8% of mental health patients have comorbid OUD: Study

Abstract

The 8% of patients with mental health conditions who have opioid use disorder (OUD) are at high risk for overdose, according to a study that analyzed a large state‐wide Medicaid claims database. The study, presented as a poster by Felipe Castillo, M.D. of Montefiore Medical Center in New York, at the American Psychiatric Association annual meeting in San Francisco last week, noted that OUD among patients — even those in treatment for mental health conditions — is difficult to treat. In particular, there is a high risk of overdose for those who are at a younger age, who have schizophrenia, or receive services in settings that typically serve individuals with more severe mental illness. In addition, the seriously mentally ill individuals with OUD were more likely to have suicide attempts, suicidal ideation and housing instability. OUD prevalence — not overdose — was significantly higher among adults aged 25 and older, American Indian and Hispanic individuals, adults who are male, those who live in a community residence and/or rural domicile, and those with a diagnosis of anxiety, bipolar, and/or post‐traumatic stress disorder. The study population of 523,885 included individuals who were 18 years and older in New York State and enrolled in Medicaid during 2020. The individuals had a mental health diagnosis on at least one inpatient or two outpatient records from a clinical setting. The diagnosis by claim excluded substance use disorders, neurodevelopmental (other than ADHD) and neurocognitive diagnoses alone. The prevalence of co‐occurring OUD was 8.1% among the population examined. Among those with OUD, 7.7% had an opioid overdose in the prior year.