Prevalence of Co-occurring Mental Health Conditions among Opioid Misusers in a Commercially Insured Population

Background: The presence of a co-occurring mental health disorder is a significant risk factor for developing opioid misuse (Edlund, Steffick, Hudson, Harris, & Sullivan, 2007). In this study, we identify mental health disorders commonly co-occuring with opioid misuse. Methods: Data were obtained from the MedStat MarketScan database, which contains data from commercially-insured and Medicare-eligible patients. Individuals who received an opioid misuse diagnosis within the two year period following their first opioid prescription claim were identified as the target sample (n = 2, 913), while 2,838,880 individuals who had an opioid insurance claim but no diagnosis of misuse were the comparison sample. Results: The average age of the target sample (M = 37.9) was significantly lower than of the comparison sample (M = 47.7), and significantly more men were represented in the target sample (59.9%) compared to the comparison sample (44.2%). Forty-five percent of the target sample met mood disorder criteria compared to 6.0% of the comparison sample, and 28.9% of the target sample met anxiety disorder criteria compared to 5.5% of the comparison sample. Co-occurring diagnoses within the target sample included major depressive disorder (45%), bipolar disorder (24.6%), anxiety disorder NOS (20.3%), dysthymic disorder (12.0%), generalized anxiety disorder (7.4%), panic disorder without agoraphobia (5.2%), and post-traumatic stress disorder (2.7%). Conclusions: The co-occurrence of mental health diagnoses with opioid misuse is extremely common, especially for mood and anxiety disorders. These findings highlight the importance of considering mental health disorders when prescribing opioids in order to prevent the development of opioid misuse.