Substance Use and Mental Health in Emerging Adult Vs Older Adult Men and Women With Opioid Use Disorder

ABSTRACT Background The American Indian (AI) population experiences significant diet-related health disparities including diabetes and cardiovascular disease (CVD). Owing to the relatively small sample size of AIs, the population is rarely included in large national surveys such as the NHANES. This exclusion hinders efforts to characterize potentially important differences between AI men and women, track the costs of these disparities, and effectively treat and prevent these conditions. Objective We examined the sex differences in diabetes prevalence, comorbidity experience, health care utilization, and treatment costs among AIs within a Northern Plains Indian Health Service (IHS) service unit. Methods We assessed data from a sample of 11,144 persons using an IHS service unit in the Northern Plains region of the United States. Detailed analyses were conducted for adults (n = 7299) on prevalence of diabetes by age and sex. We described sex differences in comorbidities, health care utilization, and treatment costs among the adults with diabetes. Results In our sample, adult men and women had a similar prevalence of diabetes (10.0% and 11.0%, respectively). The prevalence of CVD among men and women with diabetes was 45.7% and 34.0%, respectively. Among adults with diabetes, men had a statistically higher prevalence of hypertension and substance use disorders than women. The men were statistically less likely to have a non–substance use mental health disorder. Although men had higher utilization and costs for hospital inpatient services than women, the differences were not statistically significant. Conclusions In this AI population, there were differences in comorbidity profiles between adult men and women with diabetes, which have differential mortality and cost consequences. Appropriate diabetes management addressing gender-specific comorbidities, such as substance use disorders for men and non–substance use mental health disorders for women, may help reduce additional comorbidities or complications to diabetes.

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Mental Health Conditions and Substance Use Disorders Among Youth Subsequently Diagnosed With Opioid Use Disorder or Opioid Poisoning

Journal of Addiction Medicine ◽

10.1097/adm.0000000000000894 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Edeanya Agbese ◽

Bradley D. Stein ◽

Benjamin G. Druss ◽

Andrew W. Dick ◽

Rosalie L. Pacula ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorders ◽

Opioid Use Disorder ◽

Health Conditions ◽

Opioid Use ◽

Mental Health Conditions

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Stigma and the Language of Addiction

A Public Health Guide to Ending the Opioid Epidemic ◽

10.1093/oso/9780190056810.003.0005 ◽

2019 ◽

pp. 33-44

Author(s):

Michael Botticelli ◽

Colleen L. Barry

Keyword(s):

Public Health ◽

Mental Health ◽

Substance Use ◽

Public Attitudes ◽

Opioid Use Disorder ◽

Health Conditions ◽

Public Health Approach ◽

Opioid Use ◽

Policy Changes ◽

Opioid Crisis

Stigma influences attitudes toward individuals and groups, and these attitudes are expressed in how we as a nation have dealt with addiction in general and the opioid crisis in particular. Stigma is defined as a strong lack of respect for a person or a group of people or a bad opinion of them because they have done something or have traits of which society disapproves. Stigma creates misperceptions about how to end the opioid crisis and acts as a barrier for individuals with opioid use disorder to seek treatment and engage in recovery. Public attitudes toward addiction need to be changed to effectively end the epidemic, as does the language used to describe individuals who misuse drugs. Misperceptions and lack of understanding of addiction as a chronic disease have promoted the criminalization of individuals with substance use disorder rather than a public health approach. The case is made for policy changes that support new policy directions that stress parity in treatment for mental health and substance misuse with other “physical health” conditions as well as suggestions for better communications strategies to reduce stigma.

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Receipt of medications for opioid use disorder among youth engaged in primary care: data from 6 health systems

Addiction Science & Clinical Practice ◽

10.1186/s13722-021-00249-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Sarah M. Bagley ◽

Laura Chavez ◽

Jordan M. Braciszewski ◽

Mary Akolsile ◽

Denise M. Boudreau ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Substance Use ◽

Health Systems ◽

Substance Use Disorders ◽

Mental Health Disorders ◽

Opioid Use Disorder ◽

Opioid Use ◽

Medication Treatment ◽

Health Disorders

Abstract Purpose Little is known about prevalence and treatment of OUD among youth engaged in primary care (PC). Medications are the recommended treatment of opioid use disorder (OUD) for adolescents and young adults (youth). This study describes the prevalence of OUD, the prevalence of medication treatment for OUD, and patient characteristics associated with OUD treatment among youth engaged in PC. Methods This cross-sectional study includes youth aged 16–25 years engaged in PC. Eligible patients had ≥ 1 PC visit during fiscal years (FY) 2014–2016 in one of 6 health systems across 6 states. Data from electronic health records and insurance claims were used to identify OUD diagnoses, office-based OUD medication treatment, and patient demographic and clinical characteristics in the FY of the first PC visit during the study period. Descriptive analyses were conducted in all youth, and stratified by age (16–17, 18–21, 22–25 years). Results Among 303,262 eligible youth, 2131 (0.7%) had a documented OUD diagnosis. The prevalence of OUD increased by ascending age groups. About half of youth with OUD had documented depression or anxiety and one third had co-occurring substance use disorders. Receipt of medication for OUD was lowest among youth 16–17 years old (14%) and highest among those aged 22–25 (39%). Conclusions In this study of youth engaged in 6 health systems across 6 states, there was low receipt of medication treatment, and high prevalence of other substance use disorders and mental health disorders. These findings indicate an urgent need to increase medication treatment for OUD and to integrate treatment for other substance use and mental health disorders.

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Prevalence of Mental Health Disorders among Individuals Enrolled in an Emergency Response Program for Treatment of Opioid Use Disorder

Substance Abuse Research and Treatment ◽

10.1177/1178221820981998 ◽

2020 ◽

Vol 14 ◽

pp. 117822182098199

Author(s):

Christine Bakos-Block ◽

James R Langabeer ◽

Andrea Yatsco ◽

Marylou Cardenas-Turanzas ◽

Tiffany Champagne-Langabeer

Keyword(s):

Mental Health ◽

Substance Use ◽

Anxiety Disorders ◽

Emergency Response ◽

Mental Health Disorders ◽

Opioid Use Disorder ◽

Emergency Setting ◽

Opioid Use ◽

Mood And Anxiety Disorders ◽

Health Disorders

Background: Psychiatric co-occurring disorders among individuals with opioid use disorder has primarily focused on epidemiological surveys of patients in continuous or long-term treatment, yet little is known about the socio-economically vulnerable who are non-treatment seeking prior to an emergency response. Methods: We retrospectively analyzed data from patients who had enrolled in a study involving home outreach to patients referred from police, emergency medical services (EMS), or hospital emergency departments following an emergency response. The sample is largely socio-economically vulnerable with high rates of unemployment and uninsured. Eligible consenting patients received an intervention consisting of medication (buprenorphine), behavioral counseling, and peer support. Participants completed semi-structured, psychological instruments to assess current and prior history for both substance use and mental health disorders. We used descriptive statistics to evaluate rates of co-occurring mental health comorbidity. Results: Among 102 patients (average age = 36.5 years old), approximately 61 (59.8%) reported a prior mental health diagnosis, with 31 (30.3%) currently on medications for their diagnoses. Mood and anxiety disorders were most frequently recorded. Just over half (51%) had received any prior treatment for their substance use. Of those with dual disorders, 67.2% had experienced prior suicidal thoughts, and 63.7% reported polysubstance use of 5 or more substances. Conclusion: Co-occurring psychiatric disorders, and specifically mood and anxiety disorders, appear to be prevalent in vulnerable populations at an increased rate. Mental health assessments should routinely be performed in the emergency setting and in early stages of treatment.

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Primary Care Patients with Opioid Use Disorder Have a High Prevalence of Pain and Mental Health and Other Substance Use Disorders

Journal of General Internal Medicine ◽

10.1007/s11606-020-05820-3 ◽

2020 ◽

Author(s):

Claire B. Simon ◽

Jared W. Klein ◽

Katharine A. Bradley ◽

Malia Oliver

Keyword(s):

Mental Health ◽

Primary Care ◽

Substance Use ◽

Substance Use Disorders ◽

Opioid Use Disorder ◽

Opioid Use ◽

High Prevalence ◽

Primary Care Patients ◽

Prevalence Of Pain

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Mental Health and Psychosocial Needs of Patients Being Treated for Opioid Use Disorder in a Primary Care Residency Clinic

Journal of Primary Care & Community Health ◽

10.1177/2150132720932017 ◽

2020 ◽

Vol 11 ◽

pp. 215013272093201 ◽

Cited By ~ 3

Author(s):

Stephanie A. Hooker ◽

Michelle D. Sherman ◽

Mary Lonergan-Cullum ◽

Adam Sattler ◽

Bruce S. Liese ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Substance Use ◽

Food Insecurity ◽

Primary Care Providers ◽

Opioid Use Disorder ◽

Treatment Retention ◽

Psychosocial Needs ◽

Opioid Use ◽

Psychosocial Concerns

Purpose: Primary care is an ideal setting to deliver efficacious treatments for opioid use disorder (OUD). Primary care providers need to be aware of other concerns patients with OUD might have in order to provide comprehensive care. This study describes the prevalence of mental health, comorbid substance use, and psychosocial concerns of patients seeking treatment for OUD in primary care and their relation to 6-month treatment retention. Methods: Patients (N = 100; M age = 34.9 years (SD = 10.8), 74% white, 46% female) with OUD who were starting treatment with buprenorphine at an academic family medicine residency clinic completed surveys of mental health concerns (depression, anxiety, trauma), psychosocial needs (food insecurity, income, transportation, employment), and demographic variables. Chart reviews were conducted to gather information on comorbid substance use, mental health diagnoses, and 6-month treatment retention. Results: Mental health symptoms were highly prevalent in this sample (44% screened positive for anxiety, 31% for depression, and 52% for posttraumatic stress disorder). Three-quarters reported use of illicit substances other than opioids. Many patients also had significant psychosocial concerns, including unemployment (54%), low income (75%), food insecurity (51%), and lacking reliable transportation (64%). Two-thirds (67%) of the sample were retained at 6 months; patients who previously used intravenous opioids were more likely to discontinue treatment ( P = .003). Conclusions: Many patients receiving treatment for OUD have significant mental health problems, comorbid substance use, and psychosocial concerns; interestingly, none of these factors predicted treatment retention at 6 months. Primary care clinics would benefit from having appropriate resources, interventions, and referrals for these comorbid issues in order to enhance overall patient well-being and promote recovery.

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Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116163 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6163

Author(s):

Rosemarie Martin ◽

Augustine W. Kang ◽

Audrey A. DeBritz ◽

Mary R. Walton ◽

Ariel Hoadley ◽

...

Keyword(s):

Substance Use ◽

Mixed Methods ◽

Telephone Counseling ◽

Opioid Use Disorder ◽

Appropriate Technology ◽

Counseling Services ◽

Opioid Use ◽

Qualitative Evidence ◽

Positive Experiences ◽

Anxiety Depression

Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era.

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