robert Wood Johnson Medical School, examined whether two specific prosocial emotions—love and empathy—were associated with opioid use among people receiving treatment for OUD. Published in the Journal of Psychoactive Drugs, the study found that participants who reported greater capacity for empathy and dispositional tendency to experience love also reported fewer episodes of opioid use, even after researchers accounted for factors including anxiety, depression, pain, perceived social support, and substance use stigma. While the findings cannot show that love or empathy directly reduces opioid use, they raise an important question: Could emotionally meaningful connection be one part of supporting recovery? 

Why Study Love and Addiction? 

Love and opioid use may seem like very different subjects, but biologically they may be more connected than we realize. The study draws on the Brain Opioid Theory of Social Attachment, which proposes that the brain’s natural opioid system is triggered by experiences of bonding, attachment, comfort, and feelings of closeness. Experiences such as affection, trust, and social connection engage reward systems in the brain, while opioid drugs act on some of these same biological pathways. 

Researchers have proposed that chronic opioid use may disrupt these systems over time, potentially reducing the reward people experience from interpersonal relationships as drug-related rewards become increasingly powerful. This could contribute to a difficult cycle in which opioid use interferes with relationships and social connection, while isolation and reduced social reward may make it harder to find other sources of comfort and well-being. Previous research has offered clues that social interaction may help counter that cycle, including animal studies showing that opportunities for social interaction can compete with drug rewards and human research linking supportive family and peer relationships with treatment engagement and recovery outcomes. 

Examining Love, Empathy, and Opioid Use 

The researchers analyzed data from 189 adults receiving methadone treatment for OUD at community-based opioid treatment programs in New Jersey and Utah. Participants completed surveys measuring recent opioid use, capacity for empathy, dispositional tendency to experience love, anxiety, depression, pain, perceived social support, and substance use stigma. 

In this study, “love” did not refer specifically to romantic love. Instead, researchers measured a person’s tendency to experience trust, emotional closeness, warmth, and openness to forming bonds with others. Empathy was assessed through participants’ reported ability to understand and relate to other people’s feelings and perspectives. Participants reported lower average levels of tendency to or capacity for experiencing both love and empathy compared with reference samples of people without substance use disorder diagnoses. 

Higher Love and Empathy Were Associated With Less Opioid Use 

The researchers found that higher levels of capacity for love and empathy were significantly associated with fewer episodes of opioid use. These relationships remained even after accounting for several other factors that could influence opioid use, including anxiety, depression, pain, social support, and stigma. 

One explanation proposed by the researchers is that emotionally meaningful relationships may provide an alternative source of reward. If experiences of love and connection engage some of the same biological systems involved in opioid reward, these natural sources of pleasure and well-being could potentially play a role in recovery. However, because the study assessed participants at only one point in time, it cannot determine direction or causality. Greater capacity for love and empathy could contribute to less opioid use, reduced opioid use could make it easier to experience those emotions, or other factors could influence both. 

Not All Social Support May Be the Same 

One of the study’s more unexpected findings adds an important layer to the story. After accounting for tendencies for experiencing love and empathy, greater perceived social support was associated with greater opioid use. This does not mean that social support itself is harmful. Instead, the researchers suggest that the finding may highlight a difference between simply having people around and having relationships that are empathic, trusting, warm, close, and supportive of recovery. 

Not every social network promotes recovery. Some relationships may include people who use drugs, reinforce continued substance use, or lack the emotional closeness and empathy that can help support change. The finding suggests that the quality of social connection may matter alongside the quantity of support available. Understanding who provides support, what those relationships look like, and how people experience them may give researchers a more complete picture of the role relationships play in recovery. 

Connection, Boundaries, and Recovery 

For families affected by addiction, knowing how to help can be extraordinarily difficult. Supporting someone with OUD does not mean ignoring harmful behavior, removing appropriate boundaries, or protecting someone from every consequence of their actions. At the same time, these findings add to research suggesting that maintaining connection and closeness may have value during recovery. 

The researchers suggest that interventions designed to strengthen prosocial emotions and interpersonal skills could eventually complement established treatments for OUD. Approaches focused on empathy, emotional connection, group therapy, or rebuilding social skills may help people strengthen relationships that chronic substance use has disrupted. These approaches would not replace evidence-based treatment, including medications for opioid use disorder, but could potentially become another component of comprehensive recovery support. 

An Important First Step 

The researchers caution that several limitations must be considered. Because the study was cross-sectional, it cannot establish cause and effect. Capacity for love and empathy was measured through self-report, and these complex emotional experiences cannot be fully captured by a single questionnaire. The study also included only people currently receiving methadone treatment, so the findings may not apply to everyone with OUD or to people receiving other medications or no treatment. 

Future research will need to follow people over time to determine whether changes in love, empathy, and social connection predict changes in opioid use and recovery outcomes. Still, this study adds to a broader understanding of addiction as more than a biological or behavioral condition. Recovery can also involve rebuilding trust, belonging, emotional connection, and meaningful sources of reward that may have been disrupted by substance use. 

The findings suggest that when it comes to supporting recovery, it may not simply be a question of whether someone has people in their life. The emotional quality of those relationships—and the love and empathy experienced within them—may matter too. 

Date: August 21, 2026
By: Ricki Arvesen