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Addict Behav. 2014 Mar;39(3):520-31. doi: 10.1016/j.addbeh.2013.11.022. Epub 2013 Dec 2.

Prevalence of Axis-1 psychiatric (with focus on depression and anxiety) disorder and symptomatology among non-medical prescription opioid users in substance use treatment: systematic review and meta-analyses.

Author information

1
Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver V6B 5K3, Canada.
2
Dalla Lana School of Public Health, University of Toronto, Toronto M5T 3M7, Canada; Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto M5T 1R8, Canada.
3
Dalla Lana School of Public Health, University of Toronto, Toronto M5T 3M7, Canada; Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto M5T 1R8, Canada; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden 01187, Germany.
4
Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver V6B 5K3, Canada; Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto M5T 1R8, Canada. Electronic address: bfischer@sfu.ca.

Abstract

Non-medical prescription opioid use (NMPOU) constitutes a substantial clinical and public health concern in North America. Although there is evidence of elevated rates of mental health problems among people with NMPOU, the extent of these correlations specifically in treatment samples has not been systematically assessed. A systematic review and meta-analysis were conducted for Axis-1 psychiatric diagnoses and symptoms with a principal focus on depression and anxiety disorders in substance use treatment samples reporting NMPOU at admission to treatment (both criteria within past 30days). 11 unique studies (all from either the United States or Canada) met inclusion criteria and were included in the meta-analysis. The pooled prevalence of 'any' mental health problems (both diagnosis and symptoms) among substance abuse treatment patients reporting NMPOU was 43% (95% CI: 32%-54%; I(2) for inter-study heterogeneity: 99.5%). The pooled prevalence of depression diagnosis among substance abuse treatment patients reporting NMPOU was 27% (95% CI: 9%-45%; I(2): 99.2%); the pooled prevalence of anxiety diagnosis in the sample was 29% (95% CI: 14%-44%; I(2): 98.7%). The prevalence rates of psychiatric problems (both diagnosis and symptoms), depression diagnosis and anxiety diagnosis are disproportionately high in substance use treatment samples reporting NMPOU relative to general population rates. Adequate and effective clinical strategies are needed to address co-occurring NMPOU and mental health in substance use treatment systems, especially given rising treatment demand for NMPOU. Efforts are needed to better understand the temporal and causal relationships among NMPOU, mental health problems, and treatment seeking in order to improve interventions.

KEYWORDS:

Nonmedical prescription opioid use; Psychiatric disorder; Substance use treatment; Systematic review

PMID:
24333033
DOI:
10.1016/j.addbeh.2013.11.022
[Indexed for MEDLINE]

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