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Psychiatry"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Identify rates and correlates of comorbid affective and substance use disorders among an understudied population, Medicaid\/Medicare beneficiaries receiving care at an opioid treatment program serving patients from small urban and rural areas. Examine whether past-year non-medical opioid use status differentiates comorbidity status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional, venue-based design was used to recruit a convenience sample of patients treated with methadone for opioid use disorder. Measures were assessed across three domains: (1) demographic characteristics, (2) opioid use characteristics, and (3) comorbid disorders. Brief validated screeners categorized probable comorbid disorders. Bivariate analyses examined correlates of comorbid disorders and determined variable selection for multivariable analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this sample (<jats:italic>N<\/jats:italic> = 210; mean age = 38.5 years; female = 62.2%; Non-Hispanic White race\/ethnicity = 86.1%), comorbid disorders were common. Rates were as follows: current anxiety (48.1%), depression (41.1%), and PTSD (33.7%), and past-year stimulant (27.6%), marijuana (19.0%), alcohol (14.9%), and sedative (7.6%). In bivariate analyses, past-year non-medical opioid use and a greater accumulation of opioid use consequences were associated with most disorders. When including demographic and opioid use characteristics in multivariable analyses, past-year non-medical opioid use was associated with anxiety, PTSD, stimulant use disorder, and sedative use disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Few studies have investigated comorbid disorders among this understudied population. This analysis highlights a high burden, especially for affective disorders. Our findings demonstrate that routine, ongoing assessment of non-medical opioid use may be a promising and feasible strategy to detect patients needing integrated care. Future research should investigate whether changes to assessment protocols at opioid treatment programs in small urban and rural settings facilitate care coordination.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.881821","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T05:35:58Z","timestamp":1651469758000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Comorbid Affective and Substance Use Disorders of Medicaid\/Medicare Beneficiaries at an Opioid Treatment Program Serving Small Urban and Rural Communities"],"prefix":"10.3389","volume":"13","author":[{"given":"Jamey J.","family":"Lister","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guijin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer D.","family":"Ellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Pasman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Agius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella M.","family":"Resko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.2147\/NDT.S129480","article-title":"The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study","volume":"13","author":"Rosic","year":"2017","journal-title":"Neuropsychiatr Dis Treat."},{"key":"B2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/ajad.12317","article-title":"Psychiatric comorbidity among patients on methadone maintenance therapy and its influence on quality of life","volume":"25","author":"Teoh Bing Fei","year":"2016","journal-title":"Am J Addict."},{"key":"B3","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.drugalcdep.2018.12.030","article-title":"Co-occurring substance use and mental disorders among adults with opioid use disorder","volume":"197","author":"Jones","year":"2019","journal-title":"Drug Alcohol Depend."},{"key":"B4","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.jsat.2015.01.009","article-title":"Gender-specific predictors of retention and opioid abstinence during methadone maintenance treatment","volume":"54","author":"Levine","year":"2015","journal-title":"J Subst Abuse Treat."},{"key":"B5","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1097\/00005053-200109000-00004","article-title":"Influence of antisocial personality subtypes on drug abuse treatment response","volume":"189","author":"King","year":"2001","journal-title":"J Nerv Ment Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1177\/0269881110364266","article-title":"Hospital psychiatric comorbidity and its role in heroin dependence treatment outcomes using naltrexone implant or methadone maintenance","volume":"25","author":"Ngo","year":"2011","journal-title":"J Psychopharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1111\/add.15580","article-title":"Prevalence of co-occurring mental illness and substance use disorder and association with overdose: a linked data cohort study among residents of British Columbia, Canada","volume":"117","author":"Keen","year":"2022","journal-title":"Addiction."},{"key":"B8","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1097\/ADM.0000000000000166","article-title":"American society of addiction medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use","volume":"9","author":"Kampman","year":"2015","journal-title":"J Addict Med."},{"key":"B9","unstructured":"College Park, MDNational Archives and Records AdministrationMedication Assisted Treatment for Opioid Use Disorders"},{"key":"B10","volume-title":"Federal Guidelines for Opioid Treatment Programs","year":"2015"},{"key":"B11","volume-title":"Substance Use Disorder Treatment for People With Co-Occurring Disorders. 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