Association of Co-Occurring Opioid or Other Substance Use Disorders with Increased Healthcare Utilization in Patients with Depression

Nearly 20 percent of U.S. adults experienced mental illness in 2018, and nearly 20 percent of those with mental illness experienced a co-occurring substance use disorder (SUD). To help inform policy during the ongoing addiction crisis, Weill Cornell Medicine researchers examined how opioid use disorder (OUD) impacts healthcare utilization relative to other SUDs. Dr. Jyotishman Pathak, professor of population health sciences; Dr. Sean Murphy, associate professor of population health sciences; Veer Vekaria, population health sciences research collaborator; Budhaditya Bose, population health sciences collaborator; Dr. Jonathan Avery, associate professor of psychiatry; and Dr. George Alexopoulos, professor of psychiatry, compared three patient groups in a new Nature Translational Psychiatry paper. They studied the utilization patterns of people with: major depressive disorder (MDD) and a co-occurring OUD, MDD and a co-occurring SUD other than OUD, and MDD and no co-occurring SUD. INSIGHT Clinical Research Network provided electronic health record (EHR) data for patients across New York City from 2008 to 2017, which the researchers grouped by age, gender, and select underlying comorbidities. Overall, they found that relative to other co-occurring SUDs, OUD was associated with larger increases in the rates and odds of using substance-use-related services in all settings, as well as services that integrate mental health and substance abuse treatments in inpatient and emergency department settings. OUD was also associated with larger increases in total encounters across all settings. The researchers suggest policies and interventions, such as screening for opioid dependence in patients who present with mental illness, along with initiating treatment for OUD prior to evaluating and treating mental health disorders soon thereafter.

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