Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA.
Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857, USA.
Drug Alcohol Depend. 2019 Apr 1;197:78-82. doi: 10.1016/j.drugalcdep.2018.12.030. Epub 2019 Feb 14.
Co-occurring substance use and mental disorders among people with opioid use disorder (OUD) increase risk for morbidity and mortality. Addressing these co-occurring conditions is critical for improving treatment and health outcomes. There is limited recent research on the prevalence of co-occurring disorders, demographic characteristics associated with co-occurring disorders, and receipt of mental health and substance use treatment services among those with OUD. This limits the development of targeted and resourced policies and clinical interventions.
Using 2015-2017 National Survey on Drug Use and Health data, prevalence of co-occurring substance use and mental disorders and receipt of mental health and substance use treatment services was estimated for adults aged 18-64 with OUD. Multivariable logistic regression assessed demographic and substance use characteristics associated with past-year mental illness (AMI) and serious mental illness (SMI) among adults with OUD as well as treatment receipt.
Among adults with OUD, prevalence of specific co-occurring substance use disorders ranged from 26.4% (95% CI:23.6%-29.4%) for alcohol to 10.6% (95% CI:8.6%-13.0%) for methamphetamine. Prevalence of AMI was 64.3% (95% CI:60.4%-67.9%) and SMI was 26.9% (95% CI:24.2%-29.8%). Receiving both mental health and substance use treatment services in the past year was reported by 24.5% (95% CI:21.5%-29.9%) of adults with OUD and AMI and 29.6% (95% CI:23.3%-36.7%) of adults with OUD and SMI.
Co-occurring substance use and mental disorders are common among adults with OUD. Expanding access to comprehensive service delivery models that address the substance use and mental health co-morbidities of this population is urgently needed.
患有阿片类药物使用障碍（OUD）的人群中同时存在物质使用和精神障碍会增加发病和死亡风险。解决这些共病情况对于改善治疗和健康结果至关重要。最近关于共病障碍的流行率、与共病障碍相关的人口统计学特征以及患有 OUD 的人获得心理健康和物质使用治疗服务的情况的研究有限。这限制了有针对性和资源充足的政策和临床干预措施的制定。
使用 2015-2017 年全国药物使用和健康调查数据，估计了年龄在 18-64 岁之间患有 OUD 的成年人中同时存在物质使用和精神障碍的流行率，以及获得心理健康和物质使用治疗服务的情况。多变量逻辑回归评估了与患有 OUD 的成年人过去一年中精神疾病（AMI）和严重精神疾病（SMI）相关的人口统计学和物质使用特征，以及治疗的获得情况。
在患有 OUD 的成年人中，特定的共病物质使用障碍的流行率范围从酒精的 26.4%（95%置信区间：23.6%-29.4%）到冰毒的 10.6%（95%置信区间：8.6%-13.0%）。AMI 的流行率为 64.3%（95%置信区间：60.4%-67.9%），SMI 的流行率为 26.9%（95%置信区间：24.2%-29.8%）。过去一年同时接受心理健康和物质使用治疗服务的成年人中，有 OUD 和 AMI 的占 24.5%（95%置信区间：21.5%-29.9%），有 OUD 和 SMI 的占 29.6%（95%置信区间：23.3%-36.7%）。
患有 OUD 的成年人中同时存在物质使用和精神障碍很常见。迫切需要扩大获得全面服务提供模式的机会，以解决这一人群的物质使用和心理健康共病问题。
