“Who’s gonna love a junkie? But he does”: Exploring couples’ identity negotiations and dyadic coping in the context of opioid use disorder

Abstract

Opioid use disorder (OUD) is a leading cause of accidental death in the U.S., and people with OUD may rely on romantic partners to dyadically cope with their illness. Guided by the communication theory of identity, this study examines the identity tensions experienced by couples managing OUD and how identity negotiations contribute to couples’ efforts to dyadically cope with OUD. Semi-structured interviews were conducted with 19 dyads and 6 individuals (N = 44), all of whom were in relationships in which at least one partner was managing OUD. Analyses revealed that couples managing OUD experience three types of identity gaps: personal–relational, relational–enacted, and relational–communal identity gaps. These gaps coalesced around a central theme of couple identity paradoxes, which demonstrated the opportunities and potential downsides of dyadically coping with OUD. Findings deepen theoretical understanding of identity negotiation in couples and the role of relational identities in managing illness.