Co-Occurring Opioid Use and Depressive Disorders: Patient Characteristics and Co-Occurring Health Conditions

Abstract

Objective

Among persons with opioid use disorder (OUD), co-occurring depression is linked to a greater risk of opioid misuse, overdose and suicide. Less is known about characteristics and other comorbid health conditions of persons with co-occurring opioid use and depressive disorders.

Methods

This study used electronic health record (EHR) encounters from the Geisinger Health System prior to the fall of 2019. Adult patients were recruited from a medication-based treatment clinic and had an OUD diagnosis (N = 692). Co-occurring depression was defined by a depression diagnosis in the EHR. Multivariable logistic regression was performed to assess differences in characteristics, behavioral health and medical diagnoses, as well as opioid overdose and suicide attempt or ideation between individuals with and without comorbid depression.

Results

Forty-seven percent of patients with OUD had a lifetime depression diagnosis. Individuals with co-occurring depression were more likely to be female and have comorbid chronic pain or other medical conditions. Co-occurring depression was associated with an increased likelihood of other mental health and substance use disorders, as well as opioid overdose and/or suicide attempt or ideation.

Conclusions

While it is established that co-occurring depression is associated with increased risk of overdose and suicide, this study adds that other health conditions, including chronic pain and common medical conditions, are more prevalent among persons with co-occurring depressive disorders. Results highlight the need to consider these complex health needs when developing treatment plans and services.

Keywords:

• Opioid use disorder
• depression
• psychiatric comorbidity
• mental health comorbidity

Acknowledgments

We would like to acknowledge Dr. Mark Bicket who developed the algorithm of diagnosis codes to identify patients with chronic non-cancer pain conditions (lower-back pain, fibromyalgia, chronic headaches, arthritis, or neuropathic pain) used in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Tormohlen was supported by the National Institute on Drug Abuse (NIDA) Drug Dependence Epidemiology Training Program [5T32DA007292-29; PIs: Maher, Johnson]. Data for this study was also supported by NIDA [R01DA044015; PI: Troiani]. The work is solely the responsibility of the authors and does not necessarily reflect the official views of the NIH. The funding source did not play a role in determining study design, data collection, analysis or interpretation, writing the report, or the decision to submit the report for publication.